Healthcare organizations across the world submit claims through the medical billing process to payers. There are two steps of medical billing; front-end and back-end medical billing. The front-end medical billing starts well before coders are translating healthcare records. In this short guide, you will learn about the medical billing basics that involve front-end and back-end medical billing.
Medical Billing Basics
Front-End Billing
Medical billing starts when patients register at the hospital or office and schedule their appointments. During pre-registration, staff members of administration ensure that patient completes necessary forms and share patient information. This information includes insurance coverage, home address, etc. The staff confirms the financial responsibility of the patient after verification of the health plan coverage of the patient.
During the process of front-end billing, the staff tells the patients about possible costs they might be responsible for. Generally, offices can receive copayments from patients while setting up appointments. After patients check out, coders receive the healthcare records and convert this information into codes.
Back-End Billing
The medical billing basics also involve back-end billing. Together, medical billers and medical coders use patient information and codes for creating the “superbill”. Here, it is essential to know what is “superbill”. It is a detailed form that a provider uses for creating claims. Typically, this form includes:
- Provider information
- Patient information
- Patient information
A provider can also include comments or notes for justifying medically essential care. Billers prepare claims by taking information from the superbill. Usually, billers deal with CMS-1500, CMS-1450, or UB-04 forms.
Submitting error-free claims is the trait of every reliable medical billing company. Front-end and back-end billing are the most significant medical billing basics that are essential for medical billers to understand. Without a proper understanding of these processes, it is impossible to ensure reliable medical billing services.
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