Medical billing revolves around different steps that medical billing specialists complete. The billing cycle in medical billing ensures that healthcare providers get reimbursements for the services they render on time. In today’s blog, we will throw light on the medical billing cycle.
Process of Billing Cycle in Medical Billing
The process of the medical billing cycle might differ from one medical office to another. However, here is a general blueprint of the healthcare billing workflow:
1. Registration of the Patient
It is the initial step on the flow chart of medical billing. During this step, the basic data of the patient is gathered, including the patient’s name, date of birth, and why he visited the medical office. Moreover, the insurance details of the patient are also accumulated, such as the insurance company’s name and policy number of the patient. This information helps create the patient record.
2. Superbill Creation
Patients are asked to fill up forms during check-in. If the patient already has his records in the file, his information will be confirmed or updated on the file. After all the necessary details and formalities, a superbill is created. It will include medical and provider information, the medical history of the patient, etc.
3. Claims Generation
Claim submission happens after checking the compliance and accuracy of the claim. This claim is sent electronically to the clearinghouse.
4. Claim Adjudication Monitoring
Payers evaluate healthcare claims and see if these claims are compliant and legitimate through the adjudication process. The claim could be denied, dismissed, or acknowledged during this stage. If accepted, the claim would be paid as per the provider’s agreement with the insurer.
5. Payment Posting
For any practice, payment posting holds critical importance. This step includes payment posting, reconciling posting actions, and deposit functions.
6. Patient Statement Creation
During the claim processing, patients will be billed for outstanding charges. It will include details, such as services and procedures along with their costs.
7. Statement Follow-Up
Statement follow-up is the last step involved in the billing cycle in medical billing. If the bill of a patient is late, medical billers need to highlight this.
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