Medical billing is a process whereby health care providers can submit bills or what are known as “claims” for their services in order to obtain payment from insurance companies and the government. The term “medical billing” is applied not only to the submission of claims but also includes the full spectrum of tasks needed to complete the billing process and to ensure payment.
There is a tremendous need for people with medical billing skills as increased numbers of aging Americans need more health care services as well as health care reimbursement becomes a more complex and regulated environment. Positions may be advertised with titles such as medical billing specialist, electronic claims processor, medical claims reviewer, patient account representative, claims assistant professional, billing coordinator, accounts payable coordinator, or medical claim collector.
Tasks associated with medical billing
The business of billing for medical services involves much more than simply filling out forms and tracking receipts. To really succeed in a medical billing business, you need to develop technical know-how, have strong business skills, have the ability to promote and sell your services, how to meet federal requirements concerning patient confidentiality and how to collect on denied, delayed or questioned claims.
Here is a summary of the tasks involved in medical billing: A review of the patient's insurance coverage, explanation of physician fees, estimation of what the patient will pay in co-pay or deductibles, knowledge of allowable charges, preparation of claims in a timely and accurate manner, knowledge of various collection methods, legal and ethical practices both in billing and maintaining patient confidentiality, an understanding of health care reimbursement, an ability to perform accounting, database entry, word processing and bookkeeping.
In a large medical practice or hospital, these jobs are most often divided among several workers. Due to the wide range of skills needed, it is more common for physicians to either use in-office staff or contract with medical billing services rather than to contract with a sole home-based provider
No matter if you choose to specialize in one aspect of medical billing or to acquire the skills needed to run a full charge office operation, you'll find this career to be challenging and rewarding. Find out the tasks that you may have to undertake as a medical biller.