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    Medical Billing

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    Karna Palanivelu
    Medical billing is the process of submitting bills to insurance companies in a specified format for medical services provided by physicians to patients. There are three main parties involved - the patient, provider, and billing office. The billing office is responsible for coding bills, maintaining patient records and accounts, filing claims, following up with insurance companies and patients, and ensuring high productivity and reimbursement while adhering to insurance regulations. Departments within the billing office include printing, coding, pre-verification, charge entry, audit/quality control, claims/transmissions, cash posting, accounts receivables, and compliances. There are two kinds of insurance companies - federal companies like Medicare and Medicaid that aim for public welfare, and commercial companies like A

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    Medical Billing

    Uploaded by

    Karna Palanivelu
    1K views10 pages
    Medical billing is the process of submitting bills to insurance companies in a specified format for medical services provided by physicians to patients. There are three main parties involved - the patient, provider, and billing office. The billing office is responsible for coding bills, maintaining patient records and accounts, filing claims, following up with insurance companies and patients, and ensuring high productivity and reimbursement while adhering to insurance regulations. Departments within the billing office include printing, coding, pre-verification, charge entry, audit/quality control, claims/transmissions, cash posting, accounts receivables, and compliances. There are two kinds of insurance companies - federal companies like Medicare and Medicaid that aim for public welfare, and commercial companies like A

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    Medical billing is the process of submitting bills to insurance companies in a specified format for medical services provided by physicians to patients. There are three main parties involved - the patient, provider, and billing office. The billing office is responsible for coding bills, maintaining patient records and accounts, filing claims, following up with insurance companies and patients, and ensuring high productivity and reimbursement while adhering to insurance regulations. Departments within the billing office include printing, coding, pre-verification, charge entry, audit/quality control, claims/transmissions, cash posting, accounts receivables, and compliances. There are two kinds of insurance companies - federal companies like Medicare and Medicaid that aim for public welfare, and commercial companies like A

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    1K views10 pages

    Medical Billing

    Uploaded by

    Karna Palanivelu
    Medical billing is the process of submitting bills to insurance companies in a specified format for medical services provided by physicians to patients. There are three main parties involved - the patient, provider, and billing office. The billing office is responsible for coding bills, maintaining patient records and accounts, filing claims, following up with insurance companies and patients, and ensuring high productivity and reimbursement while adhering to insurance regulations. Departments within the billing office include printing, coding, pre-verification, charge entry, audit/quality control, claims/transmissions, cash posting, accounts receivables, and compliances. There are two kinds of insurance companies - federal companies like Medicare and Medicaid that aim for public welfare, and commercial companies like A

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 10

    MEDICAL BILLING

    BY
    ELIZABETH TOJO
    DEFINITION

    MEDICAL BILLING IS A PROCESS OF SUBMISSION


    OF BILLS TO THE INSURANCE COMPANY IN A
    SPECIFIED FORMAT FOR THE SERVICE RENDERED
    BY THE PHYSICIAN ON THE PATIENT.
    3 MAIN PARTIES
    PATIENT

    PROVIDER

    BILLING OFFICE

    CLEARING HOUSE

    INSURANCE COMPANY
    BILLING OFFICE
    RESPONSIBILITIES OF A BO
    CODING

    MAINTAINING PATIENT REOCRDS AND ACCOUNTS

    FILING CLAIMS TO THE INSURANCE COMPANY

    FOLLOWING UP WITH THE INS CO & THE PATIENTS

    ASSURING HIGH PRODUCTIVITY & REIMBURSEMENT

    STRICT ADHERENCE TO THE RULES & REGULATIONS


    OF THE INSURANCE COMPANIES
    DEPARTMENTS IN A BO
    PRINTING
    CODING
    PRE-VERIFICATION
    CHARGE ENTRY
    AUDIT / QUALITY CONTROL
    CLAIMS & TRANSMISSIONS

    CASH POSTING
    ACOUNTS RECEIVABLES
    COMPLIANCES
    INSURANCE COMPANIES

    THERE ARE TWO KINDS OF INSURANCE COMPANIES.

    THEY ARE :

     FEDERAL INSURANCE COMPANIES

     COMMERCIAL INSURANCE COMPANIES


    FEDERAL INSURANCE
    COMPANIES
    •GOVERNMENT INSURANCE COMPANIES

    •MOTIVE IS WELFARE

    •EXAMPLES :

     MEDICARE
     MEDICAID
     CHAMPUS
     CHAMPVA
    COMMERCIAL INSURANCE
    COMPANIES
    •PRIVATE INSURANCE COMPANIES

    •MOTIVE IS PROFIT

    •EXAMPLES:

     AETNA
     CIGNA
     BCBS
    THANK YOU

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