Hospital medical billing involves medical billing and coding which play a crucial role, supporting the healthcare industry in its expansion. The duty of medical billers and coders is to translate medical records into standardized codes that healthcare practices use while billing their patients and sending claims to their insurance companies. Hospital medical billing is not an easy task, and it involves several processes.
Must know facts about medical billing and coding
In hospitals, dedicated billers and coders will be available to handle the billing and coding functions, whereas with an independent practitioner, one person will be doing both billing and coding.
#1: Medical billing and medical coding are two different walls
We may often hear the terms medical billing and coding together and think both are the same, but it is not true. In medical billing, we submit claims to insurance companies to obtain payment for services provided by a doctor or any other healthcare provider. Medical coding is a process in which coders assign relevant codes as per the description of a patient’s condition as well as what treatment has been provided to the patient for that condition.
#2: Billers and coders should be extremely efficient and good problem solvers
Medical billing and coding is not a data-entry or paper-pushing job like how it happens in an administrative setting within a healthcare center. Medical billers and coders should have intrinsic problem solving and high analytical skills, since they have to communicate and work around patients, insurance companies, and healthcare providers and act autonomously, by quickly addressing unpaid bills.
#3: The medical coding system is an ocean
There are more than thousands of codes that medical billers and coders use to process the claims of patients. Medical codes are highly needed to make insurers identify easily for diseases, illnesses, signs and symptoms, complaints, social scenarios, abnormality in findings, and several other external causes of disease or injury. It is not possible for medical billers or coders to keep all these huge number of codes in memory.
#4: Medical Billing is of two types
Not the same billing procedure fits all processes, and there are two types of medical billing such as professional billing and institutional billing. Professional billing is the type of billing used in solo physician’s practices, whereas institutional billing is responsible for claims billing generated for work carried out by hospitals, skilled nursing facilities, and other institutions for outpatient and inpatient services.
#5: Registration and confirmation of financial responsibility
Medical claims processing may take a few days or may long even for several months. At times, there might be numerous forward and backward movements in the process. It could be due to errors in the initial registration and confirmation, which make patient verification and authorization more crucial when performed in every visit. Therefore, the primary goal of patient verification is to ascertain the financial responsibility for the medical services performed to patients.
With varying rules and procedures from one insurer to the other, many healthcare practices prefer outsourcing their medical billing and coding process to external service providers, to avoid costly errors and utilize the technology to its extreme.
24/7 Medical Billing Services is a professional providing company that caters more than 40 healthcare specialties and offers a wide range of services, with highly skilled and certified billers and coders.