The billing process starts with patient service requests. Register new patients, update files for return visits, and maintain current information.
After registering a patient, verify covered treatments under their insurance plan. Stay updated on evolving coverage rules and regulations.
Medical billing uses ICD codes for diagnoses and CPT codes for treatments. Both are crucial for accurate reimbursement and require frequent updates.
After checkout, compile codes into a Superbill for reimbursement. Include provider, patient, visit details, and billing codes.
Biller uses Superbill for insurer claims. Aim for 99% first-pass acceptance rate for efficient billing.
Payer evaluates claims: accepted for processing, denied for uncovered services, rejected for errors needing resubmission.
After payer pays their share, patient receives statement for remaining balance. Follow up to ensure prompt payment completion.
Following up on claims is crucial for revenue capture. Simplify payments with a patient portal for timely bill settlements.