Medical billing is the act of filing for insurance payments to different insurance payors on the patient’s behalf to get reimbursement for services provided at a medical institution. Billing is submitting a claim to an insurer for reimbursement for healthcare expenses such as diagnostic tests, surgeries, medications, and other procedures performed at a hospital or clinic. Billing covers physicians’ offices, nursing homes, hospitals, clinics, emergency rooms, urgent care centers, dentists, therapists, laboratories, and outpatient facilities.
Data collection forms contain multiple sections, including physician and hospital billing forms. A medical biller collects several sorts of information to be included on the CMS 1500 Form (physician billing) or the UB-04 Form (hospital billing).
Each unit requires data entry by the medical biller. Some departments require information about the patient, while others require the medical biller to record information about each service provided. At times, however, the medical biller may need to enter additional information not listed on the Form.
Billing is a complex process that requires several different skill sets. Insurance companies require claims to be handled according to strict guidelines to avoid potential liability issues. The medical provider needs to be sure that the information provided is correct. A medical biller must gather the right information and communicate it accurately to all parties. The medical billers also need to ensure that payments come from the appropriate accounts. Once the necessary communication is completed, the amount will be sent electronically to the payor.
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