As intricate and complicated as Physician billing can be, it is entirely feasible for things to go smoothly and as intended in your medical office. When this occurs, a claim is established and the procedure is completed once rather than having one or more steps repeated. This significantly reduces the time it takes to pay a claim.
That is why it is critical to collaborate with Physician billing professionals. Unfortunately, many people mistakenly believe they are experts when they are not. If you’re not sure that your practice has everything under control, these are the six important stages to a successful Physician billing process:
- Patient Check-in
The very first step of a patient’s appointment should also include noting the patient’s demographic information along with information on his or her insurance. In Physician billing, any documentation that will be relevant and/or necessary in a claim situation should be detailed at the time of patient check-in.
- Verification of Insurance Eligibility
Even returning patients must confirm their insurance details and eligibility before each consultation. Insurance information can change at any time, which is why you should ask patients if their insurance information has changed before each visit. A change in insurance information might also affect benefit and authorization information, so double-checking is always worthwhile.
- Coding and Procedures
The precise coding of claims is critical for alerting the insurance payer of what the patient is being diagnosed for as well as the method of therapy the patient is experiencing. Use the correct diagnosis codes to describe the patient’s symptoms or illnesses, and the correct procedure codes to reflect the patient’s method of treatment.
Use proper CPT and HCPCS code modifiers to provide additional information about the service or treatment provided. In Physician billing centers, the insurance payer can only make an appropriate evaluation if they have the correct codes and modifiers.
- Charge Entry
This relates to inputting the costs for services provided to the patient. The charge entry also includes the proper linkage of medical codes to services and treatments provided during the patient’s visit.
- Submitting Claims
Once the claim has been correctly completed, it must be sent to the insurance payer for payment. Medical billers must have access to the information they require about the insurance payer because there are so many factors for each insurance payer in establishing how and when to file a claim.
While most insurance companies follow a common set of billing principles, certain payers have their own set of rules. Certain components of Physician billing are payer-specific. Therefore it is critical to check with each payer and ensure you are following their claim submission requirements correctly.
- Payment Posting
This final phase comprises posting and deposit functions. The amount billed to the patient will be Null if it has been paid in whole, and it will reflect the original debt by the user at this point. This phase in the procedure should meet the insurance payer’s obligations.
Hence to conclude, following these 6 procedures should result in a flawless Physician billing experience. Nowadays, medical practitioners are finding it increasingly difficult to stay up with ever-changing business norms when it comes to physician billing. Fortunately, they can get help by collaborating with a robust Physician billing service agency.