MEDICAL BILLING by karna

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									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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