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Tuesday, December 25, 2007
Details Required for Medical Billing
In the earlier days medical billing was done on paper. Today this process is being replaced by computers and it has become possible to effectively manage large amounts of insurance claims. Who handles the medical billing process? It may be handled either directly by the doctor or by his staff or by a third party professional medical billing company. Medical billing could also be a team work process and may involve the following people.
- Office manager
- Nurse
- Receptionist
- Medical assistant
- Insurance clerk
- Medical coders
Present day medical claim process begins with proper medical coding. All medical procedures and diagnoses have codes. The Current Procedural Terminology (CPT) was developed in the year 1966 by (AMA) American Medical Association and it lists medical procedures and corresponding codes. Each medical procedure has a unique code that will be listed in a CPT manual. What are the types of details that are required for the medical billing process? They include,
- Name, address, telephone number, and ID number of provider
- Name of insurance company / groupID number of insurance holder
- Patient's name, date of birth/address/phone no
- Insured person's name, date of birth/address/phone
- Relationship between patient and insured person
- Details of provider name, address, telephone number, and ID number
- Details of other health insurances
- Patient's medical history /condition
- Details whether the medical condition is related to accident etc
A document called the explanation of benefits (EOB) often may accompany the payment that is received from the insurance or managed Care Company. This document describes details of services covered and not covered. It also mentions what bills have been sent to the provider and the patient. One can also know if the patient had missed out on his annual payments/deductibles to the insurance company making him ineligible for total claim.
OSI (Outsource Strategies International) is a US based medical transcription company that offers medical transcription, medical billing and medical coding services outsourcing either domestically or from the Philippines and India.Labels: AMA, medical billing, medical transcription company, National Medical Coding
posted by Outsource Strategies International @ 8:58 PM
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