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Wednesday, January 23, 2008
Medical Billing and Claims Management
Medical Billing process consists of interaction between a healthcare provider (like a consultant physician) and the insurance company who is the payer of the bill. It is the duty of the concerned doctor to maintain/update the patient record that has all patient information, state the nature of his illness, examination/ tests conducted, medication lists, diagnoses and also the suggested treatment etc.
Depending on the complexity of the case, the level of service first gets determined which is then translated into a specific medical code. Only after coding do they become fit enough for use in insurance claim. Hospitals and physicians use specific types of software that is used to manage the different medical claims. Such claim management software must ideally make the process easier.Doctors using such claims management software can easily track and manage their entire claims and also get quicker reimbursements from the insurance companies. Some of the main features of such claim management software include,
- Claim charges can be reviewed before posting
- Single screen view/management
- One can view claims that are not yet billed
- View bills that have been rejected
- Access to diagnosis codes
- Access to procedure codes
- Utilize all relevant claim forms
- Can track the claim runs
- Get alerts for problems
- Electronic remittance
- Direct online transmission/payments
- Online claim reporting
- Daily submission of claims
- Annual updating of medical codes
Outsource Strategies International (OSI) is an Oklahoma based outsourcing company that offers professional services in medical billing, medical coding and medical transcription.Labels: claims management, medical billing, Medical Coding, medical insurance billing, software
posted by Outsource Strategies International @ 10:28 PM
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