Billing Claim Medical Process

Outsource Strategies International (OSI) is a business process outsourcing company offering world-class medical billing claim services at affordable rates. In the billing claim medical process, we act as an intermediary for collecting and conveying information between a medical provider and an insurance company. 

Billing claim medical process starts with the office visit of a patient. Depending on the services provided, the doctor creates the patient's medical record. The record contains personal information, nature of illness, general summary of treatment diagnosis and suggested treatments, and demographic information of the patient. The combination of the method of treatment and diagnosis, and duration of service determine the procedure code used to bill the insurance. 

The doctor provides this information to a medical coder or billing specialist. Using this, a billing record is generated. The medical billing record is created either on a paper form or on an electronic form. This billing record is then submitted to us. We edit the record based on the rules and regulations stated by the payer. 

At OSI, our professionals follow strict quality control standards. They use the latest technology and software for the processing of these medical billing claims. We can receive data through our web based medical billing software or we can work with your current software. Our billing specialists are responsible for compiling and maintaining medical records of charges and services rendered by the healthcare facility. Before submission, our quality assurance team reviews all claims. If the claim does not meet essential criteria, we send it back to the medical provider, so they can make corrections and quickly retransmit it. This saves time and later complications. 

The insurance company first processes the validity of the medical billing claim. They cross check the patient’s eligibility for the payment, medical necessity, and the medical provider’s credentials. If payment is genuinely due, the payer remits the payment for the services rendered to the medical provider. We ensure clean claims with accurate billing details. If a claim does not meet their criteria, the payer rejects it and sends the rejection message to our company. 

When receiving the rejection, we make the required corrections and submit the claim again. In some cases, this process of claim submission and messages is repeated many times until the claim is paid in full. OSI can process medical billing claims within a single day. You need not have to pay any hidden cost or start up fees.

For more details of our services, contact us.