Hcr/Medical Billing Process

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The medical billing process is when claims are filed to insurance companies requesting payment to providers who rendered the services to a patient. There are ten steps to make this process that we went over earlier in the class. Those ten steps include preregistering the patients, establish financial responsibilities for visits, check in patients, check out patients, review coding compliance, check billing compliance, prepare and transmit claims, monitor payer adjudication, generate patient statements, and follow up patient payments and collections. I think that HIPAA, ICD, CPT, AND HCPCS influence the medical billing process. As far as using HIPAA , I think it goes along with the first step and all throughout. We use HIPAA to get insurance information from the patients and their demographic information to schedule appointments. HIPAA is there to protect the patient's information. When you get ready to check out the ICD code book and the CPT codes would be used to get the diagnosis, treatment, and procedures. For the HCPCS codes, they do not provide any information about the diagnosis, just about what procedure was performed. The HCPCS codes are used to process outpatient services and professional services. ICD codes are required by HIPAA for inpatient services. The coding is done by the coding team that codes based on the information provided by the doctor. The people handle the medical billing process have to make sure they keep the patient information confidential because of HIPAA regulations. All the coding must be documented correctly so that you will not have any issues with payments.
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