Steps in the Medical Billing Process

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Steps in the Medical Billing Process
Yolonda Hinojosa
November 27, 2011
Deborah Ryan

Steps in the Medical Billing Process
The sequence of steps in the medical billing process, are as follows: The visit: There are four steps in this category.
Step1. Preregister Patients; the patient is preregistered and basic information is taken from the patient. The appointment has to be scheduled or updated and the information that has to be taken is insurance and demographic. Returning and new patients are asked for the medical reason for their visit so the appropriate appointments can be scheduled. Step2. Establish financial responsibility for visits; this step is very important to determine financial responsibility for the visit. Insured patients will be asked questions about what services are covered under their plan, medical conditions that establish medical necessity for the services, what services are not covered, and how much of the bill is the patient responsible for. You must verify patients’ eligibility for their health plan in case it has expired or there has been changes made. Step3. Check in Patients; the new patient has to be checked in when they arrive at their appointment, this is when detailed information for demographic and insurance is collected at the front desk. When a returning patient checks in they are asked to review their information to make sure everything is still the same as the last time they visited. The clerk will also check to make sure that they do not have any past due bills that need to be taken care of. Step4. Check-out Patients; the patient will be checked out after their visit with the provider and the provider gives the findings to the check-out clerk so they can record the medical codes for the visit that will be billed to the health plan and the patient. The Claim: There are three steps in this category.

Step5. Review coding compliance; the coding compliance must be reviewed in order to insure that they all satisfy...
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