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The Facts About Medical Billing Companies

Aug 17, 2007
The service offered by these companies serves as the key for a doctor, or any healthcare provider for that matter, to get paid. The healthcare industry in America is alive and well, but in spite of this, many doctors and other healthcare providers dont have any idea how to get themselves paid quickly and efficiently. The answer, of course, lies in insurance. And how are insurance claimed? This is where medical billing companies come in.

Medical billing companies are the ones who would submit claims to insurance companies in order to receive payment for services rendered by a healthcare provider. The process is basically the same for most insurance companies, regardless of whether they are a private company or a government-owned one.

The Billing Process

Essentially, the first step to jumpstart the whole billing process is the patients office visit. The healthcare provider will see the patient, diagnose his illness, and suggest treatment for such. Afterwards, depending on the service provided and the examination, the doctor then creates or updates the patients medical record. This record contains the summary of each of the patients visit, including details about treatment and demographic information related to the patient.

When you combine the treatment, diagnosis, and duration of service, this forms the procedure code, determined for usage in the billing of insurance. The doctor can of course take care of claims processing himself. However, the work can become tedious, especially when he should be focusing more on his healthcare practice than on insurance. Hence, the medical billing companies shoulder the burden for him.

The medical billing companies will use the information provided by the doctor to formulate the billing record. This record is generated manually or through the use of a software program. Often, the companies generate the billing record electronically. However, there are some that also produce hard copies as well (usually on a standardized form called an HCFA). This form includes the various diagnoses identified by numbers from the current ICD-9 manual.

It is the medical billing companies who will submit this billing record or claim to a clearinghouse. The clearinghouse acts as an intermediary for the information. Typically, when electronic billing is used, the medical billing companies must send their records to the clearinghouse.

Sometimes though, the record may also be sent directly to the insurance company. This is to ensure that everything is processed as efficiently as possible.

Doctors depend on medical billing companies for the money they get for the services they rendered. They can hardly find time to process everything themselves. The services offered are a great help in reducing the things they would have to worry about.
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