Medical Billing and Coding
Medical insurance billing is the process of submitting and following up on claims to insurance companies in order to receive payment for services performed by a healthcare provider. The same process is used for most insurance companies, regardless if they are private insurance providers or government-owned. Medical billers are strongly encouraged, but not required by law, to become certified by taking medical billing classes. The medical billing process is an interaction between a healthcare provider and the insurance company. The interaction begins with the office visit: A doctor’s office will create or update the patient’s medical record, this record contains a summary of treatment and other information related to the patient. Upon the first visit, the provider will usually give the patient one or more diagnose in order to better coordinate and streamline his/her care. In the absence of a definitive diagnosis, the reason for the visit will be cited for the purpose of claims filing. The patient record contains highly personal information: the nature of illness, examination details, medication lists, diagnoses, and suggested treatment.
