How Medical Billing is Handled.
Medical billing is the process where a healthcare provider submits documents requesting payment to the health insurance for the services rendered to one of their clients. This process is done with all insurance companies, from government sponsored to private. The patient’s diagnosis and treatment information is included in the medical coding.
Health insurance has allowed many people to gain access to affordable healthcare in the United States. They have played a crucial role in changing the way healthcare is provided.
For decades, the process of submitting these medical documents was done on raw paper. The whole process was handled either through postal offices or through a fax machine. It took a long period for both parties to come to a resolution.
The evolution of technology has allowed for this process to be made entirely electronic. Manual work of filing medical billing has been replaced by the medical claims processing software. EDI Billing has improved the speed of filing these claims and has improved the communication channels.
The new technology can handle a huge number of claim filing at once. It has allowed room for instant feedback and real-time update of data. The process has also opened doors of opportunities for many people and has resulted in the formation of big companies.
Due to the rising demand for this software, technology companies have risen to the occasion and have provided hospitals and insurance companies with the best solution. The communication channels between the insurance company and the hospitals have also been improved by the claim processing software.
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These changes have also brought about the birth of medical billing clearinghouse. The main function of these clearinghouses is to act as intermediaries where they forward the medical claim from the hospital to the insurance firm. Clearinghouses also conduct claim scrubbing which is checking for errors related to the claim. They also check to see if the claim is compatible with the software of the insurance provider.
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The entire process might take a long time, and it is further complicated in case both parties are enrolled in different clearinghouses. If this is the case, then the claim will have to move from one clearinghouse to the next and may also be moving to and fro. The process means that there are higher chances of the claim getting lost and falling into the wrong hands.
It is always better to ask your claims clearinghouse where the claim will go after it leaves their office so as to avoid any unnecessary delays or loss of information and data.