Question

Hospital and office billing are similar but there are some differences. Write a 2 page paper describing how the processes differ, including the coding books and processes, and explanations and examples of the terms prospective payment system and diagnostic related group.

Include a references page at the end in which you cite the resources other than your textbook which you use to write your paper.

Answer 1

Hospital Billing :

Hospital billing process is a crucial component for hospital management.Billing process is the final step in hospital process which directly propotional to patient satisfaction.Several steps are included is medicl billing process

• Registration documentation of patient information
• Insurance verification.-The insurance submitted by the patient first step is verified
• Patient check in and check out
• coding
• checking code compliance
• preparing and transmitting claims
• Auditing claims
• claims submission.

First major form to be generated for medical billing is encoounter form.this form is created by the medical coder after the patient has seen the doctor.The medical coder uses the information from the patient’s chart to note what diagnosis was made, what procedures were performed, what services or prescriptions were given, etc. This information is then processed into codes. The main types of codes you will see on a superbill are ICD code.The super bill must be complete with location of treatment and signature with an NPI number.

Benefit Explanation:

This bill is sent to the providers and patients by insurance companies after their claim has been evaluated.It includes the services provided, the physician fees, what part of the fee the insurance company will cover, and what the patient is responsible for covering.

Office Billing :

Is the billing of claims of work that has been done by the physician or  other healthcare professionals, including inpatient and outpatient services.

Reference

http://www.iraj.in/journal/journal_file/journal_pdf/14-308-148006714425-30.pdf