Question

Please complete a 250-word write-up describing the 8 steps of the billing process

Answer 1

8 steps of billing process

1) patient registration

-Greet the patient on arrival

-if the patient is new give the registration form

-makecopy of patient insurance card

-create a new patient account, create a new encounter form.

2) insurance verification or authorisation

-it is done before the patient is seen with doctor.

-it requires patients name, policy holder name, date of birth, group number and policy number.

-call the number for the insurance provider.

-request information to be mailed or faxed to the office.

-you can also verify the insurance information using the office practice management system.

3) encounter form

-it contains both procedural and diagnosis codes.

-it is feel by the physician after encountering the patient.

Parts of encounter form:

Patient name, reference number, place of service, date of service, procedure list, miscellaneous, amount paid, diagnosis not listed, diagnosis list, doctor signature, patient return, practice and physician information.

4) coding

-first identify any diagnosis listed on the encounter form.

-to code for the diagnosis you need ICD -9 - CM code book.

-to code for any procedures, drugs or other services provided to the patient, use CPT code book.

-first look the procedures in alpha index followed by numerical index.

5) demographic entry

-most of this section should have been done at registration and is located in practice management system.

-input any information required including patients name, society security number, address, gender, marital status, date of birth, employer or school,phone number.

-next enter information of parent or spouse.

6) charge entry

-enter reference number, service provider, place of service, date of service, procedures, diagnosis, modifiers, insurance to be billed.

-it has to be done for each CPT code.

-when entering diagnosis code, be sure to enter primary code first spot followed by secondary code.

7) claim submission

-each insurance provider may have different requirements for information provider don't claim forms.

-two widely used measures to submit the claim is by paper or electronically.

-electronic claims are more efficient in case of reimbursement.

8) reimbursement

-after payment is received by the insurance provider, review the remittance advice in order to make sure the correct amount was paid.

-