The process of submitting claims to insurance companies through an electronic means and the subsequent following up of them is what is known as electronic medical billing. This is done for the singular purpose of getting a payment for services rendered by a health care provider. The process that is used is for the most part similar for many insurance companies whether they are government administered or owned privately.
The billing process has been described as an interaction between a health care provider and the payer, or the insurance company. It begins when a policy holder visits a health care provider’s office. A record of the visit will then be created or added to the existing files on that particular person.
Information about the person in question will be used for the determination of what services need to be billed for by the submission of a claim to the insurance company. This usually occurs after the visit has concluded. Electronic billing makes the submission process almost paperless which in some cases allows a claim to be quickly submitted.
After a claim has been sent to an insurance company it is reviewed by medical directors, medical claims examiners, or medical claims adjusters who check its validity. Once it has been determined to have merit the claims are then reimbursed for a predetermined percentage of the billed services. If the claim fails it is rejected and the provider who submitted the claim will be notified.
When the notice of rejection reaches the health care provider the claim must be revised, corrected and then resubmitted. This rejection and resubmission cycle often repeats numerous times until payment in full has been given or until the provider of the care accepts a payment that is not complete.
The means to accomplish the medical billing process in a way that is electronic is what is called electronic medical billing. The time that had been taken up through the billing process and the processing of a claim is much reduced in comparison to more conventional methods.
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Tags: Doctors, electronic medical billing, health, Insurance, Medical, medical billing, medical billing companies, medical billing services, online medical billing
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