Details Needed For Medical Billing

Who handles the medical billing process in any health care environment? Well, it may be handled either directly by the doctor or by his staff or by a third party professional medical billing company if it is for a bigger clinic or hospital. Medical billing is a specialized profession today and billing could be a team work process that can involve the following people.

* Office manager
* Nurse
* Receptionist
* Medical assistant
* Insurance clerk
* Medical coders

The medical claim process begins with proper identification and medical coding as all medical procedures and diagnoses have been assigned with codes. The Current Procedural Terminology (CPT) was developed in the year 1966 by (AMA) American Medical Association and it lists medical procedures and corresponding codes. Each medical procedure has a unique code that is listed in a CPT manual. What are the types of details that are required during the medical billing process? They include,

* Name, address, telephone number, and ID number of provider
* Name of insurance company / group
* ID number of insurance holder
* Patient's name, date of birth/address/phone no
* Insured person's name, date of birth/address/phone
* Relationship between patient and insured person
* Details of provider name, address, telephone number, and ID number
* Details of other health insurances
* Patient's medical history /condition
* Details whether the medical condition is related to accident etc

A document called the explanation of benefits (EOB) often may accompany the payment that is received from the insurance or managed care company. This document describes all the details of services covered and not covered. It also mentions all the bills that have been sent to the service provider and the patient. One can also know if the patient has missed out on his annual payments/deductibles to the insurance company making him ineligible for total claim.



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