Online medical billing involves the process of submitting and following up on claims with various health insurance companies so that payment for services performed by healthcare providers may be received.
When it comes to visiting a doctor, it’s actually something that involves a much larger system of both information and payment rather than a simple one-on-one experience. In fact, it’s actually a three-party system. First comes the patient, then the healthcare provider, and finally the insurance company.
In terms of medical billing, the biller’s job is to both negotiate and arrange for payment between all of these parties. More specifically, the biller helps to make sure that the healthcare provider receives payment by billing both the patient and the insurance company. This is done by the biller collecting all patient information, including about the procedure that was performed for them. This is then compiled into a bill for the insurance company, which is often referred to as a claim. From there, the biller adds in information regarding the patient, their visit, and the cost of all procedures performed to the claim. Additionally, they also check to ensure that a claim is compliant, meaning that everything involving it is formally and factually correct. Once the claim is approved, it will then be sent to the patient.
Billers also stay in contact with patients, taking the time to explain everything involving their bill to them. They will also issue an EOB, or Explanation of Benefits, to them. This is a form that lists which specific procedures are covered by the insurance company, as well as why.
Additionally, the biller will also follow up with patients regarding paying their balances on their bills as well. In the event that a patient ends up having a delinquent bill, the biller may end up having to arrange for collections on the debt. Typically, this is something that isn’t done on a day-to-day basis; however, it remains something to always be aware of.
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