Frequently Asked Questions about Medical Billing
Wondering if your in-house billing is costing more than it should? Park Medical Billing offers in-depth medical billing cost analysis to help you reduce overhead, increase collections, and improve financial performance.
The medical billing process is triggered by a patient’s care. The medical institution writes up a claim to be sent to the insurance company along with supporting details in the form of ICD, CPT, and HCPCS codes for the money to be returned to them. The insurance company reviews the request and pays the medical institution for the services that they have covered. In case there is a problem, the claimant gets in touch with the company to resolve the issue.
The main three sets of codes used by medical billing are:
- ICD (International Classification of Diseases) – for identifying the disease/condition.
- CPT (Current Procedural Terminology) – used when describing new procedures and services.
- HCPCS (Healthcare Common Procedure Coding System) – is used for a number of additional services like medical equipment.
Medical billing is all about the preparation and submission of claims to the insurance carriers and getting the reimbursement whereas medical coding deals with the standardization of the terms of the provided healthcare in the form of codes such as ICD, CPT, and HCPCS.
Well, on the whole, the criteria for a good medical billing service is HIPAA compliance and an efficient way to protect patient information. They have to follow very strict rules concerning the privacy of the data so that the sensitive health information can remain confidential.
Yes, we efficiently handle Electronic Remittance Advices (ERAs) and Electronic Explanations of Benefits (EOBs) to allow for the quick posting of payments and tracking of errors. Through such automation, we are able to identify claim issues right away and keep accurate, up-to-date financial reports available for your practice.
We usually submit claims within 24–48 hours after we receive complete documentation. Quick submissions lower the billing cycle time, cash flow gets better, and the chances of claim rejections or delays are reduced to a minimum.
A rejected claim is the one that does not go through the payer’s system due to errors. An example is incorrect patient information or missing codes. The rejected claim needs to be fixed and then sent again.
Whereas a denied claim is one that has been processed but not paid. Most probably due to coverage issues or lack of medical necessity. Park Medical Billing examines both kinds of situations thoroughly, corrects the problems quickly, and then either resubmits or appeals, depending on what is necessary to get the payment.
