Medical billing is a complex procedure and it is used for getting payments from health insurance companies. Medical billers have crucial role in solving various disputes between hospitals and insurance companies. They are also responsible for following up the claims that have been rejected or delayed. In large hospitals, an entire department will be dedicated for medical billing. Payment from insurance companies is indispensable for healthcare organizations and hospitals for operating it smoothly.
The hospitals keep detailed record of patients regarding the tests, examinations, procedures and treatment provided. Diagnoses by medical staff are also recorded. This medical record provides necessary information for the billing process. The medical billing cycle begins once you provide insurance information to the hospital or the doctor’s office.
The first stage of medical billing is insurance verification. The medical billing specialists send details of diagnostic tests, lab tests, surgeries, etc to the clinic or hospital in a prescribed format. Patient demographic entry is the second process involved in medical billing. In this stage, the billing specialist enter demographic details of patients such as, name, address, date of birth, medical history, insurance details, guarantor, etc.
CPT and ICD-9 coding is the next step. Most of the medical billing departments consist of AAPC coders, who are specialized in multi-specialty coding. Charge entry is the next procedure in medical billing. In this process, medical billers check the authenticity of insurance claims.
Claim submission is the next step in medical billing. It is submitted electronically through practice management system or paper claims. In this stage, senior billing specialist checks the claim thoroughly to ensure the quality of claims. Payment posting and account receivable follow ups are coming next. The final stage in medical billing is denial management. It is handled by senior medical billing specialists. This is the common procedure happening in a medical billing department of a large hospital.
Online Medical Billing Schools
Online medical billing schools provide you adequate training to become a skilled medical biller. You can learn medical and computer skills such as computer billing software and basic biology through online courses. If you are going to enroll in medical billing school, you need to study subjects such as medical terminology, anatomy and physiology, medical billing, medical coding, denial management, revenue cycle management, Medicare, TRICARE, medicaid, clearing house, ICD-9-CM coding, medical billing in practice, HIPAA privacy, certificate, etc. You should also learn to prepare health insurance claims forms, billing management, medial documentation, electronic data interchange and modifiers, medical insurance and managed care, government programs, etc.
Some online medical billing schools also provide training materials, practice questions, CPMB/CMRS/CMBS/CCS-P/CPC exam preparation materials, medical billing videos, etc. Online training courses also prepare you for appearing AAPC CPC and AHIMA CCS-P examinations.
Some of the accredited online medical billing schools are:
- performance Training Institute,
- Allen School,
- Harrison College,
- Newbridge College Online,
- Charter College Online, etc.
The syllabus of online medical billing course include basic medical billing overview, types of insurance coverage, procedures and diagnoses, office forms, the superbill or encounter document, CMS 1500 form, codes, ICD coding, life cycle of an insurance claim, collection of claim data, claim information data entry and claim submission, receiving and posting payments, working with billing management software, basic components of billing application, physician data, patient data, claim generation, introduction to workers compensation, etc.