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ďƒ˜Assigning the appropriate medical code to each service or diagnosis and examining medical records. ďƒ˜Making sure all the necessary forms are included and signed before medical claims are submitted.
ďƒ˜Analyzing Denied Medical Claims and communicating with insurance companies about any rejections.
Entering medical codes into database and patient records, creating itemized invoices for insurance companies.
Answering patients’ billing questions. Managing the facility’s accounts receivable reports. Contacting patients and insurance companies regarding overdue payments.
Whereas Specialized Medical Billers are supposed to be proficient in medical terminology, health system supply procedures and insurance diagnosis codes.
Must process claims for hospitals, private practices, and other care facilities. Insurance billing specialists must expedite the medical billing process. They use specialized knowledge of both medicine and insurance policies to communicate with insurance companies on behalf of medical personnel and patients. They do not provide any hands-on care. They assemble and maintain patient records, review transcriptions and interact with physicians to ensure that all relevant information has been recorded. Identifies and corrects billing errors such as misapplied credits, EMS reporting system, CAD system or other software systems necessary to trace sources of errors. As allowed by HIPPA, submits medical records to patients, hospitals or other agencies.
Now the question arises whether you would like to have an in-house medical biller or outsource to the medical billing company.
There are three vital factors to inhouse hiring and outsourcing – cost, expertise, and flexibility.