Medical Billing

Medical billing is the process of creating healthcare insurance claims to obtain payment for the medical services provided. 

In simple terms, it is the translation of healthcare services into a billing claim. 

Role of a Medical Biller

A medical biller submits the claim and ensures that the provider will obtain reimbursement for it. 

Forms and Coding practices used by medical billers

Forms mostly used for medical billing are CMS 1500 for physician billing, while a UB-04 form is used for hospital billing. 

For diagnosis ICD code is used. 

For the diagnosis services depiction, CPT coding is used. 

Responsibilities of a Medical Biller

A medical biller has to gather data and file claims to the insurance company. A medical biller also makes sure that data is error-free and submitted appropriately. 

For gathering information about patients, medical billers navigate through their medical records.

What kind of Patient data is needed by medical billers?

Medical billers need a patient’s demographics, medical history, procedure or treatment received, and insurance coverage.