Medical Billing Process

Medical billing is getting more and more abstruse as the expenses involved in processing a medical bill has to take into account different aspects and the increased costs and insurance procedures demand a perfect billing process which is both transparent and fully accountable for. As most patients pay their medical bills through insurance companies who demand the complete details of the patient and his medical affairs along with the absolute summarisation of the treatment process and the cost of investigations and medical examinations as also the billing for each head. This creates a huge demand for an accurate and extensive medical billing process. The hospitals get the final payment after the patient has submitted his/her claim to the insurance companies barring a few who pay up direct( they too require these detailed bills and medical archives to settle the bill and for future reference). This creates a bulky work flow for the billing and accounts department and if the process is not active will slow up the turnover of hospital beds which are in bulky demand and act a social cause too.

Thus most companies have been looking to outsource their medical billing process to companies which specialise in this workflow. What is thus the method and how does it help to follow a workflow otherwise the whole process will become both difficult and not efficient. The medical billing workflow can be summarised in a chart thus:

Patient -

Front Office (who will authenticate the medical insurance card or payment method-
Physician (including nursing and hospital staff) who will verify the treatment and the medicines and supplies and the cost incurred for the various tests and investigations)-

Billing department (who will confirm the costs involved and make a bill for the total amount)-

Outsourced Billing process /or in house (whose job it is to enter and check each and every aspect of the patients details are accurate and the procedure followed have been absolute and billed for or if there are any changes or accessory charges involved and make the final bill which has to be shipped for the medical insurance company for settlement of the bill)-

Medical insurance company will further check the detailed bill shipped to them for claim and using specialised software and personnel will send the payment to the hospital -
The Cashier and accounts department will verify the amount settled and if any accessory has to be paid will ensure that payment from the patient and settle his bill.

This entire method is becoming more and more abstruse as the cost of medical treatment is increasing and more people are seeking insurance settlements for their medical bills. Thus the medical billing method is not as simple as it seems and complete auditing records have to be filled and rechecked and details have to be maintained for future reference. To boost up the process these hospitals and doctors too have outsourced their medical billing and claims formalities to companies and professionals who are active and have experience on medical billing method of the different parts of the world.

By: Prologic kumar

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