All the Stages A Medical Billing Takes Before Settlement. Medical billing entails a process whereby one party, the healthcare provider, forwards documents to the next party, the insurance company, seeking payment for the medical services offered to one of their clients. This process is done with all insurance companies, from government sponsored to private. Medical coding includes all the details regarding the diagnosis and treatment of the patient. Health insurance has allowed many people to gain access to affordable healthcare in the United States. They have revolutionized the way healthcare works. Traditionally, the process of filing medical billing was entirely done on paper. It included the use of postal address and fax machines to handle the entire process. Time wastage was common before both parties came to an agreement. Technology has played a crucial role in making the medical billing process electrical. Medical claims processing software have replaced the previous manual paperwork. EDI Billing has improved the speed of filing these claims and has improved the communication channels. The health information system is well capable of handling a lot of claims at a go. It has allowed room for instant feedback and real-time update of data. Businesses and companies have emerged after realizing the opportunities that are presented by these changes. Technology companies have also played their part in providing hospitals and insurance companies with the best software to fit their needs. The software has also improved the communication channel between the transacting parties.
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As far as business opportunities are concerned, medical billing clearinghouse has been on the rise. These clearinghouses act as an intermediary whereas they help the hospital to submit the claim to the insurance company. They also conduct a process known as claim scrubbing which is to regularly check the data for any errors. Another function is to determine if the claim provided by the hospital is indeed compatible with the claims processing software of the health insurance firm.
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The process of filing a claim may take longer than anticipated, especially if the provider and the payer are both enrolled in different claims clearinghouse. If this is the case, then the claim will have to move from one clearinghouse to the next and may also be moving to and fro. Also, the probability of the claim getting lost and becoming stale is higher at this stage. To be protected from such a scenario, the healthcare providers are always advised to make sure that they know where the claim will go next after the clearinghouse.