Medical Billing Cycle: A Step-by-Step Guide

The standardized codes are used after documentation of services, diagnoses, and treatments in detail concerning the given patient by the end of his visit. The codes form an important component of the medical billing workflow because the corresponding degree of reimbursement by insurers directly depends on the codes. Adequate codes not only make the payment process faster but also makes industry regulations to be followed.

Claim Creation and Submission

After assigning codes, the claim is filled with all of the necessary details of the patient, provider and services. It can either be electronically or hand submitted to the insurance company. A clean and complete claim is much more likely to be accepted on the first pass and minimizing the re-work associated with the process of medical billing step by step.

Posting & Payment Processing

The insurance company will issue an Explanation of Benefits (EOB) or Remittance Advice about the payment or denial when the claim has been processed. The payments are subsequently informed in the account of the patient and whatever balance is left is billed directly to the patient. Posting of payments in a timely manner is an essential part of an effective medical billing workflow.

Follow-Up Management and Denial

First time payment of all the claims is not a reality. Others are rejected because the information is not completed, there is coding error, or issue with covering. At this point, the billing team reviews the denial cause, corrects whatever is needed in the claim and submits again. Denial management plays an important role in sustaining a flowing process of medical billing.

Account Closure and Collections on Patients

A patient is charged in case a balance emerges following insurance payment. Effective communication, adequate description, and easy payment methods contribute to the enhancement of the collection rates. After full payment is accepted, the account is closed, and, this billing cycle is completed.

Allow Med Brigade to Handle Your Medical Billing Needs

It is daunting and time-consuming to handle the medical billing cycle on your own. Med Brigade has the skilled workforce to manage an organization-wide medical billing process with high levels of accuracy, accuracy on claims coding, filing, and tracking. We cover the whole process of medical billing, so by using our team, your practice can maximize reimbursements and minimize errors. Contact Med Brigade to see how we can make your billing work easier and not slow down your revenue cycle.