For the medical insurance specialist to complete their duties, they need to follow a series of ten different steps in the billing process that leads to a maximum, appropriate, and timely payment for the patients’ medical services.
Step 1 Preregister patients – With this step you need to get the patients contact and insurance information. This will help in making sure the appropriate visits can be scheduled and the current insurance information is in the computer for proper billing information goes into the computer system for the vist.
Step 2 Establish financial responsibilities for visits – This is a very important step in the process because the specialist needs to verify insurance eligibility and figure out how much to collect at the time of the visit from the patient. To determine financial responsibility the specialist needs to know what services are covered and are not covered under the patients plan. The patient is also explained that they will be billed whatever services the patient’s policy does not cover.
Step 3 Check in patients –In step three the specialist will have the returning patient sign in, collect whatever necessary money from them co-payment or for an outstanding balance from a prior visit, copy or scan their current insurance card. Have the patient read and sign any new/important forms that pertain to the patient (authorizing any planned procedures and payments).
Step 4 Check out patients – Even though the specialist is to give the patient all prescriptions, lab slip or referral paperwork they might need and set up a follow up appointment if necessary. The specialist also needs to record all medical codes for the visit and to make sure that all information about the visit is up to date in the patient’s medical records.
Step 5 Review coding compliance – With this step the specialist needs to obtain all CPT and ICD-9 codes from the doctor(s) and to verify that all information is correct before entering it into the computer...