Medical Billing Guide


What Makes Up Medical Billing And Coding?medical-billing-guide

For every health or medical related procedure, whether it’s for an individual going to a doctor’s office for an annual checkup, or for an individual seeking serious medical attention at a hospital, there is a specific medical insurance code for each symptom, injury, diagnosis, condition, disease, or medication prescribed.

All of these numeric codes are collected in a patient’s medical record by a medical coding professional and are then used by the billing department in a doctor’s office, hospital, or other medical facility to determine how much of the final bill a patient is responsible for paying out of pocket, and which procedures and/or medications can be claimed and covered by a patient’s medical insurance company.

All of this information is compiled and summarized into a document called an Explanation of Benefits or, an EOB, which is mailed out to the patient after a bill has been sent.

There are three different medical billing coding systems that are currently being used by medical professionals: Current Procedural Terminology, or CPT, is used by both private practices and hospitals, Healthcare Common Procedure Coding System, or HCPCS, both Level I and Level II, are used by Medicare and relate to medical supplies and equipment, and the third coding system, International Classification of Diseases, or ICD, is used in conjunction with CPT codes to verify that the medical services an individual receives directly correlates with an individual’s health condition.

It’s important for an individual to thoroughly review their Explanation of Benefits form and their medical bills carefully to make sure that there are no mistakes in the billing as an incorrect medical code can be a costly mistake.

Getting Help With Medical Billshelp-with-medical-bills

Receiving a large medical bill for health care can be daunting — especially if an insurance claim has been denied or if there is a mistake in the medical coding and the total amount billed to the patient is incorrect. For an individual trying to navigate through the complicated world of medical billing, of eligibility, of health insurance benefits and deductibles, coverage and restrictions, it can all quickly become overwhelming.

Thankfully, getting help with medical bills is within grasp; non-profit organizations, hospitals, and medical groups can be contacted to help an individual to reduce medical bill costs, to receive free or discounted prescriptions, to consolidate unpaid medical bills and/or to set up a payment plan, and offer other medical bill assistance programs.

And then there are the skilled professionals, such as medical billing advocates or medical bill negotiators who thoroughly understand the ins and outs of the business side of the medical industry, who can answer any questions, and can significantly help to lower an individual’s medical and hospital bills.

Are you looking for a medical biller? We can help. Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP!

The Role Of Medical Billing Advocatesmedical-billing-advocates

A medical billing advocate has an expert understanding of the medical coding and billing system and armed with the knowledge of an individual’s health care coverage can answer questions and help save an individual from financial and emotional suffering. A medical billing advocate can study an individual’s Explanation of Benefits form or an insurance statement and analyze medical bills to detect any coding or billing errors which can rack up hundreds, even thousands of dollars.

Unfortunately, billing for services that were either not provided to a patient or unnecessary are very common errors and patients are often reluctant or unaware that they have the power to question these expenses.

Negotiating a medical bill can be especially difficult to deal with if an individual is sick or in recovery and is unable to dispute the charges to the best of their abilities. And for those who are well enough and have benefitted from the healthcare they received, they are grateful for the medical help and feel as though they must simply accept their medical bill, whatever the cost.

Working In Medical Billingreducing-medical-bills

Reducing Medical Bills

Medical billing and insurance coding are different careers but both require professional certification and work closely together. After the insurance coder has assigned numeric codes for each procedure, the medical biller then processes the information and prepares a claim for reimbursement. A medical billing career is ideal for someone who is detail-oriented and understands anatomy, physiology and medical terminology.

Reducing Your Medical Bills.

Reducing medical bills is available to everyone and realizing that tools are nearby is empowering; people have no problem with negotiating the cost of a new car or when purchasing real estate, so why is there any hesitation with negotiating the high cost of medical bills?

Looking for medical billing or coding help? Call us today at 866.254.1610 or fill out our contact form and we’ll contact you ASAP!