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A Few Facts about Medical Billing and Billers

A Few Facts about Medical Billing and BillersPeople have always been confused about medical billing and what medical billing professionals do. But most importantly, how medical billing professionals are essential to keep the healthcare facilities functioning properly.  Their responsibilities can vary as per the medical specialty, some of their responsibilities include:

  • Medical billers can use coded data to generate and submit claims to insurance companies for payment
  • They also work directly with insurance companies, healthcare providers and patients to submit claims, resolve denied claims and process payments
  • Review, analyze and appeal  for unpaid or denied claims
  • Review and verify patients’ insurance coverage
  • Answering and replying back to patients’ billing queries
  • Handling collections on unpaid accounts
  • Managing your practice’s account receivable reports

Medical billers can work either at a healthcare facility or they can also work at specialized outsourcing medical billing firms.

Medical Billing Industry Expected to Grow in the Upcoming Years

As the medical billing industry is a growing market, employment is projected to grow by 21% by 2020. Since it would be a growing segment, there will be new open jobs in medical billing in the US. Many would join this profession due to its increasing demand. Not just with medical billing, there would be a strong demand for experts in coding services as well. As the health sector would grow, so will the demand for industry experts in medical billing and coding services. Not to mention their high salaries as well.

As there is a large portion of people getting older in the US, this results in an increasing number of laboratory tests, treatments, and medical procedures.  As demand for such medical services would grow, so will the demand for experts and professionals in this field. Experts and professionals in medical billing and coding services help bridge the gap between doctors, payers, and patients.

As medical billing and coding are difficult and complex, it has now become a crucial part of the US healthcare industry, where healthcare practitioners are faced with the problem of filing claims, verifying patient information or balances due, checking outpatient insurance benefits and so much more.

GreenSense Billing offers simplified and comprehensive medical billing and coding services with accuracy, precision, and attention to detail with expert professionals in this field. For over 20 years, GreenSense Billing has provided quality medical billing services as per the best industry standards.

Essential Guidelines for Medical Billing Professionals

It is very important for medical billing professionals to maintain proper and accurate patient information. It is also part of their job to obtain accurate demographic and insurance information from the patient and periodically check, recheck and verify all the information correctly with the patient, just in case if anything has been changed or updated.

It is necessary for medical billing professionals to inform patients about their billing policies, guidelines or any new government regulation concerning their medical billing. Sometimes, preliminary exams or other medical services are not covered by Medicare; including physical checkup examinations. It is essential that the patient is made well aware of all such medical billing policies and that they are required to pay for certain specific services. Medical billers must always be thorough in the patient’s documentation process. They must ensure that proper medical or diagnostic codes substantiate the performed procedures and that the visit codes are supported with valid and authentic documentation during the visit.

Remembering Important Payers and Government Regulators

Although Medicare is a common payer for geriatric practice, there can be other payers as well. Medical coding is mostly influenced by HIPAA, but not the payment or coverage rules apply. However, it is a common example that most Medicare + Choice (Medicare HMOs) plans cover preventive examinations. So in such cases, you cannot bill the patient under such circumstances.

Select the Correct Medical Code

It is crucial that you select the appropriate medical code, which matches exactly with your medical service, and not the code that has a reimbursement that matches with your charge.  Sometimes, more than one code can be used to code the same service.


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