In the medical billing process, there are significant and mandatory steps that healthcare workers need to do. Preregister patients are the first step, and this contains two major duties. The first duty is to schedule appointments because the patients need to have a time and date to see the physician, plus to update appointments. Gather preregistration demographic and a patient’s insurance information. A new patient that calls for an appointment needs to provide information (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
With the second step is to establish the financial responsibility for their visit, and use the information which was received from the patient. When a patient has medical coverage, then it is necessary for them to answer some questions regarding their healthcare coverage. The uninsured patients they must be advised of their obligation for the total charge of the visit (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
With the third step is to check in the patient and it is different if a patient is new or a returning.
The returning patients’ needs to review, validate, and if there are any essential changes needs done to their record, and with new patients’ needs to fill out forms then complete the demographic and medical insurance information (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
The financial records are reviewed to see if the payments are up to date, and the payments or copayments are established in this step. The fourth step is when the bill for visit, medical diagnoses, and procedures needs to have an assigned medical code, which the codes can be verified with the data located in the patient’s medical record.
The Essay on Patient Medical Record
VITAL SIGNS: Pulse 100, respiratory rate 42 per minute, temperature 99. 1, blood pressure 156/96. GENERAL: The patient appears very tired at the present time. HEENT: negative. CHEST: There is an increased anteroposterior diaemeter to the chest. No intercostal retractions during inspiration. HEART: Normal heart sounds without murmor or racing. ABDOMEN: soft and nontender. EXTREMETIES: normal with ...
Their primary illness is given a diagnosis code that comes from the International Clarification of Diseases, 10th Revision, Clinical Modification (ICD-10- CM) (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
The fifth step every charge has a certain procedure code for the visit and many medical practices have their own standard fee. There is a separate fee related to each code, and each code might not be billable, so it all depends on the client’s rules. Certain payers merge some physician work with payment for a different code (Valerius, J., Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
The sixth step is the checkout process, which the medical codes were given, checked, and the bill amounts have been established. The charges are added and then explained to the patient, and this is when the payment for the charge is collected (deductibles, copayments).
If any payments were made then a receipt is prepared and any additional work will be scheduled (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
The seventh step is an important step because this is when the claims are accurately prepared and in a timely manner. Many facilities use the PMP when preparing claims for a patient and then they will send them electronically. A claim has all the information about all the procedures, diagnosis, and charges to the payer (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
There is a schedule for communicating claims, for example, daily or every other day. The eighth step is when the claim has been delivered to health plans, it is critical to collect the payment quickly.
When money is due from the plans or from the patients it adds up to the facilities accounts receivable, and this money is needed for the practice can run. The payers review every claim by using the process adjudication, and they can determine if the claim should be paid or not (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
The Research paper on Blood Pressure Fat Diet Patient
CASE STUDY FIELDWORK Soap Note: 1. S: Pt c c / o SOB and heart failure that comes and goes. Pt c / o poor appetite for the last few months and states she has lost 25 pounds since her surgery in December. Pt states she follows a low salt, low sugar diet and that her husband prepares the meals at home under her direction. Pt denies any CP, N/V. O: 65 y. o. white female, 67 in (170 cm), IBW 147 h (67 ...
The ninth step is when the payers’ payments will be applied to the correct patients account. In many cases, the patient will be billed for the rest because the plan does not cover the entire bill.
Any bills mailed to the patients provide the dates and services, the payments either they or the payer has paid, and then the balances are now due (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
The tenth step is when a patient doesn’t pay their medical bills and then a collection process starts. Then the patients’ medical and financial records will be stored and kept because of the medical practice policy. There are federal and state regulations that control which documents needs to keep and exactly how long (Valerius, J. , Bayes, N. , Newby, C. , & Blochowiak, A. , 2014).
