Medical billing specialists are vital to a medical team. Specialists send patients' bills to the proper insurance provider. The process is complicated and time consuming, but once you are educated in the field, it can become a fun and fulfilling job.

Significance

Patients who come to a doctor's office must pay for their services. Some patients pay their own bills and others have insurance. For those who have insurance, a staff member must handle the processing and collecting of insurance payments.

Terms

Medical billing specialists have to understand the terminology to be successful. You need to understand basics, such as health insurance and benefits, which is what the insurance plan will pay.

Benefits

Medical billing specialists find out what a patient's benefits are. They will copy the front and back of a patient's medical card, then call the insurance company's eligibility and benefits phone number. A representative of the insurance company will tell you, email or fax a list of the benefits.

Coding

Once the patient has been seen by the doctor, the billing specialist will receive the doctor's superbill or encounter form, which has such information as the medical diagnoses and procedures. Some doctors will have the information coded and some let the specialist do all the coding. The coded information is keyed into a claim form and sent to the insurance company via mail or over the Internet.

Payments

Once payment is received from the insurance company, the medical billing specialist will record the payments in the patient's file. If payment is not received, the specialist will check for coding errors and resubmit or the bill is forwarded to the patient.

Source:

Medical Coding and Billing