- 1). Verify correct contact and billing information for your patient. Ask for a current mailing address, contact numbers and health insurance information.
- 2). Explain your financial and privacy policies to the patients and have them sign a financial responsibility document. Not all services are covered by insurance. A signed copy stating the patient accepts financial responsibility is required if an account goes to collections.
- 3). Document the patients' chief complaint, or reason for visit, and keep detailed notes in their medical charts. Insurance companies may require copies of medical records before they pay a claim.
- 4). Code the claim. Medical claims tell an insurance company why a patient was seen (ICD-9 or diagnosis) and what services the physician provided (CPT or procedure code). Assigning the correct combination affects how the claim will process and pay.
- 5). Enter charges into your billing software. Charge entry creates electronic claims.
- 6). Scrub your claim for errors. Most billing software is programmed to warn you if information, such as modifiers or system edits, is missing or needed.
- 7). Transmit your claim directly to the insurance company or upload your claims to the clearinghouse. Your clearinghouse is where electronic claims are received and submitted.
- 8). Call the insurance company to follow up on claim status. Normal processing time is approximately 30 days from the date the claim was sent.
- 9). Post payments from the insurance company to patient accounts.
- 10
Bill the patient after you receive an Explanation of Payment (EOP) from the insurance company. This shows how the claim processed and will show if there is a patient balance.
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