Medical Coding and Billing
Medical Coding and Billing is the major part of the Healthcare Revenue Cycle Management process of Healthcare provider and Hospitals.
Medical Coding
Medical Coding is the basic translation process where coders or provider translate diagnosis into the CPT (Common Procedure Terminology) and ICD -10 (International Classification of Diseases) based on the document provided by the physician.
There are thousands of codes for various processes like injury, diagnosis and procedure.
Every part of the patient consultation has been documented by physician or other person and coder’s job is to provide the appropriate code based on the every bit of the information, which can be used in the billing process.
CPT codes are the 5 digit codes related to the service and function performed by the healthcare provider on the patient. ICD codes are the alphanumeric codes correspond to the patient’s sickness.
Medical Billing
Medical Billing process consists of 2 parts pre-process and post-process.
The Pre-Process starts when the patient called the physician for the appointment for any medical services. It includes collecting the data from the patient like his or her demographic information, Insurance details, past medical history etc. Post that the billers work is to check the insurance eligibility of the patient for the procedure.
Post-process starts once the coder provides the codes to the document. Billers generate claim as per the codes and send it to the private or government payer companies. Insurance companies go through the document of the patient and codes given by the coder and reimburse amount to the provider. In case the claim got denial, billing company gather information about the denial, rectify it and try to re imbursed money to the physician from insurance company. Contact us for Medical Coding and Billing, Get Medical Coding Solutions in India, Sanvill.com, Contact us at +91 989 877 8929 or email us at hello@sanvill.com.
Medical Billing is mainly consist of following steps
• Patient information like demographic entry, insurance details etc
• Insurance eligibility and verification
• Charge entry posting
• Claim submission to the insurance companies
• Payment posting
• Denial Management
