How Does Hospital Billing Work?10 Steps Hospital Billing Process

Touseef Riaz

June 13, 2022

medical coding outsource companies

If you think that profit results from the effective medical billing process, I agree with this. Now comes the question in your mind of how does hospital billing work? The medical billing process involves a series of steps completed by the medical billing specialists to reimburse medical professionals successfully. 

Every company has its way of doing work that allows them to make profits. Your Revenue Cycle Management (RCM) is improved through effective medical billing procedures. 

how does hospital billing work

How Does Hospital Billing Work? 10 Step Process

The basic principle of medical billing and coding is to generate successful reimbursements for healthcare providers and enhance their RCM. This article will go through the steps involved in the hospital medical billing services. 

1. Patient Registration

The starting phase of the hospital  medical billing and coding procedures is patient registration. As the patient enters the hospital premises and communicates with staff to acquire medical services, the process of medical registration starts. 

In patient registration, the patient’s basic information is collected like their name, date of birth, insurance information, the reason behind visiting the hospital, etc. Medical billers have to be attentive and alert in documenting the patient data to avoid any problems. 

The information gathered is utilized to develop a patient file used in the medical billing procedure. If patient registration is undertaken with care, the next steps can be initiated. 

2. Insurance Verification

In the second step, you have to ensure the financial parameters of patient billing procedures. Look for the patient’s insurance details to overview the services and processes covered under patient insurance. 

If there is anything that insurance companies won’t pay or the patients are not eligible to attain that medical service under insurance, patients are acknowledged about that situation to pay those remaining costs. 

3. Patient Recordings

When the patient meets the healthcare provider, the patient’s condition and services performed are recorded in audio or video. It provides clarity of the patient conditions and services prescribed to them. The record helps medical billers to complete their hospital billing services accurately. 

Medical Transcription

In this step, after the encounter with the physician in audio or video format, hospital billing experts convert the patient information into a report known as medical transcription. It’s essential to transcribe the information accurately. 

If the medical transcriptionist conducts any error, it can significantly impact the patient’s life. Ensure to hire a technical medical transcriptionist capable of performing this duty well. 

Medical Codes

In answering how does hospital billing works, it’s essential to know and practice the medical coding stage accurately. Medical coding is a very critical stage in the medical billing process. 

If you have experienced medical coding staff, it can minimize your claim denial rate. Most healthcare providers practice medical coding outsourcing from famous medical billing companies. Medical coding outsource companies have experienced medical coders who know about CPT and ICD-10 codes. 

Medical Billing

Before sending the claims to insurance companies, medical billers should align the medical services information properly. They have to cross-check all the information until accuracy is ensured. If an error occurs, insurance companies immediately deny claims that significantly impact your revenue cycle management process, and profits are declined. 

Charge Transmission

In this step, claims are submitted to either government or private insurance companies through EDI. In this situation, you have to look into the following things: 

  • Fill in the compulsory information; otherwise, the insurance company will reject your claim. 
  • If the information is invalid, claims are rejected. 
  • Going against the payer policies, those claims also face rejection. 

Remember, don’t ensure the confidentiality of patient information. Outsource your billing for nurse practitioner services in a hospital from a company certified by HIPAA. 

If you are responsible for sharing any confidential patient data, you can face serious penalties as a healthcare provider. 

AR (Accounts Receivable) Management

The AR team regularly examines every submitted claim to the insurance companies. The main aim behind this is to ensure effective working of the hospital lab services billing process. AR team is also responsible for providing additional information to make claims free from errors. 

They are also the source of updates on claims for patients, physicians, and insurance companies. 

Denial Management

Denial management is a crucial part of RCM. Sometimes, few problems result in claim denials from insurance companies. At this stage, denial management deals with such issues to resolve them as quickly as possible to smoothen the process of RCM. 

They conduct constant follow-ups to tackle the problems to reimburse healthcare providers successfully. While providing follow-up services, denial management continuously tracks claim performance to maximize reimbursement rate. Resultantly, claims are accepted successfully.

Your denial management team should be skilled to ensure the smooth processing of RCM. Adequate working of the denial management team can increase your revenues. 

Payment Posting

This is the end of the medical billing process where teams have to get updated about the payment situation.

Patients receive EOB (Explanation of Benefits) and ERA (Electronic Remittance Advice). The payment posting team also checks the obtained payment accuracy. 

Choose Ucontrol Billing for Your Medical Billing and Coding Tasks

Ucontrol billing is an authentic and reliable US medical billing and coding firm. We always ensure that your claims are submitted to the insurance carrier accurately the first time based on individual carrier requirements. 

We are the promising solution for your medical billing and coding process success. Our experienced medical billing staff encompasses years of experience with proven success records. If you think why to choose Ucontrol billing, then have a look at these points: 

  • We are HIPAA compliant. 
  • Our primary focus is to improve your revenue cycle management process. 
  • Cross-checking every piece of information and regularly receiving follow-ups from insurance companies in claims. 
  • We ensure 100 percent privacy of patients’ private information. 
  • Guaranteed increase in your financial revenues. 
  • We are a cost-effective solution to your medical billing and coding tasks. 
  • Decreasing your claim denials and overall expenses. 
  • Ucontrol Billing has a skilled and talented workforce along with the latest technology. 

You will feel the increase in your revenues after opting for our services. “We only get paid when you get paid.”

We have a straightforward and cost-effective pricing structure. Ucontrol Billing offers two pricing plans: 

  • Medical Billing Only 
  • Complete Revenue Cycle Management. 

You can contact us to have further information. 

Bottom Line 

Now you know how does hospital billing works. The hospital billing for reference lab services process is technical and requires exceptional expertise to attain successful results. As explained in this article, there are ten steps involved in the medical billing process. 

Developing an effective medical billing and coding team in-house is expensive and time-consuming. Healthcare providers have to invest in their training programs to update them with the changes in the industry. 

The simple and cost-effective solution is to outsource hospital billing services tasks to have more positive results. Choose Ucontrol billing as your partner and get ready to improve your revenue cycle management and earn maximum profits. 

FAQS

Why do hospitals bill separately?

It is because you might receive medical services from different healthcare providers that are not part of that hospital. 

What is the minimum monthly payment on medical bills?

There is no minimum monthly payment on medical bills as there is no law about that situation. 

What are three different types of billing systems?

The three different types of billing systems are closed, open, and isolated systems. 

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