All of us have experienced either going to a physician or a hospital or one of our family members having to receive medical attention at some time or the other, and struggled to make sense of the bills we received and the codes they contain, but even thought they may look Greek to us, the benefits of medical billing are great for both the medical practice and for the patient.
Medical billing and coding is the method that hospitals and medical practices of all kinds utilize to submit claims to insurance companies in order to receive payments for services rendered to patients. Without these services they would not be able to get reimbursement from the insurance carriers and would have to bill their patients directly. This would mean that we as the patient would have to struggle to get payment from our insurance carrier ourselves.
If the insurance carriers had to deal with payments to each and every individual patient instead of a few thousand practices it would take them much longer to process each and every claim and we would wait months for a claim to be processed and payment to be made. This then means that another one of the medical billing benefits is that payment is made much quicker this way, and the system ensures that we are not out of pocket for months on end.
Claims are submitted either via paper forms or electronically, according to the insurance carrier’s guidelines. In order for the correct claim to be made and paid, the correct diagnostic and treatment codes need to be filled in. Once these claims have been processed the payment can be made. Insurance carriers pay standard rates for each service, as per their contract with the practice. Any amounts over and above the agreed upon rates are written off, which means that the patient cannot be charged the difference. This is one of the benefits of medical billing, as it means that the patient is charged less than what they would have been had they not had insurance cover, and the practice gets their money directly and quickly.
Payments are generally made directly to the practice without involving the patient, and this means less problems for the patient and no need for them to pay on the day of the service, and having to wait for reimbursement from the insurance carrier at a later date. This is another of the medical billing benefits, as it helps a lot with cash-flow, especially in this day and age when most individuals are struggling to keep their heads above water in the uncertain economic times with which we are currently faced.
One of the other benefits of medical billing is that it is much easier to check your medical bill and ensure that you have not been charged for services that you did not receive. One should always check your medical bill against the codes provided and your knowledge of what treatment services you received. It is quite simple to calculate these costs in the comfort of your home by doing the following:
- Find out what the medical billing codes that are on your bill mean – this can be done by either contacting the billing office for an explanation or by looking the codes up online by typing the code and the number into any search engine.
- Request an itemized statement from the hospital you were treated at or your health care provider, detailing the costs of the procedures, tests, supplies and services they provided you.
- Request an explanation of the billing benefits and the coverage from your health insurance provider
Want to learn and understand more about your diagnosis and treatment? Want more about the services your practitioner has provided? This is another of the benefits of medical billing; now you can just type the code into any search engine and read up all about it. If you have any queries about the type of drug that was prescribed for you, go to the FDA website, enter the NDC Code and read all about it.
Another of the benefits of medical billing for you as the patient is that the fact that your physician can outsource their medical billing to someone who handles that whole side of the business for them means that they now have more time to spend doing what is important and what they were trained for, treating patients, and not wasting their time doing administrative work. This may not sound much to you, but the amount of time that was wasted on paperwork and filling in insurance claim forms etcetera used to take up a lot of time that the physician then lost on treating patients, and this placed an enormous amount of stress on them, especially if it was a small practice. The last thing any patient needs is a doctor who is stressed or worrying about getting payment, as this adversely affects their treatment of their patients.
Another of the benefits of medical billing is the fact that if you do spot an error or have a query on your medical bill, it is much easier to get hold of the Medical Billing Service personnel, who will be eminently qualified and able to assist you and explain everything to you in detail without the pressures of having to check in with patients, answer the phone, etcetera.
Another of the more covert medical billing benefits is the fact that before you even walk through the doors of the physician’s practice your eligibility has already been verified, which means that the whole process is handled more smoothly and with no hiccups so all you need to worry about is getting the right treatment or medication and leave the rest to the medical billers and coders to sort out viz a vis payment.
So, the next time that you receive a medical bill for services rendered, instead of being upset at the amount, or vexing over the use of medical coding and billing, rather just sit down, make yourself a cup of tea and go through the bill to see that everything that is on it corresponds to the treatment or medications that you received. While you are doing that, count yourself very lucky that there are such things as medical codes, and remember that the benefits of medical billing to you are all very positive and are geared to making your life easier.