Electronic Medical Billing

Electronic medical billing is the transmission of medical claims via computer from a billing source to an insurance company or other payer source. The use of an electronic medical billing system improves efficiency levels, reduces errors in billings thereby reducing the number of denied claims, and assures confidentiality when using HIPPA compliant software. Medical billing through electronic means can also provide a faster turn around on payments since most electronic claims are paid within 10 – 14 days of submission whereas paper claims can take 21 – 60 days.

In order to process claims electronically, specialized billing software is needed. The software consists of a relational database for management of patient and health services information and a communication program.

Process of Electronic Medical Billing

The relational database allows for the confidential entry of information such as the health care provider's patient listing, types of treatments and procedures offered and pertinent information to the patient's health record. When a medical billing claim is created, this database electronically retrieves the needed information and in doing so, places this information into a transaction file. A number of claims can be gathered into one batch known as a transaction file. Transaction files can then be transmitted to either a claims clearinghouse or directly to the offices of the health insurance company for review and reimbursement. If the claims go to a clearinghouse agency, then the clearinghouse will create a documentation trail of the claims by printing out the claims and then submitting those claims to the health insurance companies or government agencies.

More sophisticated electronic billing systems can offer appointment scheduling, track unpaid claims, generate a number of patient demographic reports and manage your accounts payable ledger.

Getting a high quality electronic system for medical billing will be an upfront expense to your business operating budget but it will also prove to be a great enhancement in your ability to collect revenues and build your business.

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Medical Coding Nexus, conceptualized in Feb, 2005, is an online portal which provides up-to-date, pertinent information about medical coding and billing. Copyright @2005 Honlyn Limited All Rights Reserved
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