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Medical Billing
Medical Billing
Medical Billing
Medical Billing
Medical Billing
Medical Billing
Medical Billing
Medical Billing
Medical Billing
Medical Billing
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Medical Billing

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  • 1. MEDICAL BILLING PRESENTATION ON BY ELIZABETH TOJO
  • 2. DEFINITION MEDICAL BILLING IS A PROCESS OF SUBMISSION OF BILLS TO THE INSURANCE COMPANY IN A SPECIFIED FORMAT FOR THE SERVICE RENDERED BY THE PHYSICIAN ON THE PATIENT.
  • 3. 3 MAIN PARTIES PATIENT PROVIDER BILLING OFFICE CLEARING HOUSE INSURANCE COMPANY
  • 4. BILLING OFFICE
  • 5. RESPONSIBILITIES OF A BO
    • CODING
    • STRICT ADHERENCE TO THE RULES & REGULATIONS
    • OF THE INSURANCE COMPANIES
    • ASSURING HIGH PRODUCTIVITY & REIMBURSEMENT
    • FOLLOWING UP WITH THE INS CO & THE PATIENTS
    • FILING CLAIMS TO THE INSURANCE COMPANY
    • MAINTAINING PATIENT REOCRDS AND ACCOUNTS
  • 6. DEPARTMENTS IN A BO
    • COMPLIANCES
    • CODING
    • CHARGE ENTRY
    • PRINTING
    • PRE-VERIFICATION
    • AUDIT / QUALITY CONTROL
    • CLAIMS & TRANSMISSIONS
    • CASH POSTING
    • ACOUNTS RECEIVABLES
  • 7. INSURANCE COMPANIES
    • THERE ARE TWO KINDS OF INSURANCE COMPANIES.
    • THEY ARE :
    • FEDERAL INSURANCE COMPANIES
    • COMMERCIAL INSURANCE COMPANIES
  • 8. FEDERAL INSURANCE COMPANIES
    • GOVERNMENT INSURANCE COMPANIES
    • MOTIVE IS WELFARE
    • EXAMPLES :
    • MEDICARE
    • MEDICAID
    • CHAMPUS
    • CHAMPVA
  • 9. COMMERCIAL INSURANCE COMPANIES
    • PRIVATE INSURANCE COMPANIES
    • MOTIVE IS PROFIT
    • EXAMPLES:
    • AETNA
    • CIGNA
    • BCBS
  • 10. THANK YOU

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