Topic > Summary of the Ten Steps of the Billing Process and Procedures

1. Ten step summary of billing processes and procedures. (explain each process)Also include:a. Content and use of registration or meeting forms,b. Explanation of Benefits (EOB) and Remittance Notice (RA), c. Advance notice to the beneficiary (ABN),d. Participation contracts, e. The contracting process for payers and providers.A. Pre-register patients: The primary function of the first step is to schedule and update appointments, as well as collect personal and insurance information on new and existing patients. New patients provide personal and insurance information to the scheduler, while existing patients update any personal or insurance information with the practice that has changed.B. Establish Financial Responsibility: The second step is considered the most important because it determines which services will and will not be covered by medical insurance. It also determines whether the patient or insurance company is responsible for paying for services. In many cases, patients will be offered payment plans with high out-of-pocket expenses, such as specialized procedures that insurance will not cover. Even if medical insurance is used, the patient generally requires a copay. Many doctors participate in more than one insurance contract, depending on the financial options offered by the plan. Managed care systems are the most popular among physicians.C. Patient Check-In: At this stage new and returning patient information is verified, outstanding balances are reviewed, insurance information is taken and placed into the patient record, necessary documents such as privacy and release information statements are signed by the patient and issued. out-of-pocket expenses...... middle of paper......Department of Health and Human Services, Health Care Financing Administration. (2000). Program Memorandum Intermediaries/Carriers (Transmit AB-00-116). Retrieved from http://www.aarc.org/members_area/advocacy/federal/AB00116.pdfAnonymous. (2007). Mpro: Michigan Quality Improvement Organization. Retrieved from http://www.mpro.org/Anonymous, . (2011). American College of Radiology. Retrieved from http://www.acr.org/Hidden/Economics/FeaturedCategories/Coverage/cac/lcd.aspxAnonymous. (2011, May 31). The Hipaa Privacy Policy takes into account information disclosed under the Health Information Technology for Economic and Clinical Health Act. Retrieved from http://www.federalregister.gov/articles/2011/05/31/2011-13297/hipaa-privacy-rule-accounting-of-disclosures-under-the-health-information-technology-for-economic# p-3 http://www.openclinical.org/medicalterminologies.html