A medical billing process is one of the chain processes in medical sector. It is the process of filling and following up on claims to the insurance companies. This is the way in order to receive payment for service made from the healthcare companies. This is used either by private or government owned insurance company. For medical billers, they must first take exam for the Certified Medical Reimbursement Specialist Exam (CMRS Exam).
The interaction between healthcare provider and insurance company are consisted in this billing process. This is how it works. The doctors will make a medical record. This record contains information of the whole treatment and demographic information that has the relation with the patient. From the first record will be given the information of the diagnose and for the nextvisits from the patient will be record the more information of the condition of the patient. This process will be done continually and it will be called the medical billing process because the medical biller in the future will transmit the claim to the insurance company. This is how the process is working.
This process is also able done by electronic billing process. The Health Insurance Portability and Accountability Act (HIPAA) is a package of rules and regulation that must be followed by hospitals, doctors, healthcare providers and health plans in order to provide this service of this billing process in medical field. Medical providers are using electronically to fulfill this need Since in year 2005. This medical billing process, was not only affected by HIPAA but many of the patient found that additional waivers and paperwork are related to HIPAA provide their insurance companies and health care providers. Some claims may get rejection also, for example these claims will be returned in form of Explanation of Benefits (EOB’s) to the providers.
