A Quick Overlook of Billing – Your Cheatsheet

Medical Claims Processing: Increasing Your Awareness and Understanding It is important to note that the health care system is a multi-billion market, with millions of people depending on specialized professionals whose primary responsibility is to ensure that medical care facilities, pharmaceutical companies, pharmacies and medical equipment manufacturers are following the law and policies governing health care system operations, products and services. One of the standard system of balance and check is through medical claims process. It is dealing with the two most important aspects of the health care system which are the medical insurance companies and health care providers. The relationship among health care providers, policy holders and health insurance companies is vital in understanding how medical billing and coding works. Health care providers are private clinics, hospitals, pharmacies, dental clinics, nursing homes, assisted living facility, in-home caretakers and chiropractor, where a patient receives and is billed for health products and services. Insurance companies on the other hand are the ones who provide medical subsidies for qualified patients or policy holders. Insurance policies are different from one company to another and many people have insurance coverage obtained privately, from an employer or from the government. The process involving how insurance companies work follows the same business operation, wherein a policy holder pays a certain amount of money to the insurance company either monthly or annually, which is known as premium. Insurance companies pays for a policy holder’s hospitalization, a medical operation or medical procedure such as diagnostics and medicines and other medical supplies in full or partially depending on the terms of the coverage. In the health care system, a patient or a policy holder is someone who purchase a health insurance, such as a young adult for example, finding a basic insurance coverage to pay all medical expenses more than the deductible, wherein the amount is pre-arranged and should be paid before the health insurance coverage sets in. The policy holder initiates the medical claims process through seeking health care services or medical intervention like medical consultation laboratory or any diagnostic procedure, surgery or hospitalization. After the patient or the policy holder receives the medical service, he is then financially responsible to pay the deductible, for which the amount of money that he agrees to pay before the insurance coverage starts. The policy holder provides their insurance details to the health care provider and the transaction between the health care provider and the policy holder ends. And this is when the transaction between the insurance company and the health care provider starts. The health care provider will ensure that all medical records are included in the medical claim or dental claim processing, and medical coders and billers are the ones responsible for creating this medical records, and they are the ones who send these claims to the policy holder’s insurance company. The insurance company will review the medical claim and will either accept or decline the claim basing on some factors.On Insurance: My Rationale Explained

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