Medical Scrubbing, Coding and Medical Transcription are all the key processes that help the Health care service provider to maintain the revenue cycle.
The billing process took several weeks to months to complete. It usually initiates when the doctor sees the patient, after the treatment all the record has been converted into the form of codes which later send to the insurance companies to get a claim.
As it is a very long process, In this article, we will break down the details of all these steps which will help you to better understand the medical billing process.
Medical scrubbing also refers to medical claim scrubbing, in which finding and getting rid of the errors which are found in the claims submitted to the insurance companies.
The errors are most usually found in the coding. In other words, it is the procedure in which the claim is audited before being submitted to the insurance companies.
Reasons Behind Medical Scrubbing
The process of medical billing is very complex; it contains several steps from identification to organizing and utilizing the data. In this process, the first step is to collect the personal details of the patient, the procedure, tests, and treatment he availed during his stay in the hospital.
This process also includes the information about the insurance company which contains the complete detail about the services he can avail of under the agreement and what services are excluded from the agreement.
The insurance companies use some defined sets of code to issue the claim,
For a successful claim, there is a need for proper coding as the process of coding is very complex and the chances of error are also very high.
While there are chances of error the medical claim scribing can reduce the quantity of rejected claims. Which turns into a better cash flow with more successful reimbursement.
Medical coding is the type of procedure in which all the services and treatment delivered to the patient is stored in the form of codes. These codes are then transferred to the insurance companies by the service providers for a claim.
All this coding procedure is handled by a medical coder whose responsibility is to ensure the accuracy of the bill which is submitted to the insurance company.
Reasons for coding
In medical practice, coding is usually described as the term in which the medical service provider recorded the history of the treatment and services provided to the patient and used it to claim reimbursement from the insurance companies.
This is one view of the broader picture, On the other hand, every day a huge amount of patient data is generated. A medical practitioner Recorded the history of the patient in terms of diagnosis of the disease, possible treatment, and medication. All these records help medical institutions and the government track the effectiveness of the treatment.
Transcription is the manual act in which the translator listens to the voice recording and converts them into written form. It includes a person’s medical history like medical treatment diagnosis and other procedures, it is considered as the patient’s permanent medical health record.
Role of Medical Transcriptionist
There are several tasks assigned to a medical transcriptionist. One of the tasks is to accurately transcribe the information related to the patient’s identification like his name, address, the social security number on medical records.
It is also the responsibility of a medical transcriptionist to check the inconsistencies and accurately use punctuation, grammar, and spelling.
The other responsibilities associated with a medical transcriptionist are to report and collect data and maintain a backup up, collect formulate and generate reports based on statistical evidence.
Importance of Medical Transcriptionists
The medical record generated by the medical transcription is helpful for the physician to evaluate the condition of the patient and use it as a reference to treat coming patients.
This medical record is also used by the support staff and nurses to cure the patient effectively according to the doctor’s prescription.
In some cases, the patient switches the doctor, the records which are generated by the transcriptionist will help the new doctor to better understand the condition of the patient with the help of all the previous records, treatment, and medication given to him. So, he can prescribe the best suitable treatment to him.
On the other side, the transcriptionist also helped the coding team by giving them accurate information about the patient’s history and the treatment he availed during his stay in the hospital so they can use this information to bill the insurance company.
It is a process in which health service providers submit the claim to the insurance company on behalf of the patient who has been treated in the hospital.
Process of Medical Billing
The process of medical billing is described below:
The first step in the medical billing process is to record the initial data of the patient including his name, age, home address, and insurance provider. This data is very essential which is used during the building process.
In the next step, the service provider will monitor all the details related to patient insurance.
By analyzing those details the service provider will determine the possible treatment process which is covered in the agreement.
After collecting all the essential details, the patient will consult with the doctor about his health, and then the doctor will evaluate the condition of the patient and prescribe him the appropriate treatment and medications.
The meeting between the patient and the doctor is being recorded to make a record of the patient’s medical history. This has been done by the medical transcriptionist, who will listen and document the medical history of the patient which is not only used by other medical practitioners but also used to generate codes for the billing process.
In the next step, the patient record has been converted in the form of codes. These codes are generated under the guidelines of the American medical association.
The coders usually used CPT and HCPCS codes, which are then forwarded to the insurance companies to submit a claim.
Claim Submission & Payment collection:
After the coding process, the claim has been transferred to the insurance company, which will process the claim if it is submitted within a specific time limit.
Once all these processes are done then the insurance company will transfer the fund to the service provider.
If you need assistance in your medical billing process, contact us at (888) 598-9181.
Med-Miles provides complete medical billing solutions to its clients, from charge entry to payment posting to clean claim submission. We assure you faster reimbursement for an active course of your revenue cycle.