Medical billing is an all-encompassing payment process within the United States medical system. The process begins with a qualified health care provider receiving insurance verification from a patient, then filing a reimbursement request, following up, in the proper time frame, on the appropriate claim forms. This request is reviewed by an individual or an entity granted authority by a United States department of health and Human Services, Department of Medicare, or a similar government agency. In order to be granted an authorization to proceed with the reimbursement, the patient must demonstrate eligibility for receipt of certain benefits.
To receive reimbursement, medical billing companies employ trained claims adjusters who are responsible for identifying the appropriate category(s) for which to file the appropriate claim form. Additionally, medical billing services ensure that the appropriate statute of limitations for filing claims has been met. Medical billing services also help ensure claims are submitted on time. Delays in submitting claims may result in the loss or termination of coverage by the patient’s health insurance provider.
To aid in the medical claims submission process, many healthcare providers turn to third party assistance. Hiring an expert medical billing company to handle this process can streamline the submission of the medical claims, provide valuable information regarding the submission of claims, and aid in the preparation of additional insurance documentation. Many third party specialists offer their clients access to claims specialists and/or agents, in addition to medical billing service. Third party specialists can also assist in the medical claims submission and filing process by providing patients, their representatives, and/or their healthcare provider information regarding health insurance coverage under their specific plans.
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