What Materials Are Needed to Do In-House Medical Billing?

Instead of outsourcing claims to a third party, practices opt to bill in-house for their services. Initially, there is a higher startup cost with in-house billing for supplies and materials. On top of that, physicians must hire qualified medical coders and billers for the entire claim cycle. The benefit to in-house medical billing is that the physician oversees the process on site and all revenue generated is applied to the practice instead of to a third party.

Office Equipment

• Standard office equipment such as a fax machine and telephones are used for in-house billing. Phones are used to call patients and insurance companies, and phones should be programmed with a secure voice mail. Fax machines are fast and efficient tools to deliver claims and appeals to insurance companies.

Computer Network

• Insurance companies have online verification tools for providers to check eligibility, benefits and claim status. A computer with Internet access and the ability to create spreadsheets and documents is needed for in-house billing.

Forms

• Physicians are required to use CMS-1500 forms to bill for non-facility claims. According to the Centers for Medicare & Services, forms are available from local suppliers or the U.S. Government Printing Office at 866-512-1800.

References

• Current copies of the ICD-9, CPT and HCPCS books are used by physicians, billers and coders to verify charges.

Billing Software

• To submit electronic claims, physicians need medical billing software and a claims clearinghouse. Software is used to create claims, which are then uploaded to the clearinghouse. The clearinghouse checks for errors then submits the claim to the correct insurance company.

Support Staff

• Support staff, including billing, coding and patient account representatives, are essential to any practice. They enter charges, submit claims, follow up on reimbursement, post payments and bill patients.