Medical Billing Facts

The medical profession has many different positions that specialize in certain parts of the medical process. Because medical treatments can be complex and involve many different steps and consultations, payment for these treatments can quickly become complicated, especially for the layperson. Medical billing is a branch that deals with these payments and how they affect patients.

Definition

• Medical billing gathers all the information available about a patient and their treatments. Usually, medical billers specialize in one particular hospital or branch, but sometimes they also gather payment information for outside procedures or consultations with specialists. Once all this information has been compiled, the medical billing department produces an invoice for the patient that shows them what they owe and breaks down all the fees involved in their treatment.

Process

• Medical billers have several different major tasks. First, they gather up all the bills and statements connected with the patient and go through them to ensure there are no errors in information. They also communicate with collection agencies and insurance companies regarding the state of the patient's payment and what parts of the payment should be covered by the insurance the patient has. Billers also frequently meet with the patients themselves and explain different components of their bill.

Coding Information

• Medicinal terminology, diseases, and treatments all have their own codes that medical billers use to communicate information to organizations like insurance companies. These codes are used throughout different medical and insurance companies so data can be exchanged quickly, but with codes for every possible disease and treatment, medical billing departments must be experts at collecting and assigning codes. There are many types of software that help them do this.

Physician Limitations

• There is a sharp delineation between a physician's practice and medical billing. Doctors do not have time to focus on billing, and spend most of their time with patients and their medical records. Typically, doctors themselves know very little about the patient's bill and the fees associated with it. Medical billers often explain aspects of billing to doctors as well as patients to help them understand specific fee structures.

Analysis

• In addition to creating invoices and bills, the medical billing department also conducts analysis for marketers and others interesting in payment patterns for their health care organization. Billers assemble reports showing where the organization makes most of its profit and where money is being lost over time.