This website uses cookies to ensure you have the best experience. Learn more

Summary Of Ten Steps Of The Billing Process And Procedures

962 words - 4 pages

1. Summary of ten steps of the billing processes and procedures. (explain each process)
In addition include:
a. Content and use of Registration or Encounter Forms,
b. Explanation of Benefits (EOB), and Remittance Advice (RA),
c. Advance Beneficiary Notice (ABN),
d. Participation Contracts,
e. The adjudication process for payers and providers.
A. Pre-registering patients: The main function of the first step is to schedule and update appointments as well as gather personal and insurance information about new and existing patients. New patients provide personal and insurance information to the scheduler, and pre-existing patients update any personal or insurance information with the practice that has changed.
B. Establishing financial responsibility: The second step is viewed as the most important because it determines what services will and will not be covered by medical insurance. It also determines if the patient or the insurance company is responsible for the payment of services. In a lot of cases, payment plans will be offered to patients with high out-of-pocket self-pays, like specialized procedures that insurance will not cover. Even if medical insurance is used, a copayment is generally required by the patient. Many physicians participate in more than one insurance contract, which are judged by the financial arrangements that are offered by the plan. Managed care systems are the most popular with physicians.
C. Check in patients: In this step, new and returning patient information is verified, outstanding balances are reviewed, insurance information is taken and placed in the patient’s file, necessary paperwork such as privacy and release of information statements are signed by the patient, and out-of-pocket expenses such as copayments and self-pay fees are collected from the patient. One form that may be presented to the patient by the physician is an advance beneficiary notice of noncoverage (ABN). An ABN will be presented to a patient to sign if the provider believes the procedure or treatment will not be covered by Medicare because it is not reasonable or necessary. The patient will be advised of this before the procedure or treatment begins, giving them the option of whether or not to follow through with the encounter.
D. Check out patients: In this step, diagnoses and procedures are recorded and assigned a medical code, which is recorded on an encounter form by the physician or the billing specialist. An encounter form is used to record the services provided by the practice. Encounter forms are also known as charge slips, routing slips, and superbills. Encounter forms list the practice’s most performed procedures and corresponding codes (fee schedules) for easy filing, as well as any insurance companies under contract with the practice. Previous balances, coinsurance, deductibles and fees for uncovered services are also listed on the encounter form and brought to the patient’s attention. Upon payment of the patient’s balance,...

Find Another Essay On Summary of Ten Steps of the Billing Process and Procedures

Influence of legislation on the development of policies and procedures

1126 words - 5 pages Legislation, policies and procedures in the workplace are designed to ensure the wellbeing and safety of all individuals and employees. They provide a set of rules which should be followed at all times by everybody, so the actions of one person cannot negatively influence somebody else. If someone is found to be acting in a way deemed inappropriate by health and safety guidelines, this can be brought to the attention of supervisors with minimum

Courtroom Procedures and the Role of the Prosecution

1206 words - 5 pages During a trial, there are many rules, procedures, and codes of conduct that must be observed. These are in place to allow a trial to proceed more efficiently and fairly for both the defense and prosecution. According to one author, “Police, prosecutors, and criminal court Judges see too much crime, so they tend to see crime everywhere. We need rules to control their conduct, Judges to carefully apply those rules, and other Judges to review

Understanding the Importance of Policy, Procedures and Protocols

689 words - 3 pages especially important for new officers, starting out. The policy is number one on the list of need to know things once you join the LSPD. Not following policy can easily get you in a lot of trouble, and depending on the seriousness of the situation, it could even lead to a dishonourable discharge. Like policies, procedure is also very important in the work place. Procedures can make or break a situation, meaning you must follow procedure at all

This is a process paper which guides a reader through the steps of a golf swing

754 words - 3 pages The Golf SwingThe golf swing is a complex and unnatural motion that can only be perfected through practice and drills. The most important thing to remember about a golf swing is that there is no one ideal swing that works for everyone. But by improving key elements of the swing a player can easily advance their game. If a person watched a professional golf tournament, they would see that there are as many different swings as there are players

The Ten Principles of Conservatism

2307 words - 9 pages Conservatives believe communities can provide structure for the natural change that they believe should be the real way of progress and that communities are capable of providing a counter force against the concentrated power within the government (Dunn, iii). Thus, community must be near the top in a list of fundamental conservative tenets, and community is the third in this list of ten principles of conservatism (Dunn, iii). Conservatives

Steps in the Accounting Process

795 words - 3 pages There are five steps in the accounting cycle, which when finished lead to the trial balance, adjusting entries, preparation of the financial reports and the closing entries. These steps are repeated during each accounting period, monthly, quarterly or yearly. I work for Fidelity Investments and the accounting cycle from start to finish is electronic. This helps the accountants, as they will always have a paper trail that is important, especially

To detemine the heat of combustion of ethanol and methanol. Procedures and conclusion

1358 words - 5 pages check the temperature. Once the temperature is 10oC greater than the initial temperature, extinguish the spirit burner.Seventhly, reweigh the mass of the spirit burner.Eighthly, Repeat steps 1 through to 7 for ethanol (CH3CH2OH).The combustion of Methanol and Ethanol can be represented through:Methanol: 2CH3OH(l) + 3O2(g) 2CO2(g) + 4H2O(l)2(358+463+(414x3)) + (498x3) (804x2x2) + (463x2x4)5620 69206920-5620= 13001300/2= -650 KJ/moleEthanol

Evolution of the Blues, Effects of Psychedelia and the Ten-Year Arc of the Beatles

700 words - 3 pages repetitive. Various artists were involved in the production of psychedelic music. They include Jimi Hendrix, Santana and Janis Joplin among others. Psychedelic songs in the 1960s include, Lucy in the Sky with Diamonds, Rain and I Feel Fine by the Beatles and Still am Sad, Over Under Sideways Down and Shapes of Things by The Yard birds. 3. The Ten-Year Arc of the Beatles The Beatles were a rock band based in England between the year 1960 and 1970

The Brave Story of Corrie ten Boom

1119 words - 5 pages The Brave Story of Corrie ten Boom “There is no pit so deep that God’s love is not deeper still.” Corrie ten Boom has spoken these words more times then she can count on her fingers; they encouraged her through heartbreak and pain, World War II and the risk of hiding Jews, concentration camps, and even the death of her sister

The 1960s: Ten Years of Trouble

1538 words - 7 pages “I Have A Dream!” These are the heart spoken words of Martin Luther King; these are words that may have defined a generation. The decade of the 60s was confined to many troubles and problems while many sought to overcome the oppression of the modern world. Men like Martin helped to bring the country together. But it isn’t the people that defined the twentieth century. It was the age of great politicians, a boom of technology, and an explosion of

5 steps to the Adjudication Process

539 words - 2 pages this flow chart is to show you the steps you must take and explain the process of each step and what the purpose is for.5 STEPS OF THE ADJUDICATION PROCESSStartPayers first perform initial processing checks on claims, rejecting those with missing or clearly incorrect information: This will determine if reimbursed each insurer has their own way of claim approval but the process is basically the same.Claims are processed through the payer's automated

Similar Essays

Ten Steps Of Coffee Production Essay

1945 words - 8 pages commonly use coffee beans which are Arabica and Robusta. Both of the coffee have different in their taste, growing conditions and price (Faith D, 2008). There are basically 10 steps to coffee production which are planting, harvesting the cherries, processing the cherries, drying the beans, milling the beans, exporting the beans, tasting the coffee, roasting the coffee, grinding coffee and brewing coffee (William, 2009). The first step in

Summary Of The Federal Reserve's History And Policy Procedures

838 words - 3 pages funds rate as an operating target promoted a procyclical monetary policy despite the Fed's lip service to monetary aggregate targets.Ć New Operating Procedures: October 1979 - October 1982In 1979, the Fed finally deemphasized the federal funds rate as an operating target by widening its target range, and the primary operating target became nonborrowed reserves. However, the deemphasis of the federal funds targets still did not result in

The Summary Of "D.L. Moody On The Ten Commandments"

1199 words - 5 pages King Belshazzar was weighed in the balances and was found wanting. Would you be if you were weighed against the ten commandments? The first commandment says “Thou shalt have no other gods before me (Exodus 20:3).” Every person has a natural tendency to worship some kind of God. We read in scriptures how the Israelites were worshipers of idols. Gods of wood and stone are not the only gods there are. Moody tells us that there are gods of

The Following Is My Summary Of The Ten Early Perspectives Of Psychology

1130 words - 5 pages is my summary of the ten early perspectives of psychology.Structuralism, as defined by our textbook, is "the earliest approach in modern psychology, founded by Wilhelm Wundt; its goal was to evaluate the basic elements of a cognizant experience." Davis and Palladino (Page 25 Para. 1) . Wilhelm's student, whose name was Edward Tichener, brought Wundt's ideas of structuralism and psychology to the United States. "Tichener's research depended upon a