What exactly is Medical Billing .......
Medical Billing is the process of submitting health insurance claims on behalf of the patient to various health insurance payors for the purpose of acquiring payment for services rendered in a medical facility.
A Medical Biller gathers several types of data to be placed on the CMS 1500 Form (physician billing) or the UB-04 Form (hospital billing). This process can also be called Revenue Cycle Management (RCM).
Revenue Cycle Management
In addition to gathering data and submitting the insurance claim form to payors, it is the responsibility of the Medical Biller to ensure that the data is accurate and that the claim is adjudicated properly. Payments coming from either the patient or the insurance payor are posted to the claim by the Medical Biller. Any remaining balances are then either written off, adjusted or pursued in collections.