Account Receivable In Medical Offices

Charges – This is the financial obligation made to a patient’s account for services rendered.

Patients become frustrated, irritable and angry that they are sick. A common response is,” Why me?”

My career that I am researching for my junior project is Medical Coding and Billing. Medical Coding and Billing are two different jobs. Medical Coding is when a patient has any medical procedure or exam such as going to the doctor for the stomach virus or even going to the hospital for a broken bone. They work with the insurance companies by putting a specific number into the computer. There’s CPT Codes which stands for Current Procedural Terminology which is “ Codes to better understand the services their doctor provided, to double check their bills or negotiate lower pricing for their healthcare services. (About Health, 2014).”

Medical billing translates a healthcare service into a billing claim. The medical biller makes appointments, transactions, and follows the claim to ensure the practice receives.

Internal and outside auditors have a heavy role and responsibility in performing audits, preventing major accounting errors, and following (GAAP) guidelines. Several duties comprise the role of internal and outside auditor to follow specific protocol and ensure ethical standards are priority. The National Health Care Billing Audit Guidelines are relevant to address as well as why audit failures happen. Finally, how internal vary from external audit and why audits are overall important to health care organizations. It’s vital for health care organizations to maintain all necessary standards to conduct proper audits and uphold ethical standards for the financial health of the organization.

Patient Accounting and Practice Management systems are designed to help health care medical practices are to improve the quality of care, cut cost, reduce risk, and increase revenues. When it comes to the size of a medical practice from small, or to a large medical practice, multi-location group this will feather the system to allow in creating and maintaining a patient billing information much faster and more efficiently then it was ever before. Medical Assistants are able to enter a patient information and post any changes much faster and more accurately with the use of a simplified medical billing software that promotes physician acceptance and much greater investment protection that provides faster insurance reimbursement and to improve

Some estimate that the federal government loses 30 percent of every dollar it spends on medical claims, due to medical billing mistakes and fraud. With so many loopholes and regulations surrounding Medicare, it is impossible for one person to know every nuance. However, constant diligence and ethical practices are a cornerstone of catching and preventing medical billing mistakes.

The process for medical billing involves a health care provider submitting, and following up on claims with health insurance companies in order to receive payment for services rendered; such as treatments and investigations. Once the procedure and diagnosis codes are determined, the medical biller will transmit the claim to the insurance company. Most physicians have medical directors that review claims for patient eligibility. Physician reimbursement and the coding to support it are critically important to the sustained health of any physicians practice. Under the contract provisions the physicians are responsible for rendering the services to the patients. In the billing process physicians need to know how services are rendered.

The billing for services not rendered for are often done as a way of billing Medicare for things or services, that basically never occurred. This can involve forging the signature of those enrolled in Medicare or Medicaid, and the use of bribes or as Healthcare calls it, kickbacks to corrupt healthcare professionals. Upcoding of services is the act of billing Medicare programs for services that are more costly than the actual procedure that was done. Upcoding of items is also very similar to upcoding of services, but it involves the use of medical equipment. For example, billing Medicare for a highly sophisticated and expensive wheelchair, while only giving the patient a manual wheelchair is upcoding of items. Duplicating claims occur when a provider does not submit exactly the same bill, but alters small things such as the date in order to charge Medicare twice for the same service rendered. Therefore rather than a single claim being filed twice, the same service is billed two times in an attempt to receive payments from the government twice. Unbundling involves bills for particular services are submitted as fragmentary, which appear to be staggered out over time. Although, these services would normally cost less when bundled together, but by manipulating the claim, a higher charge is billed to Medicare resulting in a higher pay out to the party committing the healthcare fraud. Excessive services occur when Medicare is billed for something greater than what the level of

Balance billing is when the physician was able to bill the patient for any additional balance that was left over after Medicare paid. In order, for this to happen the patient needed to pay the full co-payment the doctor wanted and then submit a form to Medicare to reimburse them the amount they would have paid. This increases the financial risk with a Medicare patient because most Medicare patients can’t afford to lay out the full price of the co-payment right then and their, so they don’t pay their doctor bills. By not paying their doctor bills, they are gaining more debt in their life. Also the patients that can lay out the money can forget to submit the form and don’t receive their reimbursement. By doctors using balance billing, it can

When a patient enters a facility ( Dr.office, Hospital, Clinic or other) a chart is created or updated containing demographic information needed to process a claim and a patient account is created or updated. The information collected is then shared ( data flow) through the proper channels needed to create a billing and reference point. Charge capture is a method of reporting every service rendered to a patient so that proper billing can be done as well as documenting all important information pertaining to individual patients.

Since I became a mother, I have always wanted a job that would allow me to work at home. I have an associate in accounting and tried doing bookkeeping from home but that did not really work out. I did some research and found that being an insurance medical biller and coder is one of the best jobs to have for working at home. Top Medical Billers can earn over $40,000 a year either at home or in the office. “Employment of billing and posting clerks and machine operators is expected to grow by about 4 percent from 2006 to 2016. In 2006, billing and posting clerks and machine operators held about 542,000 jobs; 566,000 jobs are projected by

Medical field is one of the biggest fields. When I mention the word medical, the first thing come up to your mind are doctors or nurses. Some people that never work in a medical office, they don't know there are much more position in medical file you could work at, like medical assistant, technician medical coder or biller. Someone like me, don't like to deal with patient. Medical biller and coder is a good opportunity for me to work at. But what are medical biller and coder?

Medical organizations looking to streamline their operations often turn to medical billing companies to help them achieve this goal. Doing so frees up valuable time and resources and can actually increase revenue for the organization. How should a medical practice go about making this crucial selection, however? What should they be looking for? Following are some tips to help make this process easier.

Account Payable – records information about money that organization owes to suppliers and service providers