Medical billing process refers to the interaction between the healthcare provider and the payer normally an insurance company. Usually, this is a very daunting task for most healthcare providers. But however much this whole process may seem complex and complicated there can always be ways to make it simpler and more efficient. In this editorial has put together; the various ways to bill patients that will save you all the hassle that comes with billing.
How to bill various patients
In this kind of billing, the healthcare provider will bill the patient’s primary insurance carrier. Therefore, the primary insurance carrier will make payment to the healthcare provider according to the patient’s benefit plan. It is crucial for the patient to know and understand their plan benefits including all co-payments and deductible amounts that they are responsible for paying.
Payments by the primary insurance will vary depending on the type of insurance the patient has and how the insurance determines payment. Some payment plans may look at the range of fees within the community, others may pay according to a contracted rate, and others will pay a predetermined amount regardless of the fees charged.
Self-Pay financial policy
This means to bill patients applies to individuals without valid insurance information. If the patient has insurance but unable to provide their information at the time of their visit; then they will be directed to an insurance verification specialist for confirmation. Otherwise, if the patient lacks valid such information then, they automatically become self-pay. That, therefore, means the patient will pay for healthcare services at the time service is rendered on their own. Through this kind of billing, the patient will have to pay the exact amount charged.
If you are a Medicare patient, then the healthcare provider will prepare and submit your claim to Medicare on your behalf. With the Medicare option, the healthcare provider will allow the payment plan issued by Medicare whether it is equal to their claim or not. After Medicare pays the amount they allow, the healthcare provider will bill the patient and will be forced to forgive the rest of the amount if at all it did not match their claim.
This way of billing involves an array of approaches to managing health care, ranging from health maintenance organizations to standard indemnity. Their focus is on controlling and managing health care costs. It is done through several ways such as giving incentives to healthcare providers so as to keep costs down, initiating contracts with specific healthcare providers and a review process to prevent the use of unnecessary services raising costs.
With the above, various ways to bill patients, now health care providers can charge their patients with a lot of ease. All they have to do is to check if their patient is covered by any of the above bodies.