Digisign Medical Invoice Made Easy

Esign medical invoice

so now we're going to talk about the payment process how that process flows it starts out with a patient visit to the physician who evaluates the patients and they document the conditions this information isn't in assigning appropriate diagnosis to the icd-10 code or in the cpt treatment code for any treatments they receive the diagnosis and treatment codes are typically documented on a super bill and sometimes the physician or provider will check or circle the diagnosis and treatment need any modifiers indicating modifications to the treatment and then the medical billing specialist will get involved here this is where they click the super bill the insurance information and the patient demographic information and input all this information into the practice management software this is sometimes referred to as a medical billing software this is where the claim is then created and uploaded or transmitted to me to the insurance company or more typically to the Clearinghouse continuing with the payment process if there any problems with the claim the medical billing specialist will follow up and find out what's wrong correct the claim and then resubmit it they may also file an appeal insurance payer which could be a written letter or some additional documentation to support the insurance claim and once the payments are received from the insurance carrier it's a company but what's referred to as a remittance advice statements and tons of her truism PRN for an abbreviation this information is entered into the practice management software and it's reconciled with the patient account the claim for that patient visit if there's any co-pays or coinsurance or deductibles patient statement will then be printed and mailed to the paid to the patient any unpaid claims required investigation and follow-up to keep the accounts receivable low for the practice this is something that the medical billing specialist is involved in frequently any delinquent patient accounts may require additional statements or letters and coordination with a collection agency if necessary so here's a very simple diagram of the reimbursement process it starts out when the patient visits gathering the insurance information in their demographic information and collecting their copay once that's collected the patient's visits with the provider and the encounter is documented this documentation is used to assign the appropriate diagnosis and treatment codes and all of this information is then collected and entered into the practice management software this information is then used to create a claim typically that's an electronic claim very occasionally me rarely like less than 5% of the time but paper claims is created and that's at that point it's just printed out and mailed to the payer electronic cleanser then submitted or uploading to the Clearinghouse and a batch and these are checked for any errors once they are received or uploaded to the Clearinghouse and if they pass that test pass any checks there they're then transmitted to each individual insurance company your insurance payer if there are any errors those are corrected and resubmitted to the Clearinghouse where they're once again submitted to the insurance payer is the claim is okay then it goes to the insurance payer for the adjudication process the insurance payers education process is just simply the process that they go through to determine the amount to reimburse to the provider and adjustments are made these would be indicating on the electronic remittance advice and the payment would be posted and reconciled in the practice management software once insurance payments have been received and reconciled the patient would be billed for any remaining balance that would be coinsurance or deductible typically and those statements would be sent to the patient and and payment made directly to the provider by the patient for those remaining balances so that completes lesson 1 a brief description of what medical billing is next in chapter 2 we'll be talking about some of the more common terms and acronyms used in medical billing