The Troubles of Billing in a Medical Office Part I

It is very difficult to collect claims in a medical office.

The basic premise consists of the following:

Step 1

The patient comes to see the Dr. who examines the patient and fills out a superbill that looks very similar to this:

Step 2

After Dr. completes the superbill, she hands the bill to the billing staff. We input the claim according by adding in each CPT code(or procedural code) along with the appropriate ICD codes(diagnosis codes, whatever the patient was diagnosed with.)

Step 3

That claim is then sent to the clearing house. The clearing house will run a set of checks on the claim and send it back to us if there is anything wrong.

Step 4

Once I fix the claim, the claim is sent back to the clearing house who then sends it to the insurance company. The insurance company will then go through the claim and send us the remittance.

Then you pray you get paid.  Next post:  a million ways your claim can get denied.