Best Medical Billing System
WHY DO WE BILL?
Going to the doctor may appear to be a one-on-one interaction, but it is actually part of a large, complex information and payment system. While the insured patient may only interact with one person or healthcare provider, the check-up is part of a three-party system. The patient is the first party. The healthcare provider is the second party. Hospitals, physicians, physical therapists, emergency rooms, outpatient facilities, and any other location where medical services are provided are all considered providers. The third and final party is the insurance company, also known as the payer. It is the medical biller's responsibility to negotiate and coordinate payment between these three parties. The biller, in particular, ensures that the healthcare provider is compensated for their services.Both patients and payers are billed. We bill because healthcare providers must be paid for the services they provide. To accomplish this, the biller compiles all of the information (found in a "superbill") about the patient and the procedure into a bill for the insurance company. A claim is a bill that includes a patient's demographic information, medical history, and insurance coverage, as well as a report on what procedures were performed and why.