Medical Billing Systems Definition

Today s healthcare system is evolving rapidly not just with regard to patient needs and new treatment developments but also in the often unseen arena of medical coding and billing.

Medical billing systems definition.

Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. Integral to billing medical services and procedures for reimbursement cpt is the language spoken between providers and payers. The amount owed to mayo clinic indicated on the billing statement. Medical billing translates a healthcare service into a billing claim.

Cpt modifiers are codes that are used to enhance or alter the description of service or. Balance billing balance billing is the practice of a provider billing you for all charges not paid by your insurance plan even if those charges are above the plan s usual customary and reasonable ucr charges or are considered medically unnecessary. Medical billing is a complex and integral part of the modern health care industry. The same process is used for most insurance companies whether they are private companies or.

Medical billing is a payment practice within the united states health system the process involves a healthcare provider submitting following up on and appealing claims with health insurance companies in order to receive payment for services rendered. While much of healthcare is front and center between the doctor and patient much is still left to be done when the patient leaves the doctor s office or hospital. Following a physical examination a provider identifies the five digit current procedural terminology code that best describes the level of service. In this video we ll introduce you to billing and give you an idea of what activities a professional billing specialist completes every day.

Such as testing treatments and procedures. Introduction to medical billing. Current procedural terminology more commonly known as cpt refers to a set of medical codes used by physicians allied health professionals nonphysician practitioners hospitals outpatient facilities and laboratories to describe the procedures and services. We also called it cpt modifiers here cpt stands for current procedural terminology.