MEDICAL BILLING

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MEDICAL BILLING -

Many people have heard about medical billing, but are not quite sure what business it is. In a nutshell, medical billing is the business of getting health care providers paid. Most of this work involves filing insurance claims on behalf of doctors, chiropractors, therapists, dentists, and other healthcare providers to commercial insurance companies and government agencies such as Medicare and Medicaid.

Over the past few years, the most successful medical billing services have also expanded their services to include what is called "full practice management," meaning that they handle all the bookkeeping and accounting functions for their doctor-clients, including patient statements, recording payments, preparing financial reports, and even consulting the physicians on issues such as how to negotiate contracts with the growing number of managed care companies such as HMOs and PPOs that are trying to reign in doctors' fees.

Medical billing has become a "hot" business in the past few years, partially because of the advent and growth of electronic claims. Before computers, filing claims to insurance companies was a tedious and expensive process for doctors. A typical doctor who had several hundred patients, each with his or her own insurance company, was faced with a veritable quagmire in either letting patients file their own claims and waiting to get reimbursed before paying the doctor, or filling out the claims themselves to make sure it got done quickly and that the checks would be mailed right to them. As a result, many doctors opted for the latter solution and filed the claims for their patients.

The problem was that each insurance company had their own rules and regulations, and, worse, the filing of claims had to be done using annoying paper forms with dozens of little boxes to fill in. Claims had to be either handwritten or typed, and there were often many errors made in filling out the claims. As a result, getting paid was a nightmare, and many healthcare providers who had agreed to handle claims for their patients simply gave up on collecting some of their money out of frustration or confusion. Some doctors literally lost thousands of dollars per month in unpaid claims.
d that it was the responsibility of DOCTORS to file Medicare claims on behalf of their patients. Since the majority of people who see doctors are elderly, this meant that many doctors were literally swamped with Medicare claims to file, day in and day out.