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What is Medical Billing?

Any medical center, be it a doctor's office or a hospital can not run without its medical billing. It is the way the medical center counts its revenues derived from the patients treated there.

Though the term medical billing may be familiar to you and you know what it signifies, there are a lot of others who harbor a wrong conception about the phrase medical billing.

 

Most people confuse the term medical billing with medical transcription or medical coding, when in reality, all three have their distinct differences. Though their roles sometimes overlap and all of them are inter-related, it is still true that medical coding involves only coding and medical transcription is related to transcription of a doctor's prescription or notes.

One way to understand what medical billing is that this is the way a doctors recovers his fees for his services to a patient by submitting claims to insurance companies. Perhaps the question could be best answered by this definition:

Medical billing is practice management and includes a broad spectrum of job functions. When compared to medical coding or medical transcription, medical billing is broader in its operational scope as well as responsibilities. For instance, front office implies working as an executive secretary to the practice, clerical responsibilities like patient scheduling and attending appointments, documentations regarding patient visits, keeping record of diagnostic and treatment processes, keeping track of medical records and all this is done using a medical billing software program.

What is the job of a medical billing professional? Well, it starts from the time you make the office visit where you schedule the patients' one after the other and then ensure that the patients keep their appointments. After the patient has been seen by the doctor, you ought to update the patients' medical records, depending on what has been advised and what other services provided at the center.

The medical record of every patient has to be kept in an organized manner by the medical billing professional following the system adopted earlier in the practice. The medical record contains all the demographic details as well as the summary of treatment given to the patient. The medical records are organized according to the contents. This ensures easy accessibility in future in case of a similar circumstance arising later. This record is also needed for creating the medical bill which is to be submitted either to a clearing house or to the relevant insurance company.

As is evident the job of a medical billing professional is critical in the running of a medical center. The skills required are: attention to details, accuracy, and familiarity with dealing with insurance forms as well as keeping track of patient records and accounting.

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Medical Billing Fraud Headlines

Leaders: Public is best defense against health care fraud - MetroWest Daily News


Leaders: Public is best defense against health care fraud
MetroWest Daily News
Waddell said while some perpetrators of healthcare fraud are quite dull, others are not. “As programs have expanded, there's a lot of money out there, and the crooks are getting much more sophisticated as to how they are going to get some of that money ...

and more »

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NY to boot crooked doctors from no-fault insurance - Wall Street Journal


NY to boot crooked doctors from no-fault insurance
Wall Street Journal
"For every fraudulent medical mill, there's got to be a doctor attached to it or they couldn't do the billing," Lawsky said. "The doctor is sort of at the top of this medical mill pyramid. So we have to go after these dirty doctors.

and more »

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City native agrees to pay US $676100 for health care scam - PennLive.com


6abc.com

City native agrees to pay US $676100 for health care scam
PennLive.com
A Reading native and former assistant dean of Temple University's School of Medicine has agreed to pay the US government $676100 in a civil settlement in a health care fraud scheme in which he billed patients for medical care handled by residents.
Temple University, Physician Agree to Pay DOJ $1.09M for Fraudulent BillingBecker's Hospital Review
Temple, former med school official settle with feds over billing fraudNewsworks.org

all 26 news articles »

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Report: Suspect billings at 2600 drugstores - Boston Herald


MiamiHerald.com

Report: Suspect billings at 2600 drugstores
Boston Herald
Medicare also said it has anti-fraud contractors that are already keeping close tabs on the program. "We believe it is important to note that (the inspector general's) report identified what appeared to be questionable billing based on its own data ...
Medicare billing flagged at 4 percent of US pharmacies: governmentChicago Tribune

all 435 news articles »

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107 charged in Medicare fraud crackdown - Los Angeles Times


MiamiHerald.com

107 charged in Medicare fraud crackdown
Los Angeles Times
In addition, officials in the Health and Human Services Department suspended or took other administrative actions against 52 medical providers after analyzing billing requests and finding additional "credible allegations of fraud.
107 Charged With $452M in Medicare FraudBusinessWeek
107 Medical Professionals Arrested, Connected to $400 Million in Medical FraudSurfKY News
Feds arrest more than 100 Medicare fraud suspects in South Florida, nationwideBoston Herald
Chicago Tribune -Fox News
all 201 news articles »

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