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Health Care 2 Pages

Billing And Coding Process In Hospital

Question

Select a provider or health care facility coder/biller to interview and review the process they go through to satisfy reimbursement requirements for billing purposes.

Write a paper of 750-1,000 words that describes the processes that are utilized in producing a final bill. Include in the paper:

  1. How health care charging and pricing processes are different from those in other industries. 
  2. How private and government insurers and payers impact actual reimbursement. 
  3. Cite a minimum of three references to support your rationale. 

Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required.

Solution

Title: Billing And Coding Process In Hospital
Length: 2 pages (687 Words)
Style: APA

Preview

 Billing and Coding Process in Hospital

The charging and pricing process in a medical is different from other industries because it is not undertaken and/or executed by a single individual (Ferenc, 2011). The medical coding process involves approval of front office administrators or receptionists and back office staff (usually the medical biller and coder). The billing and coding process begins when a patient visits a health facility or schedules an appointment with a doctor and ends when the final reimbursement is collected from an insurance company and/or a patient (Hirsh & Harrison, 2010). The billing and coding processes in hospitals involves the following procedures:

Patient Check-in

When a patient is given medical services by his/her physician, the services are recorded and stored in a patient’s database. Medical coders use the patient’s record in a universally coded message and translate all medical procedures and diagnosis so as to bill the insurance provider. All transaction for the patient’s visit, including charges and payments are recorded in a ledger which is used by the medical biller to calculate the patient’s balance. The transaction information is later given to a patient as receipt and he/she can check out thereafter.

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