Required Discussion Billing Workflow: Two main components

Providers of all types must first verify a patients eligibility through their health plan either before or during a patients visit or admission to a facility. The provider then bills the primary insurance, or third party, in order to receive payment. The insurance bill, also known as a claim, provides a procedure code for the services received and codes for any supplies that were used during the service along with a diagnosis code. The claim is then sent to the insurance plan for a remittance, once it is adjudicated, for a payment to be sent to the provider. Once a payment is received by the provider, it is recorded on the patient account. Most of the time, the amount billed is not the same as the amount paid. Thus, any...