Question

Provide an example of a procedure or service that can be billed. How would the procedure or service be paid by a 3rd party and a Medicare payment system? Include numerical calculations.

Answer 1

A third party payer is, to put it simply, anyone who pays for medical services other than the patient himself. There are several types of third party payers for healthcare services in various countries. The most commonly seen ones are private Insurance companies subsidies provided by government. All of these third party payers will cover a of what the patient owes for his portion medical services, and each type of payer has its own set of conditions that must be by the clinician or facility met the providing service in order for it to get paid,

Billing Cycle 1. You contact a pre-register & health care provide basic provider, information to the office such as identification & insurance information 2. Health care provider contacts your insurance company in order to venity t o 3. complete registration procen t a 4. After services are received by medical the coders Ę update your records with corresponding service codes. an insurance 5. The health care claim using provider create these codes and to 6. A claim procesor who works for your you've received Fall insurance provider & under your coverage benifits. 7. Insurance claim is valid, insurance reimburses your healthcare provider Helgi by paying for some or all of the service. & healthcare providers bills you for the remaini. balance