Question

immediate family c the medical history of the patient's , before being 25. ILO 1.61 Claims are subjected to a series of reviews, or transmitted to a payer a. status reports b. adjudications c edits APPLYING YOUR KNOWLEDGE eolWhy does a medical insurance specialist need to learn about electronic health records? 27 ILo 1.1-1.31 Now that you understand the functions of practice management programs an 28. ILO 14-1.6 Figure 1-4 illustrates the medical documentation and billing cycle. Some of the 29. ILO 1.5) Why is it important to verify a patient's insurance before the office visit? electronic health records, explain why many in the healthcare field believe these programs can trim costs and improve quality steps in the cycle, such as Step 2, Establish Financial Responsibility, focus more on billing activities. Explain how Step 4 includes a focus on both billing and clinical functions. 30. ILO 1.5) Why is it necessary to collect payments from patients during check-in? Enhance your learning by completing these exercises and more at http Chapter 1 INTRODUCTİON TO HEALTH INFORMATION TECHNOLOGY AND MEDICAL BILLING THE IT

Answer 1

Medical specialist is the one who examine all the record of the patient and compare the payment and explanations of the procedure.

The in patients procedure should followed in the benefit of the patients and the hospital. Like medical coding, medical billing might seem large and complicated, but it’s actually a process that’s comprised of simple steps. The procedure of registration, establishment of financial responsibility, for the visit of patient check-in and check-out, checking for coding and billing compliance, preparing and transmitting claims, monitoring payer adjudication, generating patient statements or bills, and assigning patient payments and arranging collections. There is a difference between front of house and back of house duties when it comes to medical billing.

It is believed that the procedure can trim the cost and improved the quality of care because of immediate access to the latest clinical research on diagnosis and treatments. T he most frequently advantages are increased patient safety, improved quality of care and greater efficiency because of the immediate retrieval of the information. The claims are processed electronically and payments received through direct deposits which cut the cost of spending on papers and stamp and other expenses that go along with the paper filing.

Financial responsibility describes who owes for a particular doctor’s visit. Once the billing authority has the pertinent info from the patient, that billing authority can then determine which services are covered under the patient’s insurance plan.

Insurance coverage differs dramatically between companies, individuals, and plans, so the billing authority must check each patient’s coverage in order to assign the bill correctly. Certain insurance plans do not cover certain services or prescription medications. If the patient’s insurance does not cover the procedure or service to be rendered, the billing authority must make the patient aware that they will cover the entirety of the bill.

To Establish Financial responsibility for the visit it needs to ask about insurance information before the visit to ensure doctor accepts insurance. Then the insurance is verified before appointment and verification can be done.

An insurance verification specialist is a health care professional working to ensure that patients' health care benefits cover required procedures. He contacts a patient's insurance company to verify coverage levels and works with individuals to educate them on their benefits information.

Verifying benefits is the process of gaining information regarding a member's insurance coverage. It also helps to alleviate surprises along the way and can be used where appeals may need to be written. Sometimes insurance company representatives give incorrect or conflicting information as the Medical insurance is an agreement between the policyholder and a health plan.

It is very important and necessary to collect payment from the patients during the check-in to maintain a regular cash flow. This maintains the flow of financial transactions in a business. A term used to describe money coming into a business and a fixed amount that is paid to a provider in advance to provide medically necessary services to patients. Under an insurance plan, it is required that a portion or percentage of the charges that the patient is responsible for paying, a small fee paid by the patient at the time of an office visit. It is a value that stands for a patient's illness, signs, or symptoms .