When you say medical billing, you are referring to the process that involves submitting your medical claims to the insurance company so that you can receive some money from the services that have been given to you by the health care professional. To get more info, visit Apex EDI. Before a patient will be treated and then billed by the hospital, the health care providers must first check if the service that they will be providing to the patient makes their services eligible for the patient getting electronic medical claims for them. Each insurance company will have their own set of medical directors who are capable of reviewing the claims process and the electronic medical claims being done by the patient. In addition, they review on how valid the payment is being done based on the necessity of the health care service or treatment as well as the credential that the health care provider has. Once electronic medical claims are made to check if they are eligible, the insurance company must get back to the patient regarding their eligibility by electronic methods most commonly through their own website. If the electronic medical claims are verified by the insurance company to be eligible, then reimbursements to a particular percentage will be given depending on the billed amount. If the electronic medical claims are not approved, then the health care provider will also be informed regarding the matter.
At the start of the year 1997, when it comes to patient interactions, everything must go as per the standards being imposed by the HIPAA. According to the HIPAA, electronic medical claims for services should be done electronically. Read more about Electronic Medical Claims at www.apexedi.com. This is required across health care institutions so that abuse and fraud will be prevented on the part of both the delivering of health care services as well as on the part of the health insurance company. In the past, manual filing was being done. Now, electronic medical claims are being done as they are more accurate and fast. By doing electronic medical claims, both denial and rejection have been drastically decreased. On the other hand, the reimbursement percentage has also increased.
When you say electronic medical billing, this is more of a combination between the health care industry and the IT industry. The current medical billing programs are currently known as medical practice management software. Medical practice management software of today makes sure to take care of several functions including generating records, patient diagnosis, patient visits, tracking insurance payments and billing information, scheduling appointments, and tracking patient demographics. Learn more from http://thechart.blogs.cnn.com/2012/03/05/could-electronic-medical-records-actually-add-costs/.
