In order to complete your duties as a medical biller efficiently; you must follow the medical billing process. Following this process leads to maximum and appropriate payments in a timely fashion. There are a total of ten steps you should follow; which include: 1.

Pre-Register Patients – In this step; patient appointments need to be scheduled and kept updated (Valerius, Bayes, Newby, & Seggern, 2008). Demographic knowledge should be collected; and basic insurance information should be put in the patient record, as well (Valerius et al. ).Reminder calls should be made so that appointments are not missed. Once patient comes in for appointment; a copy of the insurance card, front and back, should be put in the record, also (Valerius et al.

, 2008). 2. Establish Financial Responsibility – When a patient has insurance; the health plan coverage should be reviewed and eligibility needs to be verified (Valerius, Bayes, Newby, & Seggern, 2008). It should also be determined whether or not there is more than one insurance company.

If that is the case, the first payer should be determined.Check to verify that all conditions for payment have been met and the correct steps followed to assure payment for service (Valerius et al. ). 3. Check In Patients – If the patient is new to the practice; complete and detailed demographic and medical information should be collected (Valerius, Bayes, Newby, & Seggern, 2008). Returning patient’s information should be reviewed, verified, and updated if necessary (Valerius et al.

). Identification and Insurance cards should be copied, both front and back, and placed in patient chart. Any co-payment due for office visits should be collected.4. Check Out Patients – After the patient has been seen by the provider; treatments and procedures are recorded in the patient chart (Valerius, Bayes, Newby, & Seggern, 2008). A diagnosis code should be given along with any procedure codes applicable (Valerius et al.

, 2008). Any and all charges should be entered into the patient ledger with an updated balance. Any co-payments collected should be recorded, and balanced updated (Valerius et al. ).

5. Review Coding Compliance – Review all codes to be sure they have been properly applied (Valerius, Bayes, Newby, & Seggern, 2008).Make any corrections necessary to be in compliance. The payer should be able to understand the logical connection between the diagnosis and the medical services provided (Valerius et al. , 2008). 6.

Check Billing Compliance – Be sure to check that all payers’ rules have been followed for compliance (Valerius, Bayes, Newby, & Seggern, 2008). Follow the medical practices fee schedule when applying procedure codes to charges or fees being billed (Valerius et al. , 2008). Review the listed codes to verify they are billable (Valerius et al. ).

. Prepare and Transmit Claims – This is an important and major step in the billing process (Valerius, Bayes, Newby, & Seggern, 2008). Care should be given to prepare accurate and timely healthcare claims. Follow the practices schedule for transmitting claims on each individual payer group (Valerius et al. , 2008). A review should be done to ensure all charges have been captured and billed for, as well as reviewing the carriers rules against the charges to prevent denied claims (Valerius et al.

, 2008) (MedPro Solutions L. L. C. , 2010).8. Monitor Payer Adjudication – When payments are received from the payers/insurance companies; procedures, codes, and payments should be compared to assure they match (Valerius, Bayes, Newby, & Seggern, 2008).

Verify that any unpaid charges are explained and payments listed for each procedure are correct according to the payers’ contract (Valerius et al. , 2008). Prompt posting should be done into the patient and facility records (MedPro Solutions L. L.

C. , 2010), and an appeals process should be started for any discrepancies found (Valerius et al. 2008). 9.

Generate Patient Statement – After received payments from the payers have been posted; the patient account should be reviewed (Valerius, Bayes, Newby, & Seggern, 2008). The statement should contain any services rendered and the dates in which they were provided (Valerius et al. , 2008) (MedPro Solutions L. L. C. , 2010).

It should also include the charges for each service or procedure, any payments made by the patient, any payments made by the payer/insurance company, and any remaining balance (Valerius et al. 2008) (MedPro Solutions L. L. C.

, 2010). Payments received and balance should equal any expected fees (Valerius et al. , 2008). Any remaining balance should be billed to the patient with a clear explanation describing their responsibility (Valerius et al. , 2008) (MedPro Solutions L. L.

C. , 2010). 10. Follow Up Patient Payments and Handle Collections – Patient record activity and payments should be monitored and analyzed regularly (Valerius, Bayes, Newby, & Seggern, 2008).Patients with overdue bills sometimes need to be reminded; statements could be sent as a courteous reminder.

The practices financial policy should be followed in regards to overdue bills and collections started, if necessary (Valerius et al. , 2008). Although complicated; the medical billing process can be a success if everyone from the patient to the physician does their part (MedPro Solutions L. L. C. , 2010).

The more efficient and complete the biller; the more successful the practice (MedPro Solutions L. L. C. ).