Managing efficient cash flow is the skill to demonstrate in medical billing. Medical billing is the process of submission and follow-up on claims to insurance companies in order to receive payment for services provided to a patient. An Insurance company also uses medical billing & coding for payment to be justified to a healthcare provider. Essentially all the players are using medical billing of some sort in healthcare. Well, in theory. Each interested party is of course employing medical billing from a different point of view.
When researching medical billing you see a world that supports a medical practice through precision efficiency in billing communication. Hiring a medical billing coordinator or outsourcing medical billing to a medical billing service requires you ascertain how efficiently cash flow (reimbursement) will be managed from insurance companies to accounts payable at your medical practice. Cash flow is essential for any well run business. The business side of medicine must run efficiently for excellent patient care to be delivered.
Insurance companies of course ask these very same questions in reverse. Medical billing & coding is used by insurance companies to challenge the necessity of healthcare services rendered to patients. They want proof and a test of validity before each payment. This requires a medical practice’s billing department to go back and forth multiple times with an insurance company over a claim until it is paid. A medical billing coordinator at any size medical practice or facility must learn this dance. This is the essence of medical billing practices.
Many medical facilities have upgraded to electronic medical records to improve medical billing and coding practices from paper to electronic. But EMR has not defeated paper in healthcare for majority use. Medical billing & coding still requires paper and electronic skills.
To navigate the complexity of medical billing & coding, exams such as the CMRS exam and the RHIA exam offer distinction at certification schools for a career path in medical billing. It is a growing field and very rewarding for the right candidates.
To have a smoothly running medical practice you need to have an excellent billing department. For a successful insurance company you need to have an excellent billing department. Managing records, filing claims, preparing insurance forms and handling billing goes both ways in healthcare. And, the name of the game in medical billing is cash flow.