What is Refund processing in medical billing? It is the process of returning back the excess or additional money paid by the insurance or patient on request. If the payment is received in excess than the specified amount, insurance or patient can request for a refund. Whats a patient refund?Read More →
Charge entry is the process of assigning to the patient account an appropriate $ value as per the chosen medical codes and corresponding fee schedule. The reimbursements for the healthcare provider’s services are dependent on the charges entered for the medical services performed. What are demo entries and charge entries?Read More →
Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. Medical billing translates a healthcare service into a billing claim. What are the steps in medical billing? The 10 Key steps forRead More →
A CPT modifier is a code that allows a healthcare professional to indicate that a procedure or service has been altered in some or the other way. However, the original code or the definition won’t change. What is modifier use? A modifier changes, clarifies, qualifies, or limits a particular wordRead More →
A point of sale (POS) is a place where a customer executes the payment for goods or services and where sales taxes may become payable. A POS transaction may occur in person or online, with receipts generated either in print or electronically. What does POS 11 represent? Physicians shall useRead More →
These steps include: Registration, establishment of financial responsibility for the visit, 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 What are the 10 steps in the medical billing process? 10Read More →
PQRS is a quality reporting program that uses negative payment adjustments to promote reporting of. quality information by individual EPs and group practices. Those who do not satisfactorily report data on. quality measures for covered Medicare Physician Fee Schedule (MPFS) services furnished to Medicare. Who created the PQRS? The CentersRead More →
HMO means “Health Maintenance Organization.” HMO plans offer a wide range of healthcare services through a network of providers who agree to supply services to members. With an HMO you’ll likely have coverage for a broader range of preventive healthcare services than you would through another type of plan. WhatRead More →
A Tax Identification Number (TIN) is a nine-digit number used as a tracking number by the Internal Revenue Service (IRS). It is required information on all tax returns filed with the IRS. Is NPI the same as tax ID? WHAT IS THE DIFFERENCE BETWEEN A TAX ID A GROUP NPI?Read More →
Insurance Term – Coordination of Benefits (COB) This is a provision in the contract that applies when a person is covered under more than one health insurance plan. It requires that payment of benefits be coordinated by all health insurance plans to eliminate over-insurance or duplication of benefits. What areRead More →