Essential Steps To A Successful Medical Billing Process!

As a medical professional you have a lot on your plate and to provide the best to your patients you need money. The cash flow is going to be prompt only if your billing and claims are clear. The medical profession suffers the most in terms of finances due to the high percentage of rejected claims. The best way to get a successful claim is to get your medical billing right and detailed. There are organizations that provide billing services to medical professionals like G.I Health Solutions. If you want your medical billing procedures to be successful you can contact billing service providers. In case you don’t want to hire any third-party service you can get it right on your own.

Following are some essential steps to get your medical billing right every time.

Properly Document Patient’s Check-ins

When the patient is walking through the door of your clinic you need to make sure that each and every detail of his is being recorded. The detailed registration process of a patient is the key to a successful billing process.

The registration must include the patient’s primary data, the reason for the visit, and insurance details. The insurance plan and its validity are one of the most crucial things to check and verify when registering a patient.

The best way to deal with the registration is to get assistance from software so that the patient does not have to re-enter his information every time they visit. This will not only save the time of the patient but will also omit the chances of errors.

Besides the registration process, if the patient is regular you must update their demographic details and their insurance-related details. This will help you while filing medical claims.

Verification of Given Details

After registration, the verification of the given details is very important. It starts with the demographic details of the patient to the financing details. You must be aware of the insurance plan of the patient. Look for the details in their insurance plans. Ask if the insurance plan covers your services or not.

Some of the patients have a primary plan and some have a secondary plan even though some people have tertiary plans. The point is, to look for the details that can delay or decline the reimbursement process.

It is important to check for changes in insurance plans. This can damage your claim submission. You need to be careful about the number of visits your patient’s insurance covers. Look for other financial details that you think might disturb your medical claims.

Diagnosis and Treatment’s Coding

The medical billing system is very much dependent on medical codes. The code for each service will define the type of service used by the patient. These codes are standardized by CPT and ICD-10.

The diagnosis and all the procedures and treatments have certain codes that must be used by the billing staff to ensure smooth medical billing.

Not only this is important for billing but also for medical claims. These codes will give the complete information of the services availed by the patient from check-in to the facility to check-out.

Start The Claim Procedure ASAP

The claim procedure depends on the medical billing software and the information put in the software by the biller. The medical coder will receive the claim form through the billing software. The claim filed will contain the charges and details of the services.

It is the responsibility of the billing staff to check the claim file thoroughly and put everything according to the medical codes. The claims have a basic structure that has the basic information of the patient, medical history and the treatments and procedures received by the patient.

The Medical Claim Submission

After the hectic medical claim filing there comes another crucial step which is claim submission. Clean claim submission is the key to a successful claim. The claim file must include the patient’s information, all the details about the service provider, and insurance details. The billing form must be prepared by using medical coding. Once the claim is prepared it is ready to submit to the insurance company for reimbursement.

To get a clean medical submission the billing staff must make sure that the information of the patient and provided services are all correct. A little mishandling can cost a lot while idling a submission. To get full reimbursement make sure all the coding compliances are followed and submitted correctly.

Another thing that is crucial to the claim submission is the timing. Make sure you submit the claim within the time frame provided by the insurance company.

Follow Up

The most crucial step of the billing is to get paid obviously. For successful payments, it is important to get regular follow-ups from the patient. The follow-up should not just be about the payment or at the end of the service. You can take follow up on the insurance plan and services.

The billing staff or service provider is an important factor in medical billing. It is the billing staff that will ensure that the service provider is paid completely. The follow-up and payment receiving can become a little rough if the patient is hard to reach or trying to dodge the payment. In that case, proper emails, warnings, and phone calls can be used. If the patient is still hesitant to pay you can always hire a collection agency to get yourself fully paid.


The medical profession is indeed the noblest profession but it still needs its fair share of the money. To keep the cash flow steady you need a proper billing system. You can get the manual billing system on your own or you can get the service provider. Whatever way you choose you to need to get your payment as soon as possible. There are services like G.I Health Solution that can make your billing procedure a piece of cake with their services. Follow the above-mentioned steps to get every bill of your service on time.

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