Medical Billing and Coding are a process to generate healthcare claims to submit to insurance companies to obtain payment for Medical Services rendered by healthcare organizations.

There are a few steps in the Medical Billing process that involve insurance verification, patient registration, charge entry, Medical Coding, encounter, claim submission, payment posting, and follow-up on claim denials.

There is a difference between the two as Medical Coding involves translating health diagnoses, Medical Services, procedures, and equipment into universal Medical Codes while Medical Billing is about submitting and following up on claims to insurance companies.

There may be several reasons that you received a bill that may include co-payment, deductible, co-insurance, or services that may not cover insurance or services provided out-of-network.

You should view the denial reason if your insurance claim is denied, contact your insurance company for clarification, provide additional information, correct errors if any, and submit the claim.

Major reasons for claim denials may include coding errors, incorrect patient information, lack of pre-authorization, services not covered by insurance, and claim submission after the deadline.

An Explanation of Benefits is a document that an insurance company sends to you sharing details of the services and medical treatments paid for on your behalf. The information includes the amount covered, the amount billed, and any patient responsibility.

The most feasible way to dispute a Medical Bill is to first review the bill for errors, then contact the billing office to discuss the charges, and provide the essential documentation that supports your dispute. If need be file a formal dispute with your Medical Billing advocates or insurance company.

Co-payment is a fixed amount of money that you pay for covered services. Co-insurance is the percentage of the cost you pay after receiving your deductible while on the other hand, the deductible is a cost which as a policymaker you pay for your healthcare services before your insurance begins to pay.

You can contact your healthcare provider’s billing company to check the status of your Medical Bill. You can also call your insurance company’s customer services or check your insurance company’s website.