Demo Entry
Entering Patient Details, Guarantor Detail,
Employer Detail and Insurance Information into the system. ROI and AOB obtained
in front office from patient.
Coding:
Assigning predefined alpha numeric codes to
procedure and diagnosis. The coding department take this work. They will also
undertake hospital component other than professional component.
Charge
Super bill / Encounter Forms are used to
capture details like Date of Service, Referring Physician, Rendering Physician,
Place of Service, Type of Service, CPT Codes, ICD Codes, Modifiers,
Authorization or Referral Details and Copay Details.
Claim Submission
Claims
can be submitted through Electronic or Paper format. Paper claims sent directly
to the insurance. E-Claims initially sent to clearing house. Clearing house
converts into insurance specific format and dispatch to the insurance.