Medical billing|AR CALLER|JOB | Revenue Cycle Management Part-3(Encounter to Payment posting)| Tamil

Revenue cycle management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.

1.Pre-Registration: Collecting information before the patient’s arrival.

2. Registration: Collecting subsequent patient information during registration.

3.Insurance verification: is all about the process of checking a patient’s active coverage with the insurance company and verifying the eligibility.

4.Encounter: An interaction between a Patient and Doctor explaining to patient about treatment(DX , CPT code).

5:Medical transcription: also known as MT, is the process of transcribing voice-recorded file into text format of medical reports that are dictated by Physician.

6. Demo Entry: is a process of entering Patient insurance and demographic details completely updating the information in the Billing Software.

6.Charge Entry: Charge entry is medical billing charge entry process, created patient accounts are assigned with the appropriate $ value as per the coding and appropriate fee schedule.

7. Coding: Medical coders are responsible for translating physicians’ reports into useful medical code.

8. Claim submission/Billing: The medical biller can either send the claims to the insurance companies either through Paper via mailing address or Electronic via a clearinghouse.

9.Claims Adjudication: Insurance decides whether to pay or deny.

10.Payment posting: All payers either send an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of a claim. The medical billing staff posts these payments immediately into the respective patient accounts, against that particular claim to reconcile them.

11.Denial management(AR CALLER FOLLOW UP): The accounts receivable follow-up team in a healthcare organization is responsible for looking after denied claims and reopening them to receive maximum reimbursement from the insurance companies. Medical billing AR and revenue cycle management handled by an in-house team is a thing of the past.

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