What Is Medical Billing?



According to a research paper published by BLS (Bureau of Labor Statistics, US Department of Labor), the projected report shows that 3 million jobs will be generated through 2016 in Healthcare industry and CMS (Centers for Medicare & Medicaid Services) declare that Healthcare insurers process over 5 million claims for payment in United States and a medical billing specialist ensures their provider of the successful processing of the claim with accuracy so that the provider can obtain optimum reimbursements.

What is Medical Billing:

Medical billing is the process of performing and maintaining day-to-day transactions for the Healthcare Providers. In other words, medical billing is the process of billing insurance companies and patients for the services provided by the doctor or other Healthcare professionals in order to get paid and maintain their records.

Medical Billing Service Includes:

Medical billing includes management of patient data and keeping their information safe according to the HIPAA (Health Insurance Portability and Accountability Act) compliance, which sets national standards for the security and confidentiality of patient records. It's a key position as far as the financial success is concerned because this position includes claim processing to insurance companies and patients which can receive provider paid for the rendered services and also adjustments and resubmission of claims in order to get best possible collections for the services and maintain the aging of healthcare provider according to industry standard. It also includes Denial Management to identify the problem areas in claim processing and prevent delay in payments to secure collection of all receivables and successful processing of claims.

To keep the healthcare providers updated of their financials, medical billers will also compile various types of financial reports and summaries which show the revenue of healthcare provider along with the projections for future planning. Using these reports, the healthcare provider can improve the effectiveness of business operations by identifying root causes and allocating resources to maximize revenue.

Certified medical billers enjoy a good position in market. Working in this field requires keeping yourself up-to-date in your knowledge of laws and regulations of the US Healthcare industry, as well as knowledge of different plans that are offered by insurance companies. Insurance companies have different types of plans and providers accept these plans by agreeing to the insurance agreement.
The importance of research work in the field of medical billing can not be neglected as the field is extremely vast. Since, US Healthcare is rapidly growing; therefore, one should keep up-to-date knowledge of all the changes in the industry.


Healthcare is a growing and recession proof industry and there are great opportunities for medical billers in this field. Healthcare Professionals require services from medical billers to streamline the billing process and reduce medical billing errors but it requires complete training and expertise in this field.


Source by John Sage

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