Medical Billing

Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient’s medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
This bill is called a claim.Because the U.S. has a mix of government-sponsored and private healthcare, health insurance companies – otherwise known as payors – are the primary entity to which claims are billed for physician reimbursement. The process begins when a physician documents a patient’s visit, including the diagnoses, treatments, and prescribed medications or recommended procedures. This information is translated into standardized codes through medical coding, using the appropriate coding systems such as ICD-10-CM and Current Procedural Terminology (CPT). A medical biller then takes the coded information, combined with the patient’s insurance details, and forms a claim that is submitted to the payors.