A Bit about Healthcare and Medical Billing in the United States:

Healthcare in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit. According to the World Health Organization (WHO), the United States spent more on health care per capita ($8,608), and more on health care as percentage of its GDP (17.2%), than any other nation in 2011.

Medical billing is a payment practice within the United States health system. The process involves a healthcare provider submitting, and following up on, claims with health insurance companies in order to receive payment for services rendered; such as treatments and investigations. The same process is used for most insurance companies, whether they are private companies or government sponsored programs: Medical coding reports what the diagnosis and treatment were, and prices are applied accordingly. Medical billers are encouraged, but not required by law, to become certified by taking an exam such as the CMRS Exam, RHIA Exam and others. Certification schools are intended to provide a theoretical grounding for students entering the medical billing field.

Bikham provides full service revenue cycle management Services to over 75 providers and practices in the United States. Here’s a simple flow chart to explain how it works and how we do it :

rcm-1

Physician Billing DMEPOS Billing
Patient Scheduling Patient eligibility & benefit Check
Eligibility & Benefits Verification Pre-Authorization
Pre-Authorization Printing or Faxing Delivery Tickets/CMNs, etc
Pre-registration/registration Follow-up for Delivery
Medical Coding Compliance Review
Charge Entry Order Creation/Online Billing
Claims Generation (Paper/Electronic) Claims Generation
Payment Posting Log CMN/DIF Form
AR Follow-ups Working the Rejections
Patient Scheduling Payment Posting
Denial Management Medicare Audits
Correspondences AR Follow-ups
Overpayments Denials Management
Patient Scheduling Correspondences
Faxing/Mailing of Appeals Overpayments & Refunds
Redeterminations/Reconsiderations Follow Up On Appeals
Dashboards & MIS Dashboards & MIS

Email For Health Care : healthcare@bikham.com