Payment Posting Vital Part for Medical Billing Process |
Posted: September 23, 2021 |
What are the different types of payers?Different payers will require different post codes, and they will also require different methods of contact. For example, Medicare does not allow a provider to contact the patient directly. Instead, the provider must pay a postcode to Medicare and then wait for the claim to be processed. There is also a mail service available for submitting claims. Part B of the Medicare program is different from Part A. Part B is known as the Health Maintenance Organization (HMO) network. The providers of Part B of the Medicare program have different methods of billing patients, and each requires a different method of payment posting.
The Importance of Posting PaymentsMedicare, Medicaid, the Veterans Administration, Tricare, the federal government, and private insurance companies all exist in the medical billing process. Each payer has different rules and requirements when it comes to payment posting. For example, the rules for Medicare include patient names being included in the payment post so that the patients will know how much they owe the hospital. Payment post deadlines differ depending on the payer. This means that hospitals will need to be cognizant of their deadlines. For example, Medicare and Medicaid have an early pay deadline of January 31 of the following year, and the Veterans Administration has a late pay deadline of December 31 of the same year.
Coding Payment PostsThe first step in paying for a medical invoice is to create a coded post. This is a document that hospitals, clinics, and other healthcare facilities write down the most up-to-date information about their patients. The medical coding process allows hospital staff to determine the type of payment or reimbursements a patient is likely to receive, and when payments are due. The information is used to create a coding document that will determine the timing and amount of payments.
How to Code Payment PostsConsider the types of services that you offer and who you are billing for your services. For example, a dermatologist may offer cosmetic services while a therapist might offer services to the mental health community. The billing department should learn about these different areas and learn how to code them appropriately for each payer. Decide whether you will use the Postal Service, ACH or other payment options. These payment methods will work best when made in one transaction. Most payment methods require a patient to pay for the services upfront and then send a check to the billing department, but payment post methods do not require the same upfront costs. Decide on whether or not you will accept all payment methods. Some payment methods may be required for patients in certain states.
Determine if the Payer is a Medicare or MedicaidOne of the most popular payers for healthcare is Medicare. It is important to understand which are the different types of Medicare or Medicaid. Each Medicare category has its own set of conditions and rules for medical billing. However, all payers must comply with the same rules when it comes to payment posting. Insurance Coverage Details Do you have a contract with your medical facility or other provider in place? If so, you should check your contract to determine whether or not the payer is in the contract. Also, check whether or not they are considered a Deductible or Shared Risk Payer. In this case, the payment will be considered Shared Risk.
Medical Record NumberThis is the first thing any company needs to put on the payment post form. This will allow your medical billing service to list out the insurance company, which one is actually paying for the services, and how much the patient owes for that particular service. Consultation Reference Number There are many different things that your medical billing services can provide for patients who choose to pay online. For example, your medical billing service can provide a list of different providers in your city, including doctors, hospitals, and more. They can also provide a list of medications and other treatments that they can prescribe and dispense, for example.
Claim Status CodesMost billing systems use the Claim Status Codes to code payments. These codes are used by facilities to know what type of payment is appropriate for each type of claim. Common codes that are used are Claim Type Code and Claim Year Code. Number of Entities in Payments Before a facility sends out payment posts, it will need to collect payment from each of the payers for a certain claim. This is usually done by listing all the entities and amounts that are owed on the appropriate medical payment post. For example, if a facility has received reimbursement for a service and they now have over $500, the facility can put a tag on the post that says “Claim 100 and Paramedic Apparatus” to indicate that they have not yet received a check for the over $500.
Insurance Company NameIf a patient is receiving in-network treatment at a facility, they will almost always be billed using the in-network insurance company's name. However, for patients who are receiving treatment out of network, the facility will need to post payments on behalf of the patient using the insurance company's name. However, hospitals and medical clinics are not always reimbursed in the exact terms outlined in the insurance company's policy. The facility may need to pay a different portion of the cost than the insurance company suggested. Therefore, using a specific insurance company's name helps to ensure that payment is posted in the proper amount and that the facility receives the correct amount from the insurer.
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