Medical billing is the process of using the coding supplied by a physician or a coder and applying it to the medical billing claim information for government payers or the third-party payers. Having a home billing business makes the biller responsible for all of the payments based on the claim forms he or she sends to insurance companies.
Understanding Coding
A home biller must understand the principles behind coding to be able to bill appropriately. The biller must also know when to not bill a claim without further clarification from a medical facility or physician when data are missing or do not appear consistent.
Software Considerations
A home billing business must have specific types of medical billing software to be able to place all of the accurate data into the appropriate boxes on a claim form for either CMS-1500 form or the UB-04 form.
Accuracy
Accuracy is critical for a home billing business. Because the biller does not have one-on-one, immediate contact with the physician or medical personnel for questions, the biller must take the time to make sure everything is correct.
Fraud and Abuse
A medical home biller and his or her business can be held personally or professionally liable for any errors on claim forms. If this happens consistently, fines can be levied against the home biller.
Patient Privacy
A home billing business must have a quality computer with security so family or friends do not have access to the medical data.
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