Medical Classification and Medical Billing Process Essay

The hug drug steps in the medical exam saddleing cognitive operation atomic number 18 split into three sections and they ar visit, get, and post claim. The visit has four steps and they are preregister diligents, establish financial responsibility for the visit, realize in patients, and check start patients. The claim has three steps and they are review coding compliance, check billing compliance, prepare and transmit claims. The last section is the post claim which has the last three steps which are monitor payer adjudication, apply patient statements, and follow up on patient payments and handle collections. HIPAA, ICD, CPT, and HCPCS, every last(predicate) project an important role in the medical billing process. HIPAA entertain any cultivation in which individuals can identify the patient, their health and history, much(prenominal) as their name, social security number, contact and billing culture, and indemnity.When first see the medical facility a patient m ust receive a notice of privacy, this lead explain how to exercise his or her rights under HIPAA. It will protect patient records from being disclosed without his or her consent. In the medical billing process, HIPAA influences preregistering be give birth the staff must make sure the patient information is not overheard by others in the waiting room. HIPAA also influences the establishings financial responsibility because the patient provides the medical facility with his or hers personal information as well as insurances. International Classification of Disease (ICD) is diagnosing enrolls used at check out time to identify the patients primary illness. In order for the visit to be bill the physician must put down a medical code to describe the patient medical diagnoses and procedures.When the physician performs a treatment or test a procedure code is charge. These codes can be selected from the CPT or Current Procedural Terminology. Any service in which is not include in the CP T can be found in the HCPCS or the health care Common Procedure Coding System. HIPAA has made HCPCS codes mandatory for billing and coding. HCPCS codes are for patients in Medicaid, Medicare, and private insurance plans. Once the services is provided and the ICD, CPT, and HCPCS codes are assigned then the medical facility can submit the claim to the insurance provider. By not putting the right codes down it can cause the claim to be denied. The medical coder will then have to resubmit the claim so the bill can be process and paid.