{"id":980,"date":"2018-02-05T10:34:55","date_gmt":"2018-02-05T10:34:55","guid":{"rendered":"https:\/\/www.ecareindia.com\/blog\/?p=980"},"modified":"2018-03-21T11:16:00","modified_gmt":"2018-03-21T11:16:00","slug":"important-steps-professional-medical-claims-processing","status":"publish","type":"post","link":"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/","title":{"rendered":"Important Steps of Professional Medical Claims Processing"},"content":{"rendered":"<div class=\"wp_plus_one_button\" style=\"margin: 0 8px 8px 0; float:left; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\" callback=\"wp_plus_one_handler\"><\/g:plusone><\/div><p style=\"text-align: justify;\">Medical claims processing can be straightforward to complex process, depending on the circumstances. Typically, a medical billing insurance claim process would start when a healthcare provider or practice provides treatment to a patient and then sends the bill of services to the designated <!--more-->payer. This designated payer is usually the patient\u2019s health insurance company. The payer will then evaluate the claim based on their set standards along with different determining factors in order to verify services that it will reimburse.<\/p>\n<p style=\"text-align: justify;\">Medical claims processing only becomes complex when there are complications in the claim, such as insufficient coverage or the failure of a patient to stay current with dues. In a perfect world, the steps to a medical billing procedure are quite simple:<\/p>\n<ul style=\"text-align: justify;\">\n<li>The patient receives a medical service from a licensed provider<\/li>\n<li>The services are recorded and assigned the appropriate codes by a medical coder<\/li>\n<li>ICD codes are to diagnoses as CPT codes are to treatments.<\/li>\n<li>A summary of services rendered is generated through the entered code sets, which in turn makes up the bill.<\/li>\n<li>The patient demographic data along with his or her insurance information are then added to the bill; and<\/li>\n<li>The claim is now ready for processing.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/www.ecareindia.com\/blog\/choosing-a-good-medical-claims-processing-software\/\">Medical claims processing<\/a> can be done either electronically or manually. Various technical protocols as well as industry standards must then be followed so that insurance claims can be delivered accurately and expediently between the payer or the insurance provider and the medical practice. Different medical billing services use various approaches to medical claims processing. Others may use the manual or paper route, while more modern service providers do everything electronically with the help of increasingly reliable software programs and applications. Today\u2019s healthcare providers as well as insurance companies subscribe to electronic claim systems as they offer faster and more accurate, (sometimes even cheaper) processing than traditional manual methods.<\/p>\n<div class=\"wp_plus_one_button\" style=\"margin: 0 0 8px 8px; float:right; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\" callback=\"wp_plus_one_handler\"><\/g:plusone><\/div><!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<div class=\"wp_plus_one_button\" style=\"margin: 0 8px 8px 0; float:left; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\" callback=\"wp_plus_one_handler\"><\/g:plusone><\/div><p>Medical claims processing can be straightforward to complex process, depending on the circumstances. Typically, a medical billing insurance claim process would start when a healthcare provider or practice provides treatment to a patient and then sends the bill of services to the designated<!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n<div class=\"wp_plus_one_button\" style=\"margin: 0 0 8px 8px; float:right; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\" callback=\"wp_plus_one_handler\"><\/g:plusone><\/div>","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-980","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Important Steps of Professional Medical Claims Processing - ecare India Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:title\" content=\"Important Steps of Professional Medical Claims Processing - ecare India Blog\" \/>\n<meta name=\"twitter:description\" content=\"Medical claims processing can be straightforward to complex process, depending on the circumstances. Typically, a medical billing insurance claim process would start when a healthcare provider or practice provides treatment to a patient and then sends the bill of services to the designated\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dean Smith\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\"},\"author\":{\"name\":\"Dean Smith\",\"@id\":\"https:\/\/www.ecareindia.com\/blog\/#\/schema\/person\/577a4fa5cecf0940da80776760626a50\"},\"headline\":\"Important Steps of Professional Medical Claims Processing\",\"datePublished\":\"2018-02-05T10:34:55+00:00\",\"dateModified\":\"2018-03-21T11:16:00+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\"},\"wordCount\":317,\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\",\"url\":\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\",\"name\":\"Important Steps of Professional Medical Claims Processing - ecare India Blog\",\"isPartOf\":{\"@id\":\"https:\/\/www.ecareindia.com\/blog\/#website\"},\"datePublished\":\"2018-02-05T10:34:55+00:00\",\"dateModified\":\"2018-03-21T11:16:00+00:00\",\"author\":{\"@id\":\"https:\/\/www.ecareindia.com\/blog\/#\/schema\/person\/577a4fa5cecf0940da80776760626a50\"},\"breadcrumb\":{\"@id\":\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.ecareindia.com\/blog\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Important Steps of Professional Medical Claims Processing\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.ecareindia.com\/blog\/#website\",\"url\":\"https:\/\/www.ecareindia.com\/blog\/\",\"name\":\"ecare India Blog\",\"description\":\"Blog on Medical Billing, Billing Outsourcing and Healthcare Billing\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.ecareindia.com\/blog\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.ecareindia.com\/blog\/#\/schema\/person\/577a4fa5cecf0940da80776760626a50\",\"name\":\"Dean Smith\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.ecareindia.com\/blog\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/9a22ea0080c7e867f431cd1bd8e468c4297376f909a7b8216199f7edcb0ac951?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/9a22ea0080c7e867f431cd1bd8e468c4297376f909a7b8216199f7edcb0ac951?s=96&d=mm&r=g\",\"caption\":\"Dean Smith\"},\"url\":\"https:\/\/www.ecareindia.com\/blog\/author\/seovalley\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Important Steps of Professional Medical Claims Processing - ecare India Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ecareindia.com\/blog\/important-steps-professional-medical-claims-processing\/","twitter_card":"summary_large_image","twitter_title":"Important Steps of Professional Medical Claims Processing - ecare India Blog","twitter_description":"Medical claims processing can be straightforward to complex process, depending on the circumstances. 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