Healthcare Billing Services

Healthcare bills are not only confusing for the patients that receive them, they can also present quite a challenge to the healthcare providers that prepare and try to collect on them. Fortunately for the perplexed provider, there are several companies that specialize in providing healthcare billing services. The available services range in nature from claims preparation and submission to actual payment collection.

Why Use a Billing Service?

The healthcare billing services typically employ billing specialists that are rather familiar with a particular healthcare field. For instance, a podiatrist could more than likely find a billing service specifically geared toward filing claims for his type of practice. This means the biller would more than likely have a good understanding of the medical codes and terminology necessary to prepare and submit an acceptable healthcare claim.

Furthermore, the billing specialist would have a good understanding of any pertinent regulatory requirements. If submitting claims to government payers, like Medicare, the claims have to be submitted electronically and must be in a HIPAA-compliant format. HIPAA is the Health Insurance Portability & Accountability Act of 1996, and among other things, it establishes a set of standard medical diagnosis, procedure, and claims transmission codes.

In an effort to achieve compliance with the standards laid out in HIPAA, more and more healthcare plans and insurers are requiring that claims be electronically transmitted to them. However, most billing services will still accept a healthcare provider's paper claims and as part of its service translate the claim into the proper electronic format. Depending on the healthcare provider's technical ability, there are billing services that accept claim information over the telephone, via fax, or across secure internet connections.