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Health Insurance and medical billing can be complex for medical office workers.

ID: 3520478 • Letter: H

Question

Health Insurance and medical billing can be complex for medical office workers. It is a challenge to keep up with changes and to efficiently and accurately process health insurance claims.
Discuss how an Office Manager can ensure that the office's health insurance claims are accurately and efficiently processed. Include ideas about training for staff, ways the office can expedite claims, and how the manager can stay informed about changes in the industry and the status of the office's claims processing. Health Insurance and medical billing can be complex for medical office workers. It is a challenge to keep up with changes and to efficiently and accurately process health insurance claims.
Discuss how an Office Manager can ensure that the office's health insurance claims are accurately and efficiently processed. Include ideas about training for staff, ways the office can expedite claims, and how the manager can stay informed about changes in the industry and the status of the office's claims processing. Health Insurance and medical billing can be complex for medical office workers. It is a challenge to keep up with changes and to efficiently and accurately process health insurance claims.
Discuss how an Office Manager can ensure that the office's health insurance claims are accurately and efficiently processed. Include ideas about training for staff, ways the office can expedite claims, and how the manager can stay informed about changes in the industry and the status of the office's claims processing.

Explanation / Answer

Managing health insurance and medical billing in am efficient manner is not an easy task and it requires a constant attention. To maximise insurance reimbursements, each phase of revenue cycle is very important from the moment a patient is scheduled for an appointment until the time payment is received from insurance company.

It is very important for the financial stability of hospital or physician office to have a process in place for each phase of the revenue cycle.

Some of the ways to maximise insurance reimbursements is;

* Insurance verification

* Upfront collection

* Coding clean claims

* Prompt handling of denials

* Payment review

Staff education or training in insurance claim includes;

* Formal orientation program

* Cross functional training

* Coaching

* Maintainence of professional skills

* Career development

* Personal development

Physicians reason their education, energy and training should be focused on patient care and research, where as staff education is the responsibility of practice managers. Generally, physicians play important role in staff development.

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