Video Headlines:

Commercial Condo vs. a Commercial Building

Insurance Types Needed for a Medical Practice

CLIA Certification

How to Find a Medical Collection Company

How to Choose a Potential Office Location

Finding A Payroll Company

Practice Website Development

Types of Commercial Loans for Buying a Medical Real Estsate

How To Lease Office Space For Your Medical Practice

Medical Billing Company to the Rescue!

Unlocking the Mysteries of Medical Billing

How To Estimate Staffing, Payroll, And Benefit Costs

Group Practice vs Hospital

Build Or Buy: In-House Medical Coding Vs. Outsourcing

Hiring A Business Consultant

What Is Practice Legacy Planning?

Determine Employee Benefits

Types of Medical Insurance

Choosing A Payroll Company

How To Structure Practice Banking

How To Win Your Insurance Contract Negotiation

OSHA Compliance

Disability Insurance

How To Find Money Factoring Resources

Purchasing A Commercial Condo

Merchant Services – Payment Gateway

The Pros And Cons Of Leasing Vs. Buying

What to Ask for/Expect in Your Commercial Lease

Group Practice vs Private Practice

What is a Commercial Lease?

Market Assessment/Demographic Research

How To Choose A Medical Management Firm

The Mystery Of Medical Transcription

In House Medical Billing vs. Outsourcing

How To Choose A Medical Billing Company

Employee Benefits

Business/Casualty Insurance

Retirement And Estate Planning For Physicians

Events

How to get a DEA license

Merchant Services – ACH Payments

How to Choose a Medical Legal Firm

What Is Money Factoring?

Document Imaging

How to Find a Medical Management Firm

What is a Medical Commercial Building?

Building a Team of Experts

How to Find a Medical Legal Firm

How To Choose A Medical Doctor’s Insurance Company

The Best Software for Doctor’s Offices

How to Choose a Medical Bookkeeper

The Mystery Of Doctor Credentialing

How to Prepare a Cash Flow Analysis

Private Practice vs Hospital

The Mystery Of Medical Transcription

In-House Human Resources vs Outsourced

What is HIPAA Compliance?

Long-Term Care Insurance

HIPAA & OIG Compliance Plans

Life Insurance

Promotions

OIG Compliance

Advertising

Direct Mail Marketing For Your Medical Practice

Capital Funding Needs: Pre-Opening, Opening

Equipment Selection Process

How to Find a Medical Practice Lender (resources)

Medical Office Structure, Layout And Design

Recruiting

How to Purchase a Commercial Building

HITECH Act of 2009

College Savings Accounts

Patient Experience

HITECH Compliance

How To Choose A Medical Collection Company

Medicare And Medicaid Audits

What Is A Marketing Mix?

How to Find a Medical Bookkeeper

The Mystery of Doctor Credentialing

Build Or Buy: In-House Medical Coding Vs. Outsourcing

HMOs vs PPOs

What Is A Merchant Processor?

The Pros And Cons Of Money Factoring

Leasing Medical Equipment Vs Buying

In-House Human Resources vs Outsourced

Types of Commercial Loans for Buying a Commercial Condo

What Is A Commercial Condo?

Determining Location Options

The Medical Coding Company That Could

What is an NPI, difference NPI 1 VS 2?

Purchasing a Commercial Condo

What is Fraud Investigation?

The Mystery Of Medical Coding

What Is Practice Succession Planning?

Overhead Business Expenses

Patient Education

Communication Vs Branding

How to Determine a Timeline to Open Your Medical..

Information Systems and IT for Doctors

In-House Doctor Credentialing VS. Outsourcing

Search
Generic filters
Exact matches only

Unlocking the Mysteries of Medical Billing

When an unpaid medical bill is mysteriously rejected by the insurance company, Sherlock Doc is on the case!

Sherlock Doc knows that medical billing is the process a healthcare provider goes through to submit and follow up on a medical claim with an insurance company.

Medical billing is performed by medical billers, who may or may not hold special certifications from taking the CMRS Exam, RHIA Exam, or from attending medical billing school.

After a doctor sees a patient, various procedure codes and diagnosis codes are assigned to that patient based on their medical status.

These codes help the insurance company determine how much of the claim they will pay.

The medical biller submits the claim to the insurance company electronically.

Medical claims adjustors or medical claims examiners then review the claim and approve, reject or deny it based on patient eligibility and medical necessity.

The amount paid out to the healthcare provider is based on pre-agreed terms between them and the insurance company.

A claim is ‘denied’ when it has been processed and the insurer has determined it to be not payable. The medical biller may then appeal the claim for reconsideration.

A claim can be “declined” is there are any errors or inconsistencies in the submitted claim. For example incorrect procedure codes or misspelling of a patient’s name.

In this case, the medical biller must correct and resubmit the original claim.

To learn more about medical billing, insurance, coding, outsourcing, and everything you need to establish a successful healthcare practice, follow all of Sherlock Doc’s adventures on the DoctorsBusinessNetwork.com or Doctors Business Channel on YouTube!

More Videos

What is Money Factoring?

How can your medical practice stay afloat when it takes 30, 60, even 120 days for your customers to pay? The truth is that until you’re running an established practice, it’s very difficult to maintain a positive cash flow. One way around this problem is a process called money factoring. Money factoring allows you

Read More »

Asset Protection

Asset protection is a key area of financial planning often overlooked by many physicians. Not only do you need to protect your practice

Read More »
Merchant Services
merchat_services
Sybe Credentialing
Doctors Business Network