Medical Billing Reimbursements For Professional Fees

Getting Medical Billing Reimbursements For Professional Fees

Doing medical billing is only one aspect of getting reimbursed for professional fees. Many things must take place in order to get correct reimbursement for professional medical services. Services must be rendered, accurate documentation must be taken, and correct medical billing practices are all requirements of getting reimbursed for medical professional fees.

The first thing that must take place before you can even perform medical billing is the rendering of a service. A complete exam or lab, or x-ray, surgery, etc must be performed for everything to take place. It is important to treat patients with respect because if you do they will keep coming back for more medical care.

The next requirement to get reimbursed for medical professional fees is documentation. Many procedures require documentation of medical necessity. Any patient history, family history, current signs/symptoms, what was examined, what was discussed, etc should be documented in the patient’s medical record for medical billing purposes. That way, if a payer requests a letter of medical necessity when billing, you have all the information right at your finger tips.

Perhaps one of the most important aspects of getting correctly reimbursed for professional fees is accurate coding practices. This job is usually done by medical coders. Many times a claim will get processed without any question if the coding is correct. If one slight error is made in medical billing, the claim will need to be reviewed. Many times when this happens, medical records are requested. It is very important that your medical coders are fully trained to know the ins and outs of medical billing. Medical billing is a complicated process and should only be done by skilled professionals.

Your professional fees will always be paid without error if the three elements are present: rendering of service, accurate documentation, and correct medical billing.

View all Articles by: Melissa Clark, CCS-P