How is Medical Billing Supposed to Work?

Medical billing can be a confusing process. There are many steps involved, and it can be difficult to know where to start.

In this article, we will discuss the basics of medical billing and provide an overview of how the process is supposed to work. We will also outline some of the common mistakes that people make when submitting medical bills. Let's get started.


A young physician's assistant smiling, sitting at her computer

Phase #1: The Patient's Responsibility

The first phase of medical billing is the responsibility of the patient. In this phase, the patient is responsible for providing accurate and up-to-date information to their insurance company. This includes things like their name, address, date of birth, social security number, and policy number.

The patient is also responsible for keeping track of their own medical expenses. This includes things like doctor's visits, prescriptions, and any other treatments or services that they receive. The patient should keep all of their receipts and documentation in a safe place so that they can easily access them when needed.

Phase #2: The Provider's Responsibility

Once the patient has provided their insurance information to the provider, it is then the provider's responsibility to submit a claim to the insurance company. The provider will need to include things like the patient's name, the dates of service, the type of services rendered, and the amount charged.

The provider is also responsible for keeping track of any payments made by the insurance company. This includes things like co-pays, deductibles, and coinsurance. The provider should keep all of this information in a safe place so that they can easily access it when needed.

Phase #3: The Insurance Company's Responsibility

The third and final phase of medical billing is the responsibility of the insurance company. In this phase, the insurance company will review the claim submitted by the provider and determine whether or not they will cover the charges.

If the insurance company denies the claim, they will send a notice to the provider explaining why. The provider can then appeal the decision or bill the patient for the remaining balance.

Hire Us to Improve Your Medical Billing Process

If you are tired of dealing with the hassle of medical billing, then you should consider hiring a professional billing service.

At The Billing Department, we can help you streamline your process and improve your bottom line. Contact us today to learn more about our services.