One Step Ahead...! EDUCATION

A guide to medical billing in US colleges

If you are about to continue your education at college within the USA, then it is a very exciting time. One thing that you may not have given much thought to is the process for medical billing when away at college. Knowing how this works is important so you are not caught out if you require any kind of medical treatment from a healthcare provider when studying.

An overview of how medical billing works in college

If you are not sure how the medical billing process works, the step by step process below will help.

Step 1: Registration

To begin with basic data is collected on any patient who needs medical treatment. Along with personal details, your insurance information is also taken as that will be needed later. Once all the information required has been taken, the medical biller dealing with you will set a patient file up for future use.

Step 2: Determining who will pay

Next, the medical biller will determine who is financially responsible for the care that you may need from a healthcare professional. They will check your insurance policy to see which services are covered by it. If the service you need is not covered then they will let you know you will be required to pay for it.

Step 3: Creation of bill

When checking-in at the college medical office or healthcare provider, you will be asked to complete forms for your patient file. You will need a valid insurance card and ID when doing this. After you have been treated, a report known as a ‘Superbill’ is compiled to bring all the information around the care you have had together into one document.

Step 4: Claim generation and submission

Once the Superbill is ready, the medical biller will prepare the claim to be submitted to your insurance company. The biller is responsible for carefully checking the claim to ensure it is correct before sending off, and that it meets HIPAA compliance standards.

Step 5: Adjudication of claim

The next step sees the payers of the claim determining if they feel the claim is valid and whether they are responsible for paying it. They could choose to accept it and pay as required, reject it if there are errors on the claim that need fixing, or decline if they do not feel they should pay it at all.

Step 6: Patient statement and follow up

After the claim has been processed any outstanding charges are billed to you as the patient. In with that document you should receive a detailed breakdown of charges and what your insurer has paid in relation to them. Medical billers will be required to follow up on these patient statements for payment so do not ignore them!

Medical billing is important in college

You may be lucky and get all through college with no need for medical care. That may not happen though, which is why you need to get your health insurance sorted out beforehand and also know how the medical billing process works. Hopefully the above guide should give you a good start on what you need to know.

Leave a Reply

Your email address will not be published. Required fields are marked *