When a patient comes to the emergency room, he or she is quite possibly hurt badly. By definition, patients in the emergency department do not have appointments or set primary care doctors at a certain hospital. However, the hospital is still going to treat anyone who comes through the doors. That’s not the end of the interaction though. The private individual must be billed. Whether a patient is admitted to a hospital, discharged or transferred to another hospital, that person will need to be billed. It is the responsibility of a billing and coding professional to determine how much to charge each person.
How Do They Determine the Charge?
Coders go through the arduous task of reading every single correspondence between a physician and a patient. They also analyze all of the documentation. Diagnoses and medical procedures are coded using codes unique to the hospital and to the admitting physician. In addition, the coder must analyze every interaction between doctors and nurses concerning the patient. These coders are professionals well versed in medical terminology, medical procedures, diagnoses, and proper courses of treatment. To determine how much money to charge, the coder will read the codes of the diagnoses to determine the necessity of the treatment. This is not an easy thing to do. One must be very knowledgeable in the medical field.
How Do You Find a Coding and Billing Professional?
Professionals who specialize in emergency room physician billing take great care to only bill patients as much as is absolutely necessary. You should look into a management firm that has its own proprietary billing software. This way you know they have thoroughly analyzed and considered their technology as opposed to just buying someone else’s. Also, you can rest assured that they are very skilled in their profession.
You should look into a management firm that is owned and operated by emergency physicians. Only they can truly know what a doctor is going through, and only a doctor is knowledgeable enough in the medical field to accurately assess the necessity of various procedures.
You should choose a management firm that has a post-billing department that deals with any complaints patients might have. With a department devoted solely to complaints, every customer will feel as if he or she is valued and heard, instead of just a number.
You should choose a firm that does all of its work in-house. Some emergency room physician billing organizations outsource some of their work and are essentially just middle men. This means the work is going to take longer, and you will not know who is actually doing the coding and billing. You should hire a firm that does not outsource so that you know exactly what you are getting and what you should expect.
