Electronic Billing is Entering the Medical World

Posted by steelersmb
September 21, 2011

Since the invention of electronic billing, more and more services have been paid using this modern technique. So much so that even the most common of services, such as medical services are now being paid electronically. Yes, the world of medical billing has really come a long way. Long before the explosion of electronic billing, back in the day, one would go to his/her physician and get examined. Then one would obtain treatment for the affection discovered, receive a bill and to end this process, there was the submission of a check or the payment of cash money for the services. Electronic billing is even linked to your insurance carrier. Before this modern process, if you had insurance, which, mind you, was as rare as hens’ teeth back at that time, the doctor had to send a paper bill to the insurance carrier. The latter could have been a private carrier, Medicare or Medicaid. Don’t we all know just how easy it is to misplace or lose paper, be it money or documents. Now you don’t have to worry anymore because those days are long behind us. Even though some doctors still live in the stone ages, the majority have advanced into the modern era like the rest of the world. This means that they have begun to use electronic billing to receive payment for their medical services.

For one to understand exactly why using electronic billing is better than classical means of payment is not hard. What this article informs of is what actually electronic billing involves. If you read through this article, the next time you visit you physician you’ll have a better understanding of how you or your insurance pays the doctor for his services by electronic billing. This means that you don’t have to take out even one metal cent from your wallet!

Electronic billing equals paperless billing. Every time you receive a printed bill for medical services, this bill is also entered into a computer. And along with the value of this bill, other information about you is entered in the computer, such as name, address, social security number and others. Among this other information, probably the most important is who your insurance carrier is. This is because, an insurance provider lacking this piece of information would not know how to process the claim in order for the physician, clinic or individual medical laboratory to receive their money through electronic billing.

Within the process of electronic billing, all the information reaches a computer database, making use of specialized medical billing software. From your doctor’s computer, the information is electronically transmitted to the insurance carrier via a modem device, in a similar way to the fax. But whilst a fax machine uses paper to transmit information, a modem takes an electronic copy of the bill and passes it along the phone line to a fax machine which prints out a copy of the paper bill at the other end of the line. Otherwise said, by using electronic billing, paper is eliminated from the equation and, do rest assured, the money reaches its destination safely.

Finally, so that the insurance carrier is able to read the information sent their way, the information needs to be formatted in a way specific to electronic billing transactions. The format is called NSF format and is actually standard for every insurance carrier. But despite this standard format type, a special program has to be built for each carrier because different carriers may use different fields of the whole information. This is a reason why some claims are rejected, that is the transmission of certain fields that the carrier does not use for electronic billing.

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