1. Briefly describe the term "medical billing".
Medical billing is the name for the entire process of submitting and pursuing the claims with insurance companies in order to obtain payments for the services given by a health care provider to a patient. The entire process is called by the name billing cycle and may take even months in some cases.
2. Identify the two parties that are typically involved in the "Billing Process". Identify the person that typically creates and updates the patient's medical record.
The healthcare provider and the insurance company are the two parties involved in the billing process. The doctor treating the patient is the person who creates and updates the patient’s medical record.
3. Explain the process of determining the five digit procedure code and the factors that are taken into consideration. What is the abbreviation for the code? Identify each word that is abbreviated in the code.
The five digit procedure code is called the CPT code. The abbreviation CPT stands for Current Procedural Terminology Code. The extent of physical examination, the nature of the diagnosis and the background details of the patient as received from the patient are all evaluated to decide over the level of medical service, which will be used to file claims for insurance. This level of service once finalised by the qualified staff is converted into a standardised five digit procedure code obtained from Current Procedural Terminology (CPT) database.
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