The patient visits the healthcare provider for consultation or treatment.
The provider documents the encounter, including the patient’s symptoms, diagnosis, and procedures performed.
Medical coders assign ICD-10 codes for diagnoses and CPT codes for procedures based on the provider’s documentation.
The insurance company reviews the claim, processes it, and determines the payment amount.
The claim is electronically submitted to the patient’s insurance company for reimbursement.
The coded information is entered into the billing system to create a claim.
The insurance company’s payment is posted to the patient’s account, reducing the amount owed by the patient.
A bill is sent to the patient for any remaining balance after insurance payment.
The billing process concludes when the patient pays the remaining balance.
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