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We manage and process financial transactions between a company and its customers

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We ensure that medical providers receive proper payment for the services they provide. These services act as a bridge between healthcare professionals, patients, and insurance companies.

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Medical billing and coding services in Florida involve two intertwined administrative healthcare functions: medical coding, which is translating diagnoses and procedures into standardized codes, and medical billing, which is using those codes to create and submit claims for payment. These services are crucial for ensuring healthcare providers are reimbursed accurately and efficiently.

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A combination of technical skills is required, including:
In-depth knowledge of medical terminology and codes (ICD-10, CPT, HCPCS).
Meticulous attention to detail to ensure coding accuracy.
Communication and data analysis skills.
Understanding of insurance plans and processes.
Research skills to stay up to date with changing guidelines and regulations.

Medical coding is the process of transferring important medical information into simple, standardized codes so that it can be easily understood in medical records and for billing purposes.

  1. Registro del paciente
  2. Verificación del seguro
  3. Captura del encuentro y los cargos
  4. Codificación médica
  5. Entrada de cargos y revisión
  6. Presentación de la reclamación
  7. Adjudicación del pagador
  8. Contabilización del pago
  9. Gestión de denegaciones (si aplica)
  10. Facturación al paciente
  11. Cobranza
  12. Informes y análisis

Medical coding: Involves reviewing a patient’s medical records and documents and translating diagnoses, procedures, equipment, and other relevant information into standardized alphanumeric code sets.
Medical billing: Uses the coded information to create and submit claims (invoices) to insurance companies. The medical biller is responsible for monitoring these claims, managing payment denials, and following up on payments from both insurers and patients.

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