Maintaining the patient’s insurance company details in the medical facilities software is a simple but tricky one. In most cases, a patient might have single insurance but it isn’t definite as a patient might have multiple insurances.

A simple such example is if in a couple both the wife and husband are working and have a different insurance provider from each employer and in such cases, the other half can be added to spouse insurance.

The health care coding system can be simply put as the conversion of the diagnosis, treatment, or the whole service received by the patient from the doctor into codes which would be easier to bill, claim insurance, and reimbursement.

Health Insurance verification is the first process of medical billing. It’s the process to check and verify the coverage of the patient’s insurance with the company and verify the eligibility of the claims. It can be done online or by calling the insurance company.

Clearing House acts as a post office for sending the claims from health care providers to the insurance company. The reason a clearinghouse is chosen to pass the claim to the insurance company is
• Contacting and finding the insurance company details to send the claims directly to them which becomes a tedious process and it also includes testing/certification process.
• The insurance transmission method should be configured in a proper way by the billing staff or the practice management team.

An Electronic claim as the name suggests is a digital form of patient claim which is generated by the software. This is then electronically transmitted to the health insurer or any third-party vendor to process and make the payment.

Whenever a patient goes to see a doctor, the insurance information is collected from the patient which is considered an important data element for preventing any kind of delays or denials.
Even if the patient goes for a timely checkup or a pre-scheduled appointment, the patient’s insurance information is collected.