I strongly feel that the Development of PMS (Practice Management System) or Health Insurance Reimbursement System requires an extensive understanding of Medical Billing terminology and healthcare domain knowledge. A developer or Data analyst in this field of insurance reimbursement must understand the business logic of the healthcare industry. So, I read a lot of articles, blogs, and books to grab all this information which is needed to be successful in the field of medical billing and insurance reimbursement. I want to share this information here on my website so that other people can understand it easily. I try to be as simple as possible so that anyone interested in the field can understand it easily. All the concepts and processes are explained with examples and diagrams.

• What is Medical Billing Process?

• Different Format of Medical Form.

• Patient Insurance and Verification

• Electronic Claim Transmission

• Role of Clearinghouse in Medical Billing

• Medical Billing Process in detail

• Healthcare Coding system.

• Maintaining Patient Insurance in the software.

• What are the Billing Entities?

• What is Pre Authorization?

• What is an EDI?

• EDI Transactions

• Understanding EDI Structure (Beginner)

• Understanding EDI Structure (Detail )

• EDI Instruction

• Difference Between 837 Institutional and 837 Professional

• EDI 5010 Documentation 837 Health care claim: Professional

• EDI 270 – 5010 Health Care Eligibility/Benefit Inquiry

• Claim Forward to other Insurance

• EOB – Explanation of Benefits

• Understanding EOB – Explanation of Benefits

• Understanding EDI 835 Electronic Remittance Advice

• What is Copay, Co-Insurance, and Deductible in Insurance Payment Posting?

• Types of Reimbursement

• How to process Copay, Co-Insurance, and Deductible Amount in Insurance Payment Posting?