Insurance Billing for Medical Services: A Comprehensive Guide

Billing an insurance company for services rendered requires specialized codes and often specialized training. You will have to review medical records to see what a doctor has done for a patient and find the billing codes that match. Accuracy is key so you bill for everything that was done.

Things You'll Need

• HCFA form
• UB-04 form
• CPT book
• HCPC book
• ICD-9-CM book

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Instructions

Coding Bills for Insurance Companies

• 1

  A medical provider records services provided in the form of medical records. Some offices also have physicians fill out a billing sheet during the time of care. This billing sheet and the medical records determine the codes and charges submitted to the insurance company.

• 2

  The medical records and/or billing sheet will be given to the billing department, which ensures that all services rendered are documented for preparing the appropriate insurance form.

• 3

  Based on what is on the billing sheet or medical records, the coder will then utilize the ICD-9-CM book to assign a diagnosis for the patient's primary treatment. CPT procedure codes are assigned for the treatments provided to the patient by the physician.

• 4

  After the codes have been correctly assigned, the billing form is completed. Physician offices use a HCFA 1500 form. Fill in the required forms and mail them to the insurance billing address along with a letter of explanation with all pertinent and relevant information concerning the patient.