The type of insurance plan that covers treatment related to workplace injuries and ailments, known as workers’ compensation, provides financial assistance to employers who purchase it. The requirements and documentation for this are unique, necessitating medical billing professionals who are billing claims associated with these plans. They must be aware of the limitations of the plans.
Unique Features of the Workers’ Comp Plans
Workers’ comp claims, unlike other common health insurance plans, are manually processed. Industry standard related to most third-party payers being automatic processing of medical claims via electronic data interchange, workers’ comp medical claims are processed manually. It is necessary to ensure that injury-specific and work-related conditions are being treated under these plans.
The Process of Workers’ Comp
Upon being injured or having contracted a work-related medical condition, the employee will file a claim with the insurance carrier of the employer. A claim number will be assigned; it acts like an insurance ID number for claiming reimbursement. An adjuster will be assigned for the employee too, who authorizes the medical services provided to the employee.
With the relevant information about the employee, the provider’s office takes care of services. The employee’s personal insurance plans will not be involved for the services related to the injury. Nonetheless, non-related services will be billed to the personal insurance of the patient.
Workers’ comp claims may be submitted in the CMS-1500 claim form, similar to other health insurance claims. The adjuster has to review the charges and the supporting documentation for ensuring that medical services are for work-related medical conditions only. Confirming that the charges are appropriate, the adjuster reprises them in line with the carrier’s fee schedule.
Medical billing and coding solutions offered by Numinatrans enables business organizations and agencies to comply with regulatory requirements, while achieving submission of accurate and timely claims.
If you are looking for reliable and effective medical billing solutions, you are welcome to approach us. Log on to http://www.numinatrans.com/services/medical-billing/ for more details.
As with other industries in modern times, there has been a continuous evolution in the health care industry – there is no dearth of opportunities in this booming sector. Not to forget the various legal and governmental requirements and regulations. It is imperative that professionals in this field, apart from clinicians, are well-versed in the factors related to reimbursement processes and be familiar with all the relevant medical terminology.
The Role of Medical Billing Professional in the Current Health Care Sector
Entrusted with the task of preparing and submitting insurance claims to different insurance providers for the services provided by physicians and practices, medical billers make use of specially built software. In a sense, the medical billing process is one of the most vital factors that help fuel the financial engine of any medical practice.
Need for Knowledge on Medical Terminology
The medical industry is filled with terms and phrases that denote various medical conditions and treatment procedures. Not all these happen to be in a single language. Several of the terms used are derived from languages such as Latin and Greek, rendering them hard to be understood and remembered. As medical billing companies are expected to code all patient health related procedures and medical conditions, they must have deep knowledge about the complex terms used by clinicians.
Medical terminology is full of intricacies and contains allegories and metaphors. Making use of prefixes, suffixes, roots and combination of vowels is quiet common. What’s more, these may be used separately and in combination with words in this field. All these necessitate the medical billing and coding professionals to be capable of understanding the literary as well as contextual meaning of various terms and phrases.
Uniqueness of Terminology Used in the Medical Industry
Unlike other professional fields where mostly sound and logical reasoning prove to be the driving factors, in health care, the terminology is entirely different. This requires a comprehensive understanding of all the possible medical conditions of individuals, their treatment methods, and procedures adopted by medical professionals, to name a few.
Medical billing and coding solutions provided by Numinatrans helps clinicians and health care organizations to achieve accuracy and timely submission of claims. We ensure regular training and imparting updated knowledge to our team of medical billing professionals so that they are aware of the latest changes in the industry.
Numinatrans has been offering unmatched medical billing services since more than a decade. We serve all types of medical practices and specialties. Log on to www.numinatrans.com for further details.