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What are the Basics of Reimbursement Billing?

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  • Written By: Keith Koons
  • Edited By: Jenn Walker
  • Last Modified Date: 26 September 2016
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Reimbursement billing is a process of submitting a claim through which the claimant receives monetary compensation for the expenses paid out by him. Reimbursement traditionally was handled by a company's financial department, but as work volumes increased, the processed changed. Improvement was brought about over a period of time by entrusting the task to reimbursement services, a specialized branch comprised of highly trained individuals. It is obligatory for such a service to be aware of the various procedures and legal requirements involved in reimbursement billing, so it may function as an independent entity separate from the finance department or even from the company itself.

The process of reimbursement billing is put into motion when the claimant submits a form requesting to be compensated. This claim needs to conform to the format which is recognized and approved by the company and by government agencies to be considered legal. Additional requirements when filing a claim are proper documentation and accuracy of information. In order to ensure speedy reimbursement of funds, all the expenses mentioned on the bill are normally first converted into universal reimbursement codes to facilitate the ease of interpretation.

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When reimbursement billing is applied within the medical field, is performed by a specialized agency known as a medical reimbursement technician. The job description of such a person entails checking on all insurance-related aspects of the claim, such as enrollment, verification and authorization. Other related functions involve activities such as scheduling, coding, billing and reconciling amounts while making collections. Claims for reimbursement billing are usually submitted by the insurance companies and submissions may occur online, by mail, or even by fax. Alternatively, businesses also have the option of hiring the services of a freelancing medical billing specialist as well.

One of the most important facets of reimbursement billing is following up with debtors since this is the only way to prevent a claim from becoming severely delinquent or uncollectible. While preparing claims, it typically is standard to give priority to larger claims and subject them to an acknowledgement check to be able to identify clerical errors and other types of poorly transcribed information. Accordingly, submissions made after the correction of erroneous mistakes can often be much more difficult to collect, especially if the local statute of limitations has expired on the right to seek civil action. Throughout the process of reimbursement billing, there are constant obstacles that agents must overcome to ensure the company does not have these types of issues.

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