Total Medx

The terms medical billing and revenue cycle management (RCM) are often used interchangeably by healthcare providers. They may refer to different processes, even though both are necessary to collect payments for healthcare services. Learning the difference between RCM and medical billing might help in detecting revenue leaks, enhancing cash flow, preventing claim rejections, and improving the overall financial process.

Medical billing refers to the actions of sending claims for healthcare services provided to patients to different insurance companies so that payment can be received. The process usually starts after patients receive care and their medical treatment is recorded.

Specifically, medical billing comprises the following steps:

• Checking the information about the patient and insurance
• Creating and sending claims to the insurance company
• Applying and checking codes
• Controlling the status of claims’
• Recording payments from both the insurance and patients
• Managing denied claims
• Presenting statements to the clients
• Providing answers to billing-related questions