VirtuMD Assistant Frequently Asked Questions

Medical billing is essential for healthcare providers to receive proper reimbursement for the services they provide. It ensures that healthcare professionals are compensated for their expertise, time, and resources. Proper medical billing also helps maintain the financial health of healthcare practices and organizations.

Medical billing codes, such as Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes, are used to represent specific medical procedures, diagnoses, and treatments. CPT codes describe the services provided, while ICD codes classify the patient's condition or diagnosis.

A medical biller is responsible for preparing and submitting claims to insurance companies, ensuring the accuracy and completeness of the billing information. They follow up on claims, communicate with insurance companies, resolve any billing issues or denials, and work to maximize reimbursement for healthcare providers.

Medical billing claim denials can occur due to various reasons, including errors in coding or documentation, incomplete or missing information, lack of medical necessity, billing for non-covered services, or exceeding coverage limits. Denials can also result from issues with patient eligibility or insurance policy limitations.

Outsourcing medical billing can be beneficial for healthcare practices, especially for those that do not have the resources or expertise to manage billing processes effectively. Outsourcing allows practices to focus on patient care while leveraging the specialized knowledge and efficiency of professional medical billing services.