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Importance of Successful Medical Billing Charge Entry

Author: Shrikant Guthe
by Shrikant Guthe
Posted: Oct 29, 2020

The Medical Billing Charge Entry Process is an essential part of Medical Billing Process.It determines the amount of reimbursement that the provider will receive from the insurance payer. A trained, experienced individual must execute this process, and the charges from the coded documents must be entered correctly. If the charges are not correct, or if any part of the form has errors, the entire process will likely have to start over.

It's an intricate process that requires a high degree of training and quite a bit of experience.

Medical Billing Charge Entry is the first step in the Medical Billing Services. It begins with filing claims using Medical Charge Entry information provided to patients and creating bills. It's done electronically to shorten the revenue cycle.

Patient Demographics and Medical codes applied to charts are appropriately verified. Every claim is confirmed to check: DOS, POS, Provider Info, Units, Modifiers, CPT code, Facility billed from, and Referring Doctor, to reduce the chance of claim rejection.

Claims are also submitted to clearinghouses to make sure that complete accuracy is maintained. CMS 1500 forms are also generated for Government Healthcare providers.

Spin The Wheel, Win a Prize!

There's an enduring television game show- watched worldwide- that involves a giant spinning wheel. The wheel has 28 sections, the contestant spins the wheel, and whatever section ends up on the pointer, that's the prize (or penalty) the player receives with the appropriate sound effect (beep!), of course.

One can easily imagine a scenario where a wheel like this is used for revolving claim denials because of missing or incorrect information on a typical insurance claim form. Get a code wrong? Beep! Leave a field blank? Beep! Use the wrong modifier? Beep!

This is not a fun game.

To avoid any delay in payments, minimize the instances of denied and rejected claims, and increase the amount of income recovered in the billing process, EVERYTHING needs to be done right! And there's a lot to do:

Charge Entry in Medical Billing consists of Medical Data Entry:

  • Creation of New Patient Accounts
  • Demographic Detail Entry
  • Collection of Received Super-bills
  • Medical Record Scanning
  • Medical Coding
  • Charge Entry From Coded Documents Into Existing Patient Account
  • Creation of Insurance Medical Claim
  • Audit and Quality Check
  • Supervisor Review
  • Submission of Medical Claim to Insurance Payer
  • Follow Up and Revision (if needed)

From the above list, you can see that the process is long, complicated, and requires training and experience to execute. Do you have the time and resources to train one of your existing staff? And continue that training so they can keep current on the changing rules and regulations? This is just one of the reasons that outsourcing charge entry makes a lot of sense.

If you could hire a team of professionals with an outstanding track record in Charge Entry Services, and do this at a fraction of the cost as your in-house process, wouldn't you?!?!

This is where Outsourcing comes in to save the day.

The world of Business Process Outsource has exploded over the last two decades. What was once just a call center to handle customer inquiries or field orders is now a sophisticated, comprehensive industry that offers an abundance of different services to almost all business sectors, including healthcare.

Most of BPO's training and experience matches and often exceeds that of onshore counterparts. Language proficiency is first-rate, with many multi-lingual operatives. And for a Successful Medical Billing Charge Entry, use a BPO to supply:

  • Billing Information Entry: Using medical billing software, a trained team of professionals will carefully enter all the patient's details.
  • Charge Assignments: Using the medical history, diagnosis, X-rays, and other imaging, test results, and chart information, they can create a new patient account, then enter the details from the coded documents sent by the healthcare organization. A key here is an error-free entry, something that Offshore sources excel at.
  • Charges Submission: The whole process seems to be one challenge after another, and your team has to be proficient at each step.
  • Patient Demographic Entry: All the essential patient details must be correct, or the claim will be rejected.
  • Billing Data Quality Checking: Even before entering the data, your team will check for errors and missing information. They understand that mistakes in any of the process can start a whole chain of events that will delay payment or reimbursement.

If you've done Charge Entry or even watched someone else do it, you know that it's a complicated, time-consuming job. The various codes and modifiers seem to offer an infinite number of possibilities for error, and each keystroke is crucial.

To hire an experienced specialist for your office rarely makes sense. That's why the offshore markets exist. And Outsourcing solutions can save you 40% or more of the cost of hiring an in-house specialist. And they can scale the team to suit your needs, so there's even more economies to be had.

Don't spin that wheel and take a chance! Find someone to trust!

For more than 20 years, Rely Services has been a leader in Business Process Outsourcing. Their innovations have become industry standards. Their accuracy is the envy of competitors. Their standards are second to none.

  • HIPPA Compliant and have been since Day One.
  • Their Charge Entry Specialists complete a rigorous training course with periodic re-testing.
  • A Charge Entry error rate of less than.01%
  • Using only the latest tech, including software and hardware with state of the art security procedures.
  • Offering worldwide services, including quick turn around with 24/7 response.
  • Cost-effective methods that routinely save clients 40% or more over onshore services.
About the Author

Rely Services is a leading global Business Process Outsourcing - BPO company delivering business solutions for over a period of 20 years. Our authors consistently publish articles on various business processes.

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Author: Shrikant Guthe

Shrikant Guthe

Member since: Nov 11, 2019
Published articles: 14

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