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Ch 2/6/06 5:49 PM Page 131. 131 Section One: Section Title Chapter 00: Chapter Title 131. Chapter 5. The Hospital Billing Process T he purpose of this chapter is to provide an overview of the Hospital Billing Process . The Billing Process includes submitting charges to third-party payers and patients, posting patient transactions, and following-up on outstanding accounts. As discussed in the previous chapter, information collected during the patient visit is utilized to complete the tasks required to bill for services rendered. A review of the purpose of the Billing Process will Outline provide an understanding of how vital Billing functions are PURPOSE OF THE Billing Process . for the Hospital to maintain a sound financial base. PAYER GUIDELINES. The role of Hospital Billing and coding professionals is Participating Provider Agreements complicated because of the ever-changing health insurance Claim Forms environment and variations in payer guidelines. It is Clean Claim essential for Billing and coding professionals to understand Reimbursement Methods payer guidelines in order to ensure that proper reimburse- Reimbursement Methods by Service Category ment is obtained and to be compliant with payer guidelines.

The purpose of the hospital billing process is to obtain reimbursement for services and items rendered by the ... certifications, medical record documentation, coding,

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