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Chapter Overview
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Chapter 2 introduces the hospital billing process. When patients visit a hospital, the facility's business staff works together with the clinical staff of physicians and nurses and with the support staff, such as housekeeping and food service, to make the encounters as satisfactory as possible. Clinicians plan and perform medical treatments and procedures. The business staff follows a process that helps ensure that all services are documented and reimbursed.

After patients are registered, the medical care provided to them is documented in their medical records. Also recorded is the cost of each service or supply that is billable to a patient's account. At the end of the inpatient hospitalization or outpatient visit, the charges are collected and entered in the patient accounting system. Patient account specialists use this system to prepare insurance claims and patients' bills. This work is done carefully to avoid billing errors that might lead to incorrect charges, unpaid bills, or late payments. The process continues with sending insurance claims to third-party payers and bills to patients, processing payments, and collecting overdue accounts.

Learning Objectives

Describe the main steps in the hospital billing process.

List the items that are entered into the patient accounting system to establish the patient's account during preregistration or registration.

Compare and contrast routine charges and ancillary charges.

Discuss the content and purpose of the charge description master.

Identify the main causes of billing errors.

Identify the advantages and disadvantages of using information technology in the hospital billing process.







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