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However, with technologically advanced improvements of medical practice management software systems, standardized electronic transactions, EDI, clearinghouses and payer portals, managing the payment process has become much more efficient.
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Employers often require billing certification.įor several decades, medical billing claims were submitted almost entirely on paper and many of the processes utilized in doctor's and medical billing offices were manually performed. Medical billers are encouraged, but not required by law, to become certified by taking an certification exam, such as the CMRS Exam (Certified Medical Reimbursement Specialist) in which billers demonstrate proficiency in the medical billing process. Medical billers can work in a doctor's office or in an independent third party billing company. Medical billers facilitate the claims paying process and are often viewed as an extension of the doctor's office reimbursement process. This process involves a medical biller submitting claims, following up on unpaid claims and appealing improper denials with health insurance companies in order to receive payment for services rendered. Medical billing is a payment process within the United States healthcare system that is used by doctors and other healthcare providers and insurers to get insurance claims paid.
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