Outpatient Facility Coding Alert - 2012 Issue 7
Reader Question: What's the 'Right Way' to Bill Medicare?
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Article Overview
This article addresses a practical Medicare billing question for participating providers and compares two common approaches to submitting claims and posting adjustments. It is aimed at coders, billers, and practice managers who handle Medicare reimbursement workflows, accounts receivable, and patient balance handling. The discussion focuses on high-level billing process considerations, remittance posting, and practice policy choices rather than on specific procedure coding.
Why This Topic Matters
Medicare billing workflow affects cash flow, patient statements, contractual adjustments, and how remittance advice is reconciled in practice. Understanding the general options helps office staff align billing methods with internal policy and reimbursement operations.
What You Will Learn
- How participating Medicare providers may structure claim billing workflows.
- How remittance posting and contractual adjustments fit into Medicare billing processes.
- What operational factors practices may consider when choosing a billing approach.
- How billing method choices can affect accounts receivable and patient balances.
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Revenue cycle staff
- Healthcare compliance staff
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