Now as mentioned above the insurance company pays the fee to the health care provider on behalf of his client. But in order to claim this fee, the health care provider must go through the process, which is known as medical billing.

A patient comes to visit his doctor or health care provider. He makes a diagnosis of the disease and then creates or updates the patient's medical record, which contains personal information, nature of illness, prognosis and suggested treatment as well. This is called an 'encounter'.

The patient record is handed over to the medical coder, who then translates all information such as services, tests, treatments, supplies and procedures into coded billing statements referring to ICD-10 and CPT codes (which consists of a set of numbers and combinations of sets of numbers) onto a billing record (paper or electronic) known as CMS1500. This claim is sent to either a clearinghouse, which acts as an intermediate, or directly to the insurance company.

Choosing a 'clearinghouse' is very cost effective for medical billing because they edit the claim based on the rules stated by the payer, and also if the claim does not meet the criterion, the claim is sent back to the user, so they can make corrections and quickly retransmit it. This saves time as well as later complications.

If it is to be sent directly to the insurance company then after a patient's visit a medical biller assesses the super bills or encounter forms to decide the patients' eligibility for the payment; double checks the medical provider's qualifications and the fee, and will approximate what charges will be covered by insurance. He is the one who sorts the medical bills, check for errors and omissions, answers all the patient's queries and spends hours on the telephone with insurance companies for the sake of the client.

If all of this is not verified then the claim is rejected and sent back. The healthcare provider will have to make the necessary changes and resend it through the original procedure. Sometimes this exchange of claims and rejections is repeated a number of times until the payment is finally made.

Medical transcription is a process of transforming medical data dictations recorded by doctors or healthcare professionals into a proper written document that can be stored in printed form or as an Electronic Medical Record (EMR), which is much preferred these days as it is an efficient and secure way of storing valuable patient information.

The documents include physical examination reports, operation room reports, patient history, consultation notes, images, autopsy reports and discharge summaries.

The Process:

Whenever a patient comes to see the doctor, it could be for a number of reasons. The doctor examines the patient and then prescribes treatment in the form of medicines, tests, and certain other procedures. He records all patient information i.e. personal and medical through a Dictaphone or by using Speech Recognition software. It is very important that doctor speaks slowly, clearly and succinctly. They also should try to spell medical terms with accuracy, but this seldom the case.

This medical record is then given to the Medical Transcriptionist. After the document is ready, both the MT and doctor must carefully review it, because if the MT inadvertently makes a typing mistake and the doctor does not go through it either, then this could result in dire consequences.

What are they? They are computer-based patient records or simply a medical record available in a digitized format and have quickly overtaken over the traditional paper records because of the following reasons:

- Maintaining these records requires less effort and time.

- Doctors and nurses can easily access patient information.

- If a patient changes his medical facilities, transfer is no longer a problem.

- Patient history can be looked up easily.

- Claim processing in medical billing has been greatly facilitated as well.

These records have also reduced typing errors and interpretation of terms. That is why in case of emergencies like allergies, heart attacks, hemorrhages etc, having patient information on hand can prove to be critical in saving a patient's life. Therefore in the past years the number of deaths has decreased in the US, which were caused by such miscalculations.