How Do Healthcare Claims Work?

After a patient encounter, your practice must convert the services you provided into CPT codes. These codes standardize the commonly administered services listed above.

Without them, healthcare claims would often include lengthy practitioner descriptions of administered services that would introduce inconsistencies. Instead, with CPT codes, payers instantly know which health services you provided and can determine whether the patient is covered by healthcare insurance.

Healthcare claims should also include your medical practice’s charges for each coded service. CPT codes have no impact on what you can and can’t charge for your health services – that decision is entirely yours to make.

The ultimate question becomes whether the patient’s health benefits will result in the payer entirely reimbursing you or deferring some – or all – of the payment to the patient.

Read More Click Here: Health Insurance Denial