Medical Billing Data Entry

Medical Billing Data Entry - Entering claim information and posting payments. Find out what the typical data entry tasks are for a medical billing specialist.

The primary medical billing data entry tasks are entering claim information and posting insurance and patient payments.

Claim Information
This includes entering patient name, address, date of birth, insurance ID's, insurance company information, and what family member the policy is under. The patient visit is usually documented on a superbill, after the patient visit, the biller will enter the ICD-9 diagnosis and correspondingCPT treatment codes and modifiers in the billing software.

Sometimes a medical billing specialist is trained in coding and can interpret the doctors notes into the appropriate codes first. It also involves making sure the CPT treatment codes match the ICD-9 diagnosis code.

Payment Posting
Post of payments from EOB's (Explanation of Benefits). This is a medical billing data entry task that involves reconciling the payment information for each paid claim, the write-off, deductible or co-insurance, etc. Once the EOB information is entered, the patient is billed for any remaining balance.

For a large practice, this can be several hundred statements if the patient accounts have not been maintained. You can imagine how long it can take to fold and stuff all those envelopes. Not to mention the postage.

Depending on what billing software you are using, a lot of clearinghouses now offer the ability to send patent statements electronically - similar to electronic insurance claims. They will print and mail the statement with a return envelope. Believe me - this is a real time and cost saver!

Electronic Remittance Advice – ERA
Many insurance companies have the ability to send payment information electronically. This is called an ERA – Electronic Remittance Advice. This is like and electronic version of an EOB. Most clearinghouses have the ability to post these ERA’s on their website – for an extra cost of course.

Our clearinghouse ENS Health charges about $30 a month for this. However this is a time saver as we can retrieve the payment information as soon as it’s available and it saves the physicians office from having to fax to us. Some software vendors claim to have the ability to electronically post insurance ERA’s.

I’ve tried that but it ended up taking as much time as manually posting payments. We had to check and “clean up” everything posted electronically. So beware when a software (or online billing software) claims posting electronically is as simple as point and click.

Check out the billing specialist job description page for more details on all the different tasks performed by the medical billing specialist in addition to data entry.




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