Although medical billing can be complicated especially for the ordinary citizen, it can run smoothly if all components of the process are put into consideration and followed appropriately. In my opinion, the two most essential elements of the medical billing workflow include the Explanation of Benefits and the bill itself. The two components enhance effective communication between the patient and two parties he or she deals with, which are the insurance company and the healthcare provider.
The insured patient should receive Remittance Advice (RA), also called Explanation of Benefits (EOB), detailing the date of treatment, the type of treatment received, the provider, and the amount that the insurance plan allows among many other things. The explanation of benefits is offered by the insurance company to enlighten patients about a medical claim, including possible adjustments and deductibles. It is important for a patient to understand the document clearly and be careful not to mistake it for a bill. Although the document does not require any further action, it affects healthcare reimbursement in that they happen fast and the customer knows if he or she is expected to add any cash payments or not.
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On the other hand, the healthcare provider should provide the patient with an elaborate bill. The provider should clearly label the bill, showing the amount due and the due date to remove any doubt that it is indeed a bill. Additionally, the provider should be sure to use simple and understandable language. Clear and timely customization of bills increases the chances of the patient receiving medical reimbursement in full and on time. For instance, electronic billing increases flexibility by ensuring that patients can receive e-bills and alerts directly.
