Insurance claims’ life cycle is initiated when patients contact healthcare facilities to book an appointment. The process ends when the insurance company reimburses generated medical bills. Medical billing and insurance specialists play significant roles in the insurance claim process.
My role as the medical billing and specialist is to print, record, and submit insurance claim forms while adhering to the Health Insurance Portability and Accountability Act (HIPAA). I record patient data using software that reduces my chances of errors significantly (Staff Writers, 2019). I also use optical character recognition to decode patient information for submission to insurance firms electronically. Hence, I process and submit insurance claims electronically.
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The most challenging aspect of my job is processing manual insurance claims. The hospital mandates me to print and mail paper claims to insurance providers for payment. I interact with vast data and forms daily, which enhances my chances of human error. My likelihood of printing documents improperly and handwriting codes wrongly are high compared to software use. Additionally, records may be damaged in transit. Hence, processing paper claims challenges my role execution.
The Fair Debt Collection Practices Act (FDCA) provides ethical guidelines for use requesting payment from insurance companies. First, FDCA requires debtors to prove the debt exists (Fay, 2018). Second, FDCA prohibits debtors from harassing creditors through threats or profanity. Third, debtors should not lie to collect debts or impersonate for collection purposes. Moreover, debtors may not engage in an unfair practice, garnish wages, or provide misleading correspondence. Hence, debtors should adhere to FDCA debt collection guidelines.
My responsibility is to process patient insurance claims. I use electronic software and manual paper claims processing to conduct my duties. I ensure that I adhere to the FDCA policies when processing insurance claims.
References
Fay, B. (2018, May 7). Fair debt collection practices act: What you should know. Retrieved from https://www.debt.org/credit/your-consumer-rights/fair-debt-collection-practices-act/
Staff Writers. (2019, September 6). The medical billing process. Retrieved from https://www.medicalbillingandcoding.org/billing-process/
