Billing Information for Patient Encounters

To begin billing, providers must take several steps before and during patient encounters. Your practice may need to set a fee or sliding fee schedule that takes your patient population into account. Creating a policy and procedures manual that defines a systematic approach to implementing your practice’s policy expectations and work routines may also be useful.

Additionally, creating a process for scheduling appointments could help your practice manage the flow of patients through your clinic. You can gather insurance information when scheduling appointments to perform insurance verification and inform patients of any out-of-pocket costs prior to appointments. Health care providers can use medical claims management systems software or health plan secure provider portals to verify insurance.

During a patient encounter, a patient registration form may be useful in collecting demographic and insurance information necessary for billing. Providers also usually complete a patient encounter form with the procedural and diagnosis codes corresponding to the patient’s examination. The information in this form is necessary for submitting claims.

• Child and Teen Checkups (C&TC)
  Child and Teen Checkups (C&TC) is a comprehensive child health program provided to children and teens (newborn through the age of 20) enrolled in Minnesota Department of Human Services–Medical Assistance (MA) or MinnesotaCare. Consider billing for immunizations as a part of C&TC appointments.
• Referral Definition
  A referral code is necessary for billing for C&TC.