Thursday, 1 March 2012

Medical Billing

Looking for best Practice Management software ? Please email at

I strongly feel that Development of PMS Product is more on the domain/business logic other than the technology. So would to like to share the information in PMS thru my blog.

There are lot of articles/books/document sitting on my desk which I have collected from various sources for the past 10 years. From that, so I will try to educate on that in a simple and easy to understandable way with an example when necessary.

Chapter 1: Medical Billing Workflow
1. Medical Billing Use Case

Chapter 2: Medical Billing Process
1. What is Medical Billing Process ?
2. Different Format of Medical Form.
3. Patient Insurance
4. Electronic Claim Transmission
5. Medical Billing Clearing house
6. Medical Billing Process in detail
7. Healthcare Coding system.
8. Maintaining Patient Insurance in the software.
9. What are the Billing Entities ?
10 What is Pre Authorization.

Chapter 3:  EDI Transactions

1. What is an EDI ?
2. EDI Transactions 

3. Understanding EDI Structure
4. EDI Instruction
5. EDI 5010 Documentation 837 Health care claim : Professional
6. EDI 270 - 5010 Health Care Eligibility/Benefit Inquiry

Chapter 4: Payment
1. EOB – Explanation of Benefits
Understanding EOB - Explanation of Benefits
3. Understanding EDI 835 Electronic Remittance Advice
4. What is Copay, Co Insurance and Deductible in  Insurance Payment Posting ?

5. Types of Reimbursement
6. How to process Co pay, Co Insurance and Deductible Amount in Insurance Payment Posting ?

Chapter 5: Claim Submission after Primary Insurance
1. How to submit the claims after primary insurance ?

Chapter 7: Claim Processing by the insurance company

1. Claims adjudication and Payment process.?


New to Health care Domain ?  Here are some documents which can help you to understand the basics.  I am trying to refer to official link(where i downloaded the document)   and as well as link to my server(some time, official links are broken).

1. Introduction_to_Health_Care_in_USA   (or you can click here to download)
Medicare Incentive Program Beginners guide MU Stage 1 ( or you can click here to download)

All about Prescription

Flow charts

Medical Billing blogs


  1. Thanks for sharing. You have been shared very useful information. The Medical Billing Outsource would turn the healthcare practice to get the reimbursements ASAP and makes ensure that the claim amounts should be accurate and not an un-paid or rejections.

  2. Hi Senthil,

    This is very Nice blog.... I really appreciate your hard work and dedication to create this blog.

  3. Many thanks for the exciting blog posting! I really enjoyed reading it, you are a brilliant writer. I actually added your blog to my favorites and will look forward for more updates. Great Job, Keep it up..
    chiropractic emr software

  4. Thanks for the FANTASTIC post! This information is really good and thanks a ton for sharing it :)
    Top Medical Billing Companies

  5. You are so cool! I don't suppose I've read anything such as this prior to. So nice to get somebody by original thoughts on this subject. Really thanks for beginning this up.

    21 Best Chiropractic Websites in 2017, Designed by Optimized360.Com

  6. Hey,
    Thank you for sharing such an amazing and informative post. Really enjoyed reading it. :)



    Medical Claims Management

  7. Great blog post and really helpful and your blog are very interesting...
    Medical Coding Training Hyderabad


  8. awesome post presented by you..your writing style is fabulous and keep update with your blogs.

    Medical coding training


  9. The article provided by you is very nice and it is very helpful to know the more information.keep update with your blogs .I found a article related to you..once you can check it out.

    Medical Coding Surgery training

  10. I really enjoy reading your blog and waiting for your next update. I appreciate all the work you put into this site, helping out others with your services.

    durable medical equipment billing


Passing Parameter between two files using MVVM

This examples shows how to pass parameter between two zul screens. In this example, we are passing some parameters from the parent vm to...