.svg){kind=icon}
.svg){kind=icon}
Expert knowledge of all the states guidelines and Medical Billing Process. And expert knowledge of Medical Coding
Get to know
.png)
.png)
.png)
Detailed guide to Hawaii
Medical Billing Process Overview
- Patient Registration: Collect patient demographics and insurance information when scheduling appointments
- Eligibility Verification: Check patient's insurance coverage and financial responsibility
- Charge Entry: Use encounter forms to enter procedures performed into practice management system
- Claim Preparation: Convert encounter forms into claims, ensuring coding and billing compliance
- Claim Submission: Submit claims to payers electronically or by mail
- Claim Follow-Up: Monitor claims status and appeal denied claims
- Patient Billing: Generate patient statements and collect outstanding balances
- Collections: Pursue collections on delinquent accounts
Billing Compliance
- Follow HIPAA and OIG guidelines for billing compliance
- Ensure coding is accurate and procedures are billable based on patient's insurance
- Include required claim elements like patient info, procedures, diagnoses, provider NPI, and place of service
Occupational Outlook
The job outlook for medical billers in Hawaii is projected to grow 8% from 2020-2026, faster than average. The median pay for a certified medical biller is $56,981.In summary, medical billing in Hawaii involves submitting claims using the CMS-1500 form for physician services, following state-mandated reporting requirements, and adhering to billing compliance standards. The process consists of patient registration, eligibility verification, charge entry, claim preparation, submission, follow-up, patient billing, and collections. Proper training and certification are important for success in this growing healthcare career field.
Billing Form Requirements
- For physician services and pathology/laboratory, use the CMS-1500 form
- No specific form is required for facility, pharmacy, or dental services
State-Mandated Physician Reporting Requirements
- Initial Evaluation: Physician’s Report due within 7 days
- Interim Evaluation: No form specified
- Final Evaluation: No form specified
- Consultation: Consultation Report due within 14 days
Electronic Billing Mandate
Hawaii does not require electronic billing, so providers have the option to submit either paper or electronic claims.
Medical Billing Process Overview
- Patient Registration: Collect patient demographics and insurance information when scheduling appointments
- Eligibility Verification: Check patient’s insurance coverage and financial responsibility
- Charge Entry: Use encounter forms to enter procedures performed into practice management system
- Claim Preparation: Convert encounter forms into claims, ensuring coding and billing compliance
- Claim Submission: Submit claims to payers electronically or by mail
- Claim Follow-Up: Monitor claims status and appeal denied claims
- Patient Billing: Generate patient statements and collect outstanding balances
- Collections: Pursue collections on delinquent accounts
Billing Compliance
- Follow HIPAA and OIG guidelines for billing compliance
- Ensure coding is accurate and procedures are billable based on patient’s insurance
- Include required claim elements like patient info, procedures, diagnoses, provider NPI, and place of service
Occupational Outlook
The job outlook for medical billers in Hawaii is projected to grow 8% from 2020-2026, faster than average. The median pay for a certified medical biller is $56,981.
Education Requirements
- High school diploma or GED equivalency is strongly recommended
- Post-secondary education in medical billing and coding is available through certificate programs or Associate’s Degrees
- Certifications from AHIMA or AAPC are recommended but not required
Certification Requirements
- Certifications can be achieved separately or as one comprehensive certification
- Various post-secondary schools offer these certifications, which can be achieved in one year
- Many employers require a two-year Associate’s Degree from its medical billers and coders
Medical Billing Codes
- CPT codes are used for physical therapy services, such as CPT code 97110 for therapeutic procedure on one extremity
- CPT codes are used for radiology services, requiring significant knowledge of CPT codes and appropriate modifiers
Additional Resources
- Medical Billing and Coding Jobs in Hawaii: List of current job openings
- Hawaii Health Information Exchange: Variety of Hawaii health information resources
- Medical Billing Jobs in Honolulu: Latest medical billing job openings in Honolulu
- Health Information Management Association of Hawaii: Resources specific to Hawaii