The Billing Agent

The job of the billing agent is to bill individuals, and mainly insurance companies for the treatments that a patient receives. This sounds like an easy job, but it is rather complicated and it requires extensive use of mathematics.

First of all, all billing is done with numbers. Patients are referred to by numbers instead of names because it would be too hard to quickly differentiate between all of the different William Jackson's in the world for example. So, each patient has a unique number assigned to them so that the person can be easily distinguished by all of the different companies that are involved in the billing process. This number is usually a person's social security number.

Most patients have an insurance policy which has a unique policy number. This allows the billing agent to quickly find out information about which company insures the patient and what is covered under the policy. One mistake in any of these numbers could cost the company thousands of dollars.

Secondly, each treatment that a patient receives has a code number and a price. So, each code number must be input correctly in order to bill the patient the correct amount of money. The billing agent must be able to add all of the different prices together in order to find the total amount of money the the patient will be charged. Currently, most of this is done with computer programs so that the billing agent serves mainly as a check of the calculations that have been done by the computer.

Third, each insurance policy has different parameters. Some have co-payments, others have deductibles, some pay different percentages of the treatment price. Other insurances have contracts that require price adjustments to the treatment price because they will not pay what the office wants to charge. This is when the billing agent really has to use mathematics. He/she must be able to calculate percentages and bill the correct amount to the insurance company and the correct amount to the patient. The agent must also be able to adjust treatment prices and totals using addition and subtraction. When deducibles are involved, the billing agent must be able to subtract the deductible and then often times find percentages based on the new amount to be billed to the patient and the insurance company.

 

So, it is impossible for the billing agents to do their jobs without using mathematics.


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