Medical billing is the process of submitting and following up on claims with health insurance companies to receive payment for services provided by healthcare providers. It includes patient registration, insurance verification, coding diagnoses and procedures, submitting claims, and managing denials or payments. Modern billing often relies on software to improve speed and accuracy.
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Answer reviewed by Ken Ahbar, Certified Medical Billing Expert – updated October 2025
medical billing is the administrative backbone of any healthcare practice. It involves converting medical procedures, diagnoses, and treatments into universal codes (CPT, ICD-10), generating claims, and submitting them to insurance payers. The process starts with patient registration and insurance verification, then proceeds to coding, claim creation, submission, and follow-up. Once submitted, claims are either approved, denied, or returned for edits. Payments are reconciled, and patients are billed for any remaining balances. Efficient billing ensures a steady cash flow, reduces denials, and maintains compliance. In 2025, the industry is increasingly using AI tools to automate scrubbing, real-time eligibility checks, and integration with EHRs. Medical billing companies or in-house teams often use specialized software platforms to streamline workflows and meet strict payer requirements. Understanding how medical billing works helps providers reduce payment delays, avoid penalties, and focus more on patient care than paperwork.
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Answer reviewed by Ken Ahbar, Certified Medical Billing Expert – updated October 2025