Health IT JumpStart: The Best First Step Toward an IT Career in Health Information Technology

Chapter 9

Operational Workflow: Back Office

• Revenue management cycle
• Contracts
• Medical billing and coding
• HIPPA and EDI
• Claims process
• Collections process
• Dispute resolution
• Third-party billing

Healthcare is one of the few industries where services are not paid for when they are received. The medical practice provides service to the patient and bills a third-party insurance company to receive payment for the service provided. Cash flow is essential for any business, and managing the flow of money is critical to the viability of a medical practice. The provider’s back-office staff is responsible for the administrative functions of the medical practice, including patient billing and accounting. Medical billing is a complex job that demands knowledge ...