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What is Medical Billing & RCM?

Medical Billing is the process that ensures healthcare providers get paid for the services they deliver. It begins the moment a patient schedules an appointment and continues until the final payment is collected. Medical billers take the clinical information from doctors and convert it into standardized codes, prepare claims, and submit them to insurance companies for reimbursement. They also follow up on unpaid claims, correct errors, appeal denials, and communicate with both patients and insurers to make sure every service is billed accurately.

Revenue Cycle Management (RCM) is the complete financial ecosystem behind medical billing. It covers every step of a patient’s financial journey—from verifying insurance eligibility, obtaining prior authorizations, capturing charges, coding diagnoses and procedures, submitting claims, posting payments, to handling denials and patient billing. RCM brings together the administrative, financial, and clinical aspects of healthcare into one streamlined process, ensuring providers receive timely and accurate revenue.

Claim forms are official documents used to request reimbursement from insurance payers for healthcare services provided to patients. They act as the financial communication bridge between healthcare providers and insurance companies, ensuring all clinical, demographic, and billing information is accurately submitted. In the U.S. healthcare system, there are two primary claim forms, each designed for specific types of services:

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