At first, a patient arrives and show off their insurance cards to their respective doctors. The doctors can check the validity of their insurance in their office or they ask us to validate it. After the validation, data entry works begin where all the information is entered into the system. Afterward, the data is sent to a medical coder (reconciliation level 1) to abstract and translate it into useable medical code. Reconciliation level 2 checks for error and edit it if required. When all the codes are received, the claim report is then sent to the payer (insurance companies) electronically. Within the span of thirty days, the payment process report is received. Three scenarios come up:

• Payment successfully received and the claim is resolved
• The claim is in process
• Claim denial

The claim payment received is then sent to the respective physician and the patient is called to ask about their insurance and the effectiveness of the insurance. If the payment is still in the process then we ask for updates and make the process completed as early as possible. The last is when the claim is denied then the A/R follow-up team receives it and looks for solutions to the problems that occurred during the claim. The patient is called and information about their insurance and the claim is then resubmitted after knowing the error. In the end, a report is made and sent to the doctor about the patients and their claims.