ELI5: Explain Like I'm 5

Medical billing

Medical billing is the way that doctors, hospitals, clinics, and other healthcare providers get paid by insurance companies or patients. When you go to the doctor or get medical treatment, they write down all the things they did to help you feel better. This is called a “medical claim”.

The medical claim usually includes codes for the services and procedures you got, like a doctor’s visit or an X-ray. The healthcare provider sends the medical claim to the insurance company or patient. The insurance company or patient then pays the healthcare provider for the services they provided.

Sometimes, the insurance company doesn't want to pay for everything that was done or the patient can't afford to pay for everything themselves. In that case, the billing department works to negotiate with the insurance company to make sure the medical claim gets paid as much as possible.

Summing it up, medical billing is the process of getting paid for medical services and treatments. Medical providers send the medical claim to insurance companies or patients to get paid for the services they have provided. The billing department works to make sure the claim is paid as much as possible, even if the insurance company doesn’t want to cover everything.