Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for healthcare services provided. As healthcare costs continue to rise, it’s becoming increasingly important for healthcare providers to accurately and efficiently bill insurance companies to maximize revenue.

One term that is commonly used in medical billing is “premium”. In the context of medical billing, a premium refers to an additional charge that is added to the cost of a medical service. Premiums are typically associated with services that are considered to be “above and beyond” the standard level of care.

Premiums may be charged for a variety of reasons, including:

1. Specialized equipment or supplies: Some medical procedures require the use of specialized equipment or supplies that are not typically used in standard medical care. For example, a magnetic resonance imaging (MRI) scan requires the use of specialized equipment that is not found in most healthcare facilities. The cost of using this equipment may be passed on to the patient in the form of a premium.

2.  Additional time or expertise: Some medical procedures require additional time or expertise from the healthcare provider. For example, a surgeon may need to spend more time performing a complex surgical procedure than they would for a routine procedure. The additional time and expertise required may be reflected in a premium charge.

3.  Non-covered services: Some medical services may not be covered by insurance, either because they are considered experimental or because they are not medically necessary. If a patient chooses to receive a non-covered service, they may be required to pay a premium for the service.

4.  Concierge services: Some healthcare providers offer “concierge” services to patients, which may include access to a dedicated physician, same-day appointments, or other perks. These services may be provided for an additional fee, which may be called a premium.

It’s important for patients to understand what premiums are and when they may be charged. Patients should ask their healthcare provider or insurance company if they have any questions about premiums or other charges associated with medical services.

In addition to understanding premiums, patients should also be aware of their insurance coverage and any out-of-pocket costs they may be responsible for. Insurance policies can be complex and difficult to understand, but patients can usually find information about their coverage and costs online or by contacting their insurance company directly.

Finally, patients should always review their medical bills carefully to ensure that they are accurate and that they are not being charged for services they did not receive. Billing errors can and do happen, and patients should not hesitate to contact their healthcare provider or insurance company if they notice any discrepancies on their bill.

In conclusion, premiums are an additional charge that may be added to the cost of a medical service for a variety of reasons. Patients should be aware of what premiums are and when they may be charged, and should always review their medical bills carefully to ensure that they are accurate. By staying informed and proactive about their healthcare costs, patients can help ensure that they receive the care they need without breaking the bank.

You can enroll for our Online Medical Billing Training here: