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What does ICN stand for in medical billing?

Jul 25

Although invoicing and coding are independent procedures, they are both required for suppliers to be paid for medical services. Medical billing services and medical coding services are two distinct but related processes.

Healthcare billing employs these codes to generate insurance requests and patient invoices by collecting chargeable data from the patient history and clinical paperwork. Healthcare invoicing and coding come together in the process of making claims to create the foundation of a medical billing services companies

A patient visit in a doctor's clinic, hospital, or other medical center is when medical coding begins. Whenever a patient interaction takes place, healthcare professionals document the visit or treatment in the person's medical file and provide a justification for why they provided particular services, goods, or processes.

According to AHIMA, reliable and thorough clinical recording is essential for medical invoicing and coding throughout the patient contact. "Do not code it and invoice for it when it is not recorded in the clinical record" is the cardinal rule of invoicing and coding in the medical industry.

In many ways, medical billing is just what the name suggests. It entails using the healthcare codes to produce an insurance claim, which is a charge for health insurance companies. To receive payment for the treatments provided, a healthcare professional must file these requests to the health insurers of the patients. This procedure is known as medical invoicing. Keeping tabs on insurance claims to assure the compensation is made is another duty of medical billers.

The medical facility's medical billing company are crucial since it protects and increases revenue.

What are the duties of a healthcare biller and coder?

The task of a healthcare account holder and coder is to take health data and further transform it into codes so that the provider can be compensated by health insurance providers. This person is typically in charge of reading and analyzing patient information, coding it, putting it into the database, and filing the codes and requests to insurance providers. The Healthcare Biller and Coder is frequently a single person, but this position can also be held by two independent professionals—one Biller and one Coder—who collaborate to make sure bills are cleared in a timely manner.

On the healthcare coding aspect, the specialist would be in charge of analyzing clinical declarations, patient records, transcriptions of doctor's notes, and laboratory or radiology data, and putting conventional medical codes, based on a categorization system, each treatment or diagnosis.

The healthcare biller would next convert the code into health claims, which would be promptly sent to insurance providers or other providers according to the billing portion of the job role. The case will then be followed by this individual to make sure the provider is properly compensated for the work done.

On the very same page as the beneficiary's identity are the ID and the Internal Control Number (ICN), also known as the Claim Control Number (CCN). For each claim, a separate number will be used. One reimbursement of one request is uniquely identified by this 15-digit number. When completing a "void" or "exchange" of an initially paid claim, this number is necessary. The insurance provider assigns a number to each claim that is known as an "internal control number" or "ICN."

The internal control number (ICN), which is a reference number, is given to claims whenever they are submitted into the system. Each claim is given a 13-digit identification code or ICN. The following is the meaning of the digits:

  • Digits 1-2 indicates whether the request was filed digitally or on paper. 
  • Digits 3–4 identify the year when the claim was submitted, and 
  • Digits 5–7 identify the day of the year it was obtained.
  • Digits 8 through 13: These stand for a special set of numbers that the contractor allocated.

A 13-digit internal control number is a special way to identify a claim. The ICN is used by medical billing businesses as the claim ID. If you do have the right to do so, depending on the system setup, you can directly insert ICNs throughout the claim entry process using Smart Claims Engine.

ICNs are always discernible while exploring a claim because they are shown at the head of the claim screen.

Inbound 835s and XML responses to external programs use ICNs. The logic of the Put Claims and Post Claims APIs also uses ICNs.

The following details are among the information in an ICN:

  • The day on which the claim was submitted to Smart Claims Engine: the claim's service-level agreement (SLA) administration is based on the first seven numbers of the ICN, which indicate the decade, year, and Gregorian day when the claim was filed to Smart Claims Engine
  • The medium in which the submission was made: The 8th digit of the ICN denotes the medium in which the claim was made, such as print or electronic batch.

Indicator

Media type

P

Paper

E

Electronic batch

V

VAN (Value added network) POS

W

Web POS

 

  • The order number: The ICN's digits 9–11 show the sequence in which claims were submitted on the day they were filed to the Smart Claims Engine.
  • The claim edition: The edition is represented by the final two digits of an ICN; if a claim is modified, the edition is increased by one.

The Document Control Number (DCN), which certain healthcare payers give to claims, often contains similar basic metadata as an ICN.

Two systems event codes in the Smart Claims Engine are connected to ICNs. When a directly entered ICN is less than 13 digits long or if a double ICN is found, the corresponding event codes are set off.