Not necessarily. While a medical biller plays a crucial role in processing and submitting healthcare claims, the creation of the claim often begins with the healthcare provider or facility itself, such as a hospital, doctor's office, or clinic. The healthcare provider generates the claim by documenting the services provided to the patient, including medical procedures, diagnoses, and other relevant information.
Once the claim is created at the provider's end, it may go through various stages of processing, including coding, billing, and verification. This is where a medical biller may come into play to ensure that the claim is accurately coded and submitted to the insurance company or third-party administrator for reimbursement.
So, while a third-party administrator receives and processes electronic healthcare claims, the responsibility for creating the claim typically starts with the healthcare provider, and the medical biller plays a role in the subsequent processing and submission of the claim.