What is Medical Billing and Coding? – Overview
Medical billing and coding professionals are essential in healthcare settings. These professionals are the key to ensuring that a healthcare service remains successful.
This field is for those who wish to join the healthcare community.
The Difference between Medical Billing and Medical Coding
Most people talk about medical billing and medical coding together. However, these are two very different professions.
While entry-level medical billing positions might require minimal educational qualifications, many employers prefer candidates with postsecondary education or certification in medical billing and coding.
Medical billing professionals submit claims to insurance companies and types of payers. This needs to be done in a timely and accurate manner.
It ensures that the healthcare provider gets paid on time for their services.
Medical coding typically requires specialized postsecondary education or certification, reflecting the technical knowledge and expertise needed.
Coding professionals play a critical role in the revenue cycle management of healthcare providers by accurately coding services for billing and reimbursement.
Individuals with in-depth knowledge and the ability to handle additional responsibilities are ideal for working as medical coding professionals.
Medical coding professionals review clinical documentation from healthcare providers and assign appropriate codes for billing and reimbursement purposes.
There are opportunities for healthcare providers to hire the same individual to handle medical billing and coding.
Everything About Medical Billing
Medical billing professionals are responsible for submitting claims. These claims need accurate and relevant codes entered by the medical coder.
This is important to communicate with insurance companies and other payers. Billing is a time-sensitive task and is tied to reimbursement for medical services.
A medical biller takes up once the medical coder has finished their work. Apart from submitting claims, medical billers also follow up on unpaid invoices.
They are responsible for creating patient invoices, developing payment plans, etc. A medical billing professional ensures that a healthcare facility is reimbursed for the complete invoice amount.
Medical billing also requires an immense eye for detail. Medical billers must check for errors to ensure timely reimbursement, necessitating a foundational understanding of medical coding practices and systems.
Medical billers ensure that healthcare providers receive an accurate amount of payment. Usually, a day in the life of a medical billing professional involves:
- Using diagnosis and treatment codes from medical coders to create and submit compensation claims
- Reviewing claims and codes to ensure accuracy of the level of healthcare provided by the hospital/clinic
- Communicating with healthcare providers, medical coders and insurance companies to iron out any inaccuracies or discrepancies.
- Working with patients to recover unpaid invoice amounts by insurance companies or other payers
- Communicating with healthcare providers and insurance companies to get pre-authorization for procedures and treatments as required
Everything about Medical Coding
Medical coding professionals are required to work on time-sensitive tasks. Their work directly impacts the healthcare provider’s cash flow.
This means that healthcare organizations depend on medical coders to ensure continued reimbursement. Although medical coders primarily focus on coding clinical documentation for billing purposes, some are also responsible for managing medical supplies and stocking, among other tasks.
Medical coders need to have an eye for detail. This is essential to pick relevant information from documents and convert it into correct medical codes.
Medical coders are integral to the functions of healthcare providers. Usually, a medical coder’s typical day involves:
- Reviewing medical documents and translating notes into different codes
- Communicating with doctors, insurance companies and other payers
- Using digital coding software tools and patient record platforms
Employment opportunities for medical billing and coding professionals
Certified medical billing and medical coding professionals are employed by healthcare facilities. They can work with clinics, standalone doctors’ offices, healthcare systems and hospitals.
They can also find work at nursing homes, long-term care facilities, rehabilitation centers and even the prison system.
The average salary for medical billing and medical coding professionals
Medical billing and medical coding professionals are classified in the general category of health information specialists.
The salary range for these professionals varies significantly. Medical coders tend to earn more than medical billing professionals.
This is because the medical coders’ task is significantly more technical and requires additional education and training.
As of the latest US Bureau of Labor Statistics (BLS) report, health information technicians, which include medical billers and coders, have a median annual wage, but specific figures should be verified for the most current statistics. See more at Medical Billing and Coding Salary.
The salary will differ according to location, type of healthcare setting and certification.
Conclusion
Medical billing and medical coding professionals are in high demand thanks to the digitalization of the healthcare industry.
As a certified medical coder or biller, you can find employment in numerous workplaces.
Please check our previous article to learn more about certifications and other requirements to become medical billers and coders.
See Also
4 Week Online Course for Medical Billing and Coding
How to Apply Medical Billing and Coding Schools
Medical Billing and Coding Grants
How Long Do Doctors Keep Medical Records
Free Medical Billing and Coding Course
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