What is Medical Billing and Coding?

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 be a part of the healthcare community but want to avoid the blood and guts.

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.

Difference between Medical Billing and Medical Coding

Medical billing requires comparatively fewer educational qualifications. You can even become a medical billing professional even if you only have a high school degree.

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, on the other hand, requires additional education and special certification and credentials.

Coding professionals work with revenue cycles and financial health medical service providers.

Individuals with in-depth knowledge and the ability to handle additional responsibilities are ideal for working as medical coding professionals.

These professionals are required to review documents from doctors and translate codes for reimbursement.

There are opportunities where healthcare providers hire the same individual to handle medical billing and medical coding.

Everything About Medical Billing

Medical billing professionals are responsible for submitting claims. These claims need to have 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 invoices for patients, 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 need to check potential mistakes so reimbursement is not delayed. For this, medical billing professionals need to have basic knowledge of the medical coding systems being used by employers.

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

What is Medical Billing and 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. Expert medical coders are also responsible for payment, medical supply and stocking, etc.

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 coders’ 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.

According to the report by the US Bureau of Labor Statistics (BLS), the average median salary for medical billers and medical coders is around US$ 44,090 per year.

The specific 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 different types of workplaces.

To learn more about certifications and other requirements to become medical billers and coders feel free to check our previous article.

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