Difference Between Medical Coding and Billing

Frequently mistakenly assumed to be the same, medical billing and medical coding are two very distinct separate jobs. Although there are many similarities between the two and small healthcare entrances for a single person for doing both the tasks; most medium and large healthcare facilities have different individuals responsible for the two different jobs. Both of these jobs come under medical records and health information technicians. In order to understand the differences between medical coding and medical billing, let us look at the responsibilities of two job profiles.

Medical Coding

Medical coding is concerned with assigning the relevant code to various treatments given to the patient, to facilitate their insurance claims. Medical coders study the patient by the doctor, surgeon, nurse and other members of the healthcare team. They check the doctor’s transcriptions, laboratory tests and documentation related to the patient’s treatment. If there are no further details or clarification is required, the medical coder assigns the correct diagnosis or procedure for the corresponding service given to the patient. The codes are assigned using the Current Procedural Terminology (CPT) for the diagnosis and diagnosis of the patient Medical Condition.

It is very critical for the medical coder to be used for insurance companies when processing patient claims. Medical coders often have to be interacted with and coordinated with other healthcare and staff to gather more information regarding the patient’s medical data to ensure that the coding process becomes smooth and efficient .

Medical Billing

Medical billing is concerned with checking the assigned medical codes and transmitting the claim. Making use of special software developed to input the codes assigned by the medical coder as well as other relevant insurance information for medical billers for insurance claims to facilitate the payment. Once the insurance claim has been forwarded, the medical biller continues to be a touch with the patient and the insurance company to ensure that the claim has been paid. In case of delays, denied claims, the medical biller needs to be done between the patient and the insurance company and the claims with necessary adjustments; if required by the insurance company.

Medical billers often have to explain the benefits and answers to questions about their insurance when they get insurance. They are also responsible for clarifying any queries regarding the bill, should the patient ask for it. The medical biller is also responsible for explaining deductibles, co-insurance and insurance requirements, in the case of the patient’s need to pay for being covered under insurance. At the same time, medical billers have to know the claims process and be submitted to process a claim. It is a job to ensure that the billing format is followed, all the questions that have to be addressed, and the claims to the insurance company.

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