Are Medical Billing and Medical Coding the Same?
Medical billing and coding: Just what is it, and what do the specialists in these jobs do each day?
Though they may be found more behind the scenes than physicians and nurses, medical billing and coding specialists are enormously important members of the allied health team. They often work closely together as the liaison between patients, physicians and insurance companies.
Without billing and coding specialists, health care providers would be inaccurately reimbursed for services rendered. These inaccuracies can affect hospitals, doctors, and healthcare providers with fines – and even lawsuits. Medical billing and coding specialists are essential to keeping these unnecessary costs at a minimum, and must have an unbelievable eye for detail.
What Does Medical Coding Involve?
Medical coders work specifically with the financial and technical aspects of the medical world.
They check medical records of patients, along with doctors’ notes, records of testing, and possible diagnoses to corroborate that work was carried out.
Medical codes tell a sort of story about the patient’s visit. Whether a patient was seen for a routine check-up, or a doctor ordered an MRI for a workplace injury, each procedure and service receive a specific code.
The coding specialist must translate this information into precise medical codes for each one of thousands of possible services, which need to be valued for reimbursement purposes.
If the coder is uncertain about a particular patient’s records, they then need to speak with medical staff or other staff members to receive more details.
How Is Medical Billing Different?
Medical billers are expected to audit and submit claims for each patient’s diagnoses and the medical procedures carried out by physicians and nurses.
Using special medical billing software that medical coding specialists have translated and entered into the system, billers communicate directly with patients, medical professionals, and insurers responsible for paying bills. If a clinic or hospital needs authorization from insurance companies to perform procedures, the institution’s medical billing specialists will likely be responsible for calling insurers for guarantee of payment.
It’s also expected that medical billing specialists will be the professionals who follow up on overdue invoices by contacting patients directly, submitting claims with collections agencies and appealing denied claims. They also typically walk patients through information regarding deductibles, copay, and various other requirements from insurance companies.
Where Do Medical Billers and Coders Work?
You can find medical billers and coders in a variety of settings. Typically, they’re found behind the scenes at clinics, hospitals and nursing homes, but they may also find work in pharmacies. With such a wide range of possible employers, it’s a great opportunity to find a career close to home!
Because so much of the work is done with computer systems, many billers and coders are given permission to work from home one or two days a week. Medical billing or coding can be a great choice for those who seek a more flexible working environment.
At a small facility, there’s a good chance that billing and coding will be done by the same person or a close group of associates.