Information on Medical Coding and Billing

Coding and billing are indispensable in the medical field. Without it, doctors won't get paid standard and correct prices for the services delivered, and patients wouldn't be billed correctly.

Do you want to know more information about medical billing and coding? Our basic guide could tell you more about this process and the people behind this important task.

Medical coding and billing are important processes in the medical field. These are tasks that “keep the ball rolling”. It is because without medical coding and billing, the doctors won’t get paid. And without payment, it is impossible for the profession to thrive.

What are Medical Coding and Billing?

Medical coding and billing are two different tasks. But they are so inter-related that they are often done side by side. The process goes this way: a doctor examines a patient, make diagnosis and perform the necessary procedures as the patient will allow him. All the tasks he did are recorded in the patient’s information sheet. Each of these functions is logically standard procedures that are known throughout the medical field. In medical coding, each of this function is associated with a certain code. Corresponding to these codes are the required billing fees.

The process of coding and billing is done to make sure everyone gets what should be for him – the patient is billed a standard price for the procedure he had availed and the doctor is paid the right amount for the services he delivered. Corresponding to these codes are the required billing fees. You’ll learn these procedures in medical billing and coding training.

Medical Coders and Billers

Coding and billing are done by people who were specifically trained for the job. These medical information specialists usually have certificates and diplomas from colleges and vocation schools that train them on medical coding and billing. They study subjects like medical transcription, claims filing, billing management, and privacy. There are those that are certified, like those who passed the Certified Medical Reimbursement Specialist Exam and those who took certification from The American Health Information Management Association. Some specializes in certain fields like cancer registry.

Overall, they can be called interpreters of patient and doctor correspondence. They read charts -- either had or soft copy – interpret what transpired based on the examination, diagnoses and treatment, and assign a number the services received and rendered. Further, they act as liaisons between doctors’ offices and insurance agents or government offices. They process invoices and follow up claims.

Medical coding and billing are done in doctor’s offices, in various medical centers like nursing homes, cancer facilities and rehabilitation facilities, and also in insurance agencies. The codes are based on standardized databases, one is the Current Procedural Terminology database, which is five-digit, that tells of the level of service delivered. It is done using software that is not only capable of coding but also of factoring in discounts for insurance, Medicaid and Medicare coverage.


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