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What is Medical Billing and Coding?

In the modern health care system, medical billing and coding are considered an essential part of a system. Medical billing and coding involve the financial proceedings making sure to have a viable and engaging service system. It requires interaction with health care professionals and patients. Billing and coding are often taken as similar tasks but technically speaking; both are very much different concerning the functionalities.

Medical Coding:

In medical coding, the coder is the person responsible for coding medical treatment. In easy words, we can say that coding is like translation. So coder is a translator who translates the prescription, diagnosis and symptoms of a patient to numeric or alphanumeric form in compliance with the specific format. A coder needs to be efficient and accurate in this task because any mistake in coding can lead to incorrect billing because, after coding, billing is the next stage.

Medical Billing:

Medical billing implies the codes formed by coders to generate the bills. It is merely a payment practice. It involves interaction with health insurance companies, including submission and following up of claims. Responsibility of medical biller includes taking payment from health insurance companies for the services provided by health care company. There is a more interaction of billers with customers, so it is more a customer-oriented task.

Difference between medical coding and billing:-

Medical BillingMedical Coding
Medical billing mainly involves data entry with the help of software specific to billing.Medical coding involves extensive interaction with medical professionals, practitioners and nurses to designate the services given to the patient.    
Medical billing officials submit the insurance claims to the assigned health insurance companies.A medical coder is more concerned with the ISO standards of health codes which are applied to the patient record to evaluate the services received by patients correctly.
Billings, payments and invoices are managed by the medical biller.Medical coder analyzes the reports of operation during surgery to implement accurate coding on the report.
Claims which are denied or rejected by customers are handled by the medical biller.Medical biller performs a medical chart analysis when some claim is denied or rejected.
Medical billing department makes sure that practitioners and patients have received the payment from health insurance companies.Medical coding department ensures that the department is running according to the latest trends in the market.
Medical biller verifies the correctness of standard codes generated by medical coders to segregate services and products.Medical biller analyzed the patient medical thoroughly so that coding reflects the medical chart of a patient.

Medical billing and coding cannot work without each other. Both have distinct advantages. We shall discuss one by one.

Advantages of Medical Billing:-

Medical billing has many benefits. Few of these are as follows:

Revenue:

 Medical billing if handled efficiently, increases revenue generation with time.

Cash flow:

            As medical billing deals with health care insurance companies, so it handles the insurance claims. Eventually, it leads to healthier cash flow.

Efficiency:

            Due to medical billing, other areas of Health Company are separately focused. It enhances the overall efficiency of a health company.

Fewer employees:

            Due to less employees, practice overhead cost is reduced.

Advantages of Medical Coding:-

Customer-specific reports:

            Medical coder generates the reports which are customer-specific which results in customer satisfaction. Eventually, it leads to the credibility of the health company.

Accuracy:

            Medical coding brings correctness in the reports marking it up to the maximum accuracy.

Few denials:

            Due to medical coding, there are fewer denials in health insurance claims.

Back billing:

Due to medical coding, massive and costly task of back billing can be easily avoided.

Everything in the world is undergoing rapid change and expansion. Same is happening with medical billing and coding companies. In future, both fields need to equip itself with future demands.

Future of Medical Billing:

 As the world is transforming from a volume-based structure to value-based structure, so medical billing must put its focus on gaining more industry knowledge. Its approach should be more customer-centric meeting the customer’s requirements and providing best, credible, and quality services to the patients.

Future of Medical Coding:

 In the coming years, medical coding will emerge as a separate field with immense employment opportunities. Medical coding is taken as a fragment of the health care company, and it worked under the direction of Health Company. Still, in the near future, it will emerge as an independent field as coding is the task needed in every sensitive company.

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