What Is Medical Billing and Coding?

Have you ever asked yourself, “What is medical billing and coding?” We’ve created a guide for you with all the info you need.

According to the Bureau of Labor Statistics, medical record and health information technicians have a faster than average job outlook from 2016-2026.

Today, medical billing and coding are becoming more necessary than ever. With technology advancing the process is necessary to comply with HIPPA laws and to keep patient information safe.

To learn exactly what it is and what it looks like in everyday business read on:

Medical Coding Explained

Medical coding is what occurs after a patient visits the hospital. The physician examines the patient and writes down the symptoms, illnesses, and treatments for this patient and the medical coder takes it from there.

As soon as a person walks into a healthcare building all parts of their visit is documented. Information such as who they are, what time their appointment is, and what the doctor’s observations were.

This information is then given to a medical coder. And the important information is translated into coding. Every piece of information has its own line of code.

The coding could be each symptom or the specific diagnoses. Here is an example:

• Total Abdominal Hysterectomy: code- 68.4, description: TOTAL ABD HYSTERECTOMY

As you can see there are different descriptions and numbers for each one. This can be very tedious to remember and type out. There are guidelines for each code and even subsets of codes that medical coders use.

This code is often entered into an online program or form and then sent off to the biller. A lot of this code needs to be in a specific order so that it is easily transferable to the medical biller.

Medical Billing Explained

When the biller receives this coding they start the billing process. They take all the information from the program that sent it and use it to file a claim. To make this claim they also need to use a separate program.

They send this claim over to the insurance company once they are done. And then the insurance company will look at it and send it back to the biller with any comments.

When the biller receives the claim they determine how much the patient owes for their visit and how much their insurance covers. If a patient does not pay the money they owed then the biller would hire a collection agency to handle receiving the money.

Medical billing is also seen as translating the code into the bill.

Types of Software that is used

As mentioned before there is a large amount of software and programs used for this process. These are some of the software used:

NextGen Healthcare

This company offers software that helps with the billing process. It also offers help with scheduling, keeping patients satisfied, and helps with the decision making process.

It also includes the ability to make templates to make the billing process faster. Data and analytics are also offered in its billing process to help you decide how to optimize your process.

MedClarity

This software claims that it offers the billing process in an efficient way. It offers training to use its software as well as online support.

It also holds patient records, registration, and is compliant with HIPAA. It can also be used with multiple physicians and different offices.

Kareo

Kareo offers the option to manage your billing as well as reporting on its software. It offers to schedule within its systems as well as analytics for your billing.

It also offers a communication system in its software. This is to help communication between the biller and the office.

ChartLogic

Chartlogic offers the option to use electronic medical records. This includes the ability to use voice dictation to document your medical records. It also has fast note taking practices.

Its medical billing solution offers to help increase revenue but optimizing the billing process. They also offer credentialed coder to help with the coding aspect of medical billing and coding.

An Average Day

Medical billing and coding is usually a job for one or two people. The tasks can be tedious and plenty so usually two separate people are needed to ensure accuracy.

A medical coder will work at a desk for most of their day. They will log in to whatever software their company provides and pull up charts from overnight or the day of.

You will use these charts to pull the relevant information of diagnoses and treatments or procedures that should be sent over to the medical biller. During this coding process, you will likely be using two separate subsets of codings. These are:

• International Classification of Diseases
• Current Procedural Terminology

A medical coder will pay extreme attention to detail in the codes they are recording. As a mistake can cost the patient hundreds of dollars.

Some of the information on your chart may be tricky to understand or may not have the information you need. In these cases, you would do your research or reach out to the office that the chart came from.

The billing process would then be taking these codes from the same program and translating them financially for the insurance companies. You would then send them off and when they are returned you would have a better idea of how to process the patient’s bill.

Medical coders and billers usually work at healthcare offices. These can be offices like doctor’s offices, emergency rooms, and home health care offices.

Medical Billing and Coding as a Career

Medical billing and coding is a field that expected to grow by 21% by 2020. And is considered a fast-growing field. There is a large number of jobs open at the moment. And the standard salary in 2016 was $38,040.

In order to become a medical biller and coder, you will need the proper education. A high school degree is necessary to become a professional in the field. You do not need to get a college degree but it can be helpful.

There are many coder programs out there that will help you become a medical coder. But it is important to take one that is accredited. Here are a few well-known ones:

• the American Academy of Professional Coders
• the American Health Information Management Association

Be wary of other programs as there are a lot of scammers who claim to be credible programs.

More Career and Business Advice

It’s always important to revisit the professional world for the fastest growing professions. You never know! You might stumble upon a fast-growing passion of yours.

Author: Mike Cynar

Mike Cynar brings buyers and sellers together by producing reviews and creating non biased webpages allowing users to share their experiences on various products and services. He and his staff write informative articles related to the medical field, legal, and other small business industries.