The Importance of Medical Billing and Coding

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A physician's job is important. A Registered Nurse's job is important. They're the ones who are visible, and have the responsibility of a human life in their hands. But they can't do their jobs alone. A medical office is only as good as its staff. They need someone to ensure that the billing is done properly, and that the medical codes are correct and up-to-date to ensure that insurance companies will reimburse appropriately.

Typically, medical billing and coding goes hand-in-hand, and those who do the billing are also responsible for ensuring that the coding is correct and accurate. Some places do divide their staff into coding and billing, but smaller offices often cannot afford to separate the two. That's why it's so important to have the proper studies and degree in medical billing and coding - to be prepared and versatile for whatever the office or hospital will need at any given moment.

Medical Billing and Coding Differences
It's important to understand what is demanded from a job that requires both medical billing and coding. The jobs can and are divided up often, but these days, they are mixing the two more and more, so it is vital to understand what each job does.

Medical billing is an administrative position that requires working with both insurance companies (billing for reimbursements), and working with patients (setting up payment plans, collecting overdue payments, and helping to resolve billing issues). The medical billing job ties in directly with coding - a billing agent must know the codes to ensure that their patients are being billed for the appropriate procedures and diagnoses.

Medical coding is the job that is considered "behind the scenes and makes for very little patient contact. The coding job is a detail-oriented position that makes sure the ICD codes and CPT codes are correct prior to submission to the insurance companies for reimbursement. ICD codes are codes that physicians use in order to render a diagnosis of a patient, and CPT codes are codes for the treatments and services that are given to the patient upon receiving a diagnosis. For example, if a patient visit (called an "encounter by coding professionals) results in a diagnosis of a laceration requiring stitches, there will be a number of codes associated with the entire visit. Those codes will need to be checked and submitted to the patient's insurance company for reimbursement.

It's easy to see how medical coding and billing go hand-in-hand, and how smaller offices will require a professional to be conversant in the two. That's why it's important to be certified and trained in both areas - to maximize versatility or marketability in the workforce.

 

 

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