With our population ever increasing, the demands for health care keep growing, which has made the healthcare industry to keep up in order to meet the rising needs. In order to keep track of all the data and paperwork involved, the healthcare sector came up with a system that helps them keep such information flowing efficiently between the medical service providers and the insurance providers. The terms medical billing and medical coding have mutual ties as they are both very important in the reimbursement cycle. This goes both ways, to the health care provider and to the patient. To better define medical billing and coding, it’s best to break the phrase into two easily ingestible terms. So what exactly is medical billing and coding, and why is it essential?
What Is Medical Coding?
Medical coding involves a process more or less like a translation. Most of every medical procedure, diagnosis, and injury has a corresponding code to it. It’s the work of a medical coder to assign a standard code to the medical classification system. Such medical codes are used to summarise the final medical services and reports.
Medical codes come with their own set of rules and guidelines, which is in accordance with either the International Classification of Diseases (ICD) or the Current Procedural Terminology (CPT). After a patient visit to the doctor’s office, it’s the coder’s mandate to translate the relevant information in regards to the patient’s report, from the symptoms, tests, diagnosis, and medication. The codes are then entered into a software program which is then used to bill.
What Is Medical Billing?
Medical billing is the information gathered, in codes, from the medical coder in making the bill for the insurance companies, which is also known as a claim. It involves the medical biller analyzing the codes, looking at the doctor’s diagnosis, and scrutinizing the prescriptions, to create a claim form.
It’s the duty of the medical biller to relay such information to the relevant insurance company for evaluation. The insurance company will then, after evaluation, return it to the medical biller who then calculates how much the patient owes after the insurance is deducted.
Why Is Medical Billing And Coding Necessary?
These are the most important components in any medical environment. When these two components are handled with accuracy, it ensures safe, rapid, and efficient operations. Below are some of the reasons why medical billing and coding are necessary.
- Regulates Contract Compliance
The medical practitioner’s contracts are bound by the insurance companies. These contracts spell the right rates for various medical procedures and treatments. Adhering to an accurate coding and billing system ensures that all the medical practices are in contract compliant.
- Ensures the Proper Flow of Payments
The medical billing system ensures the smooth operations of the revenue cycle in a medical environment. For there to be an improvement in terms of service delivery, the collection of revenue needs to be efficiently handled throughout the practice.
- Helps Take Care of the Patients
Proper medical coding ensures that the insurers have all the appropriate information in regards to diagnostic codes, for better reimbursements. Disease prevalence studies, demographic assessments, and treatment are as a result of accurate medical coding.
With the information above, it’s now clear that medical billing and coding are the integral components in medical practice. And as a practicing health professional, it might come to a point where you need medical billing and coding services. Thanks to the internet, all you need to do is type the phrase medical billing services near me and you’ll have lots of options to choose from depending on your area or level of practice. These services make things easier for you and your patients, as well as the involved insurance companies and other parties.
