Medical Billing and Coding are often used to describe the same overall function. However, while they are part of the same process, they are two different things. Medical coding is the process of assigning standardized numerical medical codes to patient medical charts. This coded information is used to ensure that insurance companies, government organizations, such as Medicare, and patients alike all receive accurate billing statements for medical services performed. Medical coders perform the work of converting diagnostic and medical procedural information into simplified numerical codes that can be electronically processed for payment by third party payers – Insurance companies and Medicare, for example. A medical biller will take the coded documents and prepare them so that they can be submitted for proper payment or reimbursement. In many small physician offices or smaller clinics, the same person performs both the medical billing and coding functions. In large hospitals, the medical billing and coding functions are generally separated. Medical coding specialists and medical billing specialists will perform their respective roles.
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The medical billing and coding processes require an attention to detail to ensure accuracy of medical billing and coding records. Because of the large dollar amounts involved, medical billing and coding are highly regulated and tightly supervised activities. Medical billing and coding outputs are also subject to frequent and rigorous audits to ensure accuracy in the medical billing process as there are literally billions of dollars at stake. In many ways, medical billing and coding is a much more scrutinized activity than, say medical transcription.
Medical billing and coding work is typically performed in hospitals or clinics, although we are beginning to see some of these medical coding and medical billing jobs migrate to work at home positions. Medical coders generally begin with a transcribed patient medical record and transform procedures and diagnoses etc. into numerical codes. This takes a great deal of expertise in medical terminology and the associated medical codes. Of course this requires medical coding training. Medical billing takes the coded output produced by the coder and submits it for reimbursement to insurance companies, Medicare, or the patient. As previously indicated, many times a single person will perform both the medical coding and the medical billing functions. This is particularly true in smaller clinical settings. In large, high volume healthcare operations, medical coders and medical billers are often separate and specialized functions. Of the two, medical coders generally enjoy a higher income and require more specialized training. We recommend an integrated online medical billing and coding training program that prepares individuals for either a medical billing and coding career in a clinic setting or leads to a specialty medical coding or medical billing role in a hospital setting.