Medical billing and medical coding are two related fields when it comes to health information management. People who work in these fields are required to use similar skills, but for different purposes. While billing and coding specialists often work together, they serve two distinct purposes in the medical office.

Many medical billers and coders can do the work of the other simply because the skill sets overlap. In most healthcare facilities, the two jobs are kept separate just for simplicity sake. The positions also allow for a buffer between health care staff and their patients when it comes to administrative work.

Think of it like this: you wouldn’t ask a billing specialist how to set a broken arm just like you wouldn’t ask a doctor how much it costs to set that broken arm. Professional coders will take information from the medical records and provide information to medical billers to relay to patients and insurance companies.

The two act as a bridge between the administrative and care aspects of the industry. Using universal Current Procedural Terminology (CPT) coding for each and every procedure (medical, diagnostic, and surgical), each visit is assigned codes. Billers take those codes and create claims and bills for patients.

By assigning codes to different medical terminology and then using billing software, the two sides of the healthcare coin are kept separate although irrevocably linked. Medical billers are dedicated to providing accurate and timely reimbursement based on the medical codes that are used in the doctor’s office. 

Medical coders aren’t as focused on reimbursement issues, but rather using the right codes when it comes to billing. With the proper codes, billers have an easier time dealing with money-related aspects of running a medical practice. Medical coders deal with a wide variety of codes. Medical billers are generally more knowledgeable about insurance restrictions, claim submission rules, and what codes can be billed to various insurance companies.

More about medical coding

Medical coding is the foundation of both professional fields. Coders are generally interested in complying with universal code meanings and it requires learning the language. The language is made up of a wide variety of procedure codes and diagnosis codes and many times, there are specialized codes used for Medicare and other levels of patient care.

More about medical billing

Each medical practice needs a well-trained medical billing specialist to offer medical services. Successful medical billers will quickly and efficiently file claims without coding or clerical errors so the office receives payment quickly. Medical billers need to be extremely well-versed in the variety of healthcare contracts and make sure that the requirements that are out there are adhered to at all times. 

Medicare, Medicaid, and other insurances each have rules and guidelines to follow and a medical biller will become familiar with these so there are no slip-ups or issues of non-payment.

Whether it’s coding or billing, medical professionals working in this field learn to navigate the ins and outs of insurance claims and unique medical services. This ensures an accurate description of each patient visit is on the record and that each service has been paid appropriately and in a timely manner.

Do you have additional questions on how medical coding or medical billing works or need additional help on using the medical billing system for your practice? Are your coders or billers working double time, leading to miscommunications or even unfortunate errors?

Contact our professional and experienced team at MBA Medical. We’ll help get you the additional information you need to keep your medical practice running with professional efficiency. Our services are ideal for both large and small practices that need to find a more efficient way to incorporate the two sides of your practice.