Medical Billing vs. Coding: What’s the Difference?

Maintaining medical records is of utmost importance for every individual. It documents a person’s complete medical history. This makes it easy to refer to whenever required in the future. Physicians can diagnose and treat quickly as the time spent on learning the patient’s medical history is less.

Medical payments, reimbursements and insurance claims are also made simpler with medical records. It improves the delivery of healthcare and the outcome of medical treatment. Because accurate information is made available promptly.

To facilitate medical record keeping of patients by the healthcare provider, medical coding and medical billing are carried out. Often mistaken to be the same, both have distinct differences.

Medical coding and billing overview

What is medical coding?

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Converting medical records written down by physicians into code is referred to as medical coding. A patient’s diagnosis, treatment, medical procedure, and reports are encoded. This code can be referred to by healthcare service providers, insurance companies and government agencies.

Medical codes can be numeric and alphanumeric. It is a standard language in the medical community and is followed by insurance companies and government agencies as well.

What is the purpose of medical coding?

The medical coding process involves condensing large information into easily readable bites. This saves time for the healthcare service providers to go through elaborate medical documents. Time is crucial in medicine that can make life and death decisions. Medical codes aid in data collection, analysis and reporting.

What does a medical coder do?

A medical coder collects information about the medical procedure, diagnosis, tests, and everything about the patient’s visit. Each part is encoded and recorded.

What is medical billing?

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Investigating, processing and insurance claim submission is referred to as medical billing. Following up to receive claims is also included. Any interaction and communication with the patient, treating medical staff and healthcare to settle medical claims is a part of the medical biller’s work.

What does a medical biller do?

Medical billers possess in-depth knowledge of medical insurance policies, procedures and claims. This ensures that a medical biller gets higher reimbursement on a medical claim when compared to a layman.

Professionals involved in medical coding and medical billing rely on each other to complete their work duties. Let’s get in-depth with the differences in their tasks.

1.Communication with insurance companies and patients

The medical coding process does not require communication between the insurance company and the patient. All communication is only with the healthcare providers to get information and encode the same.

Medical billing service involves communicating with the patient and insurance company since their work is submitting an insurance claim and having it processed.

2.Personality of the professional

Coding is a technical and highly analytical process. It requires an individual to be focused, detail-oriented, patient and have the discipline to include all information even when it is time-consuming. Communication is limited to fetching, verifying and confirming information. An introvert will be able to perform well.

Billing requires communicating most of the time. Communicating with the healthcare professional, and insurance company on the insurance claims. Following up on the claims, resolving issues and navigating through the process in a friendly manner will support & be beneficial to all the parties. An extrovert who is capable of handling any situation and persistently following up performs medical billing well.

3.Skill set

Medical coding staff has an in-depth understanding of medical procedures and the corresponding code for each. Also, knowledge of medical terminology and an understanding of medicine for every problem in the human body.

The on-the-job role of a medical coder is to encode each service provided to a patient by the healthcare provider and intercept it by a code.

Medical Billing Services UK files insurance claims after getting instructions from the coding staff. When you outsource medical billing, they take care of all the work including but not limited to following up with insurance companies to receive claims and settlements, send invoices and work out rejections.

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Benefits of medical billing and medical coding

1.Better financial health for healthcare providers

With experts making claim submissions, higher reimbursements are processed at a faster pace. Claim denials are reduced and this results in improved financial health of the healthcare service providers and hospitals.

2.Quick patient care

Medical coding provides a complete, detailed and accurate medical history of the patient. It can be studied quickly which reduces the time to diagnose and treat a patient correctly. Time is crucial in medicine and medical coding helps with the same.

3.Increased efficiency

Medical coding and billing involve utilising software that automates mundane tasks. This saves time and reduces manual labour. As repetitive work is eliminated, it increases the efficiency of the staff.

4.Improved data management

Accurate, detailed and standardized data is maintained by coding. This improves data management. This is crucial for analytics and research.

5.Reduced administrative staff

With automation in place, the overhead costs are reduced for healthcare centres. It results in increased profits. The cost of hiring, training and deploying staff is reduced.

Final word

Medical coding and billing are two separate professions. The roles and responsibilities are different as discussed above. The roles are interdependent and work best in harmony. At smaller healthcare centres, the roles of coder and biller are usually merged for lack of funds and minimal work capacity.

At larger healthcare centres, the roles are pre-defined and individual. Though the work responsibilities overlap and are interdependent, they are treated as two separate departments.

Based on the requirements of the healthcare centre or hospital, the role is defined. To ensure efficient and effective work, you could outsource medical billing services in the UK. It will free your time and help you focus on medical practices.

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