Medical Billing and Coding: Know The Difference!

Medical billing coding differences

A lot of people tend to believe that medical billing and coding are the same. Some of the medical billers are known ad coders and vice versa. In reality, they are not! In this post, we have rounded up all the differences that you need to know about medical billing and coding.

Medical Billing and Coding in a Nutshell

Medical Billiing

Medical billing refers to a payment practice that involves a healthcare provider submitting or appealing claims with healthcare insurance companies to get the payments for services rendered. On the other hand, medical coding is the transformation of healthcare procedures to the medical alphanumeric codes.

Here is how the role of billers and coders differ from each other-

Medical Billers

A medical biller enters all the treatment codes into insurance software so that he claims can be processed accurately. They also audit and submit claims for the patient’s diagnosis and all other procedures performed by physicians.

The billers often take up the patients insurance directly and are responsible for taking care of copays, deductibles, and other claim details. Along with this, they also monitor the claim regularly and make sure the payment has been made seamlessly.

Medical Coders

The medical coder is mainly responsible for assigning the proper codes to claims. He is equipped with many skills and information on various subjects, including ICD-9 and ten codes, HCPCS coding, customer billing, inpatient and outpatient coding, anatomy, clinical documentation, and health information technology.

They have to identify and apply from 144,000 different codes and then communicate with the biller to process and file the claim with the insurance company.

In some instances, both the processes work in conjunction; so do they both come with the same set of benefits?

Medical Coding

The quick answer is no.

Benefits of Medical Billing and Coding

The medical billing services reduce the cost, lead to faster claim processing, and increases the revenue generation. Some of the specific benefits include:

  • Faster claims processing.
  • Lets you to focus on core processes.
  • Gives you the ability to avoid negotiations with insurance and payer companies.

When it comes to coding, the benefits include:

  • Seamless generation of customer-specific reports.
  • Fewer claim denials.

Medical Billing and Coding- Shall You Go In-house or Outsource it?

Various studies have found that there are high rates of errors in medical billing. It is found that 10% of all U.S. deaths are due to medical error, and the third highest cause of deaths is also the same. On the flip side, the claims are incorrect, due to which there is a loss in revenue.

Did you know that 90% of the claim denials are preventable? Considering these stats, processing billing in-house comes with a risk of delays and claims errors.

Medical billing and coding
Health Insurance Policy brochure

Outsourcing the billing not only reduces the errors; it also leads to increases cash flow, enhanced patient security, reduction in training charges that help you save on finances.

The Bottom Line

So, whether you are planning to outsource the billing or want to do it, GreenBills is a patient-friendly billing solution that focuses on maximizing the insurance payments by processing the provider’s claims properly. For more details on our service, fill our contact form, or drop us an email at hello@getgreenbills.com.

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