Essay On Medical Billing And Coding

Medical billing and coding professionals play a critical role in the reimbursement cycle to ensure that providers get paid accurately for the services they provide. And since billers and coders share a close working relationship in healthcare, educational programs often combine both topics into one program. By doing so, it gives the individual a big-picture look at how it all works together. However, billing and coding are two separate professions, and often the individuals work in two separate areas. Only in a small office will one individual or group of individuals be responsible for both the medical billing and coding functions.

What Medical Billers Do

Medical billers process insurance claims so that physicians and staff get paid for the services rendered. Billers use medical billing software that coding professionals have entered into the system. The job of a biller involves communication with patients, medical professionals, and insurance carriers responsible for submitting payment. If authorization is required from an insurance carrier before performing a procedure, the billing professional will probably be the individual to call the insurers for guarantee of payment. They will also need to follow up on overdue …show more content…
Their job is to review the documentation provided by the physician and translate the information into medical codes. For instance, a patient may be seen for a check-up, or a physician may have ordered an X-ray for an acute traumatic injury. Whatever the reason for the visit, a specific code should be assigned for each diagnosis and procedure or service provided for accurate reimbursement. These codes are assigned based on the national classification system and may be entered into computer software, handwritten notes, or both paper and electronic files. If there is any question as to the documentation, the coder needs to discuss it with staff members or query the