Medical Billing and Coding is the process of reporting the payment details of the patient to the insurance company for the service provided by the health center. There is a small difference between Medical Billing and Medical Coding even if the person who does both is the same. It is the job of the coder to abstract and assign codes while the biller with the data obtained from Medical Coding claims for reimbursement.
First Things First:
The foremost step in the billing process is coding. A coder with good intellect on the anatomy and medical terminology, who is certified with sound knowledge, is preferred for this. The basic necessity of any coder is to know the acronyms used to help complete work effectively and efficiently. This information is then passed along to the Medical Billing, where the document is processed and sent to the insurance to claim the required reimbursement.
There are two must-know criteria in Medical Billing and Coding without which the whole process collapses. They are as follows:
- Filling a clean and error-free claim and
- Knowing the Billing and Coding Acronyms
ICD-9 to ICD-10:
A clean medical claim is the one which does not have any mistake from top to bottom and no additional information required from the third party. Each procedure code must have a diagnosis code and the basic necessary information regarding the patient. The International Classification of Diseases, ICD-9 which was used in the United States since 1979 is slowly disappearing with the introduction for ICD-10 which will provide more accurate data and aid the WHO. A number of payers have a standard contract which is given to the heath care providers. An expert biller and coder know the specifications of a standard contract and produces an error free perfect document to claim insurance from the insurance provider.