What is the Difference Between Medical Billing and Coding Services?


Are you one of those people, who still think that medical billing and coding [1] is the same thing? If yes then you need to explore these aspects again, so you can clarify this misconception. No doubt medical billing and coding streamline the revenue cycle management process, but both have different functions.

These processes are different in nature but both are vital to streamlines the cash flow of medical practice. Moreover, due to the constant evolutions in the healthcare industry and the negative impact of COVID-19, healthcare providers are facing immense challenges to keep their medical practices financially stable. In these circumstances, accurate and optimized medical billing and coding is the only solution for the struggling practices. [2] 

How Medical Billing is Different From Coding?

The medical billing and coding process starts with the first encounter of patients and healthcare providers. It ends when medical practitioners receive full payment for all services delivered to patients.

Depending on the complications in services rendered, denial management, and the accuracy of collected information, these processes can take anywhere from a few days to several months to complete a cycle.

Medical billing and coding is a complicated and time-consuming task. Healthcare providers find it difficult to manage these processes along with their busy schedules. Therefore they should hire dedicated but separate teams that can perform these tasks on your behalf.

As medical billing and coding streamline the revenue cycle management process, medical practitioners must invest in the constant training of their employees. Because it is important to keep billers and coders updated with the new, deleted, or modified billing rules and regulations.

Are you still confused about the the difference between two processes? Here are the biggest reasons to consider billing and coding as two separate jobs:[3] 

  1. Job Nature of Medical Billers and Coders

The employees who are responsible for medical billing and coding have different skills and responsibilities

Coders have a complete understanding of medical codes including Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and International Classification of Diseases. 

Coders extract information about the patient’s diagnoses and medical procedures from medical record documentation. Then they transform this data into universal standard codes. Though it’s a time-consuming and hectic task, it plays a critical role in the optimization of the revenue cycle.

On the other hand, medical billers are trained in the accounting of the patient’s monetary obligations. They use these codes in the preparation and submission of medical claims to insurance companies. They are also responsible to track and monitor the submitted claims until healthcare providers get paid. In case of claim denials, billers work with payers to sort out the denials/rejections or other issues.

Sometimes in smaller businesses, healthcare providers may hire an individual who can perform both medical billing and coding tasks. Meanwhile, larger healthcare facilities are more likely to employ certified coders and well-experienced billers to carry out their individual tasks.

  1. Personality Difference

Many medical practitioners voice concerns that if both medical billing and coding streamline the revenue cycle management process, then how is it possible that billers and coders have unique personalities. You may find this argument weird but it’s a fact.

Billers are extroverts. Their job demands to be talkative, social, and action-oriented. They should be able to clearly communicate with the patients and insurance agencies to get different information or to resolve the issues.

Meanwhile, coders are introverts. Coding is an exciting and attractive job for those who are analytical, detail-oriented but feel uncomfortable while talking to people all day. In a coding job, they do work on their own in occasional collaboration with other healthcare staff.

  1. Interaction with Patients

Usually, medical coders don’t interact directly with patients. They complete their tasks while collaborating with physicians, nurses, and other healthcare professionals to get information about the medical services a patient has received.

However, medical billing demands communication with patients. Billers must act professionally to help patients understand their charges, deductibles, co-pays as well as payment options.

  1. Qualification Requirements

It’s a fact that accurate medical billing and coding streamline the revenue cycle management process. More surprisingly, it doesn’t need any specific qualification. Educational requirements are the same for both billers and coders. Sometimes, employers may hire candidates with a diploma or associate degree in either billing, coding, or both.

The simple success formula in this field is; the more you and gain experience in the field, the better chance you’ll have to achieve higher management posts in coding and billing.  However, primary industry certifications include Certified Billing and Coding Specialist (CBCS) and Certified Coding Associate (CCA). Salary & job outlook can vary.

Hence optimized medical billing and coding streamline the revenue cycle management process. Therefore healthcare providers must focus on the optimization of these processes.

Are you looking for certified and well experienced medical billers and coders? Then no look further. Medcare MSO is an industry-leading medical billing company in the United States. We provide extensive services to ensure the streamlined cash flow of your medical practice.

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