Healthcare expenditures in the United States account for almost 18% of Gross Domestic Product at a whopping $3.8 trillion a year!
The administrative side of healthcare is an important part of the industry. Coordinating payments between healthcare providers, insurance companies, and patients is no small task.
Are you considering medical billing vs medical coding? These are two jobs that many people think refer to the same position.
Although there are similarities, there is a difference. In this article, we’ll explain the medical billing and coding professions.
What Is a Medical Coder?
A medical coder distils down every patient-physician interaction into a code. Each code helps categorize the services rendered by the physician.
The coder communicates with nurses, doctors, and other healthcare professionals to make sure all the codes are correct. The codes facilitate reimbursements from the insurance company.
Coders audit charts for proper codes when an insurance company denies a claim. The more accurate the coder, the fewer the insurance denials. This is because the more precise the codes, the easier it is for insurance agents to understand the bills.
Coders don’t interact with patients as much as medical billers do.
What Is a Medical Biller?
The medical biller submits a patient’s medical claims with the codes to the insurance company for reimbursement. A medical biller manages accounts receivable for the hospital or doctor.
Sometimes an insurance company denies a claim. Medical billers investigate rejected or denied claims.
Medical billers interact with patients. They also talk to insurance providers and healthcare professionals while doing their job. They do a lot of data entry into billing software.
Medical billers and coders both need an industry certification. Most employers want applicants with at least a high school diploma.
Want to be a medical coder? Get your Certified Coding Associate (CCA) certification from the American Health Information Management Association.
You can also get the Certified Billing and Coding Specialist (CBCS) certificate from The National Healthcare Association (NHA). This is a certificate for medical billers as well as coding specialists.
The Difference Between Medical Billing and Coding
What’s the main difference between medical billing and coding? Medical coders get information from doctors, nurses, and other professionals. They translate the procedures into codes for billing.
Medical coders don’t interact with patients as much as medical billers do.
Medical billers use the coding information to bill insurance companies. Billers also follow up with patients about their bills. They work in a doctor’s office, a hospital, or for a medical billing service.
Medical Billing vs Medical Coding in the Healthcare Industry
In comparing medical billing vs medical coding, both jobs have the same goal. They help patients and doctors with insurance reimbursement. Coders put the information together and translate it into codes.
Medical billers use the codes to bill insurance companies, patients, and other providers. Both professions are crucial in the healthcare industry.
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