Medical Billing vs Medical Coding – What’s the Difference?

Medical billing and medical coding are both integral parts of the healthcare process. However, there is often confusion over what the difference is. Indeed, some people think they are the same thing. Although both are part of the same process, they are two separate jobs each with different responsibilities.

Medical Coding

Medical coding is the first step in the billing process. Coding includes going over the patient’s records to determine which services were received and labeling them with an assigned code. This process relies on total accuracy from the clinical documentation department. Without it, the coder will not be able to extract the correct information. Correct and accurate medical coding is an integral part of getting the claim information to the insurance company. Essentially, it tells the insurance company what happened during the medical encounter. It is incredibly important that the medical coder double-check their work as providers can be sued for insurance fraud if incorrect claims are submitted to insurance companies.

Medical Biller

Medical billing starts as soon as a patient walks into the office by collecting their insurance copay. Billers will use this check-in time to ensure that the patient fills out the correct paperwork. This makes it so that the provider has all relevant information when it comes time to bill the insurance company or the individual. By ensuring that this process is completed, the medical biller ensures that the entire billing and payment process is a smooth one.

During patient check in the medical biller may also be responsible for checking with the patient’s insurance company to make sure that services are covered. If the patient does not have medical insurance then the biller must confirm the patient’s payment responsibility. After the patient checks out, this information along with the details from the visit are sent to the medical coder to be translated.

Once the information from the medical biller reaches the medical coder it is combined into what is often referred to as a “superbill”. This superbill is an itemized list that will be used to submit the claim to the insurance company. The bill details out the provider’s information, the patient’s information, and information about the visit.

If you are interested in becoming a medical biller, there are many options available. Medical billers are an integral part of our healthcare process so you can be assured that you will have job security for years to come.