The Differences Between Medical Billing & Medical Coding

Medical Billing is not the same thing as medical Coding. Medical Billing is traditionally done by a person who works closely with doctors and clinic staff to process the necessary paperwork so that insurance companies can pay for services rendered to patients. Medical coders are mainly responsible for ensuring that procedures rendered to the patient are correctly coded as required for insurance companies to make payments. Medical Coding involves assigning codes to medical bills for insurance purposes, as well as other purposes. There are two main classifications of Coding: procedural and diagnosis. They both require different skills, and although they may appear similar, there are also many differences.

• Medical Billing
  To be a medical biller or medical billing specialist, there aren’t a lot of requirements. However, it often helps if you are certified as a Medical Billing Specialist because this shows potential employers and customers that you have the background and experience necessary to be successful in the role.

 

• Medical Coding
  Medical Coding requires a bit more technical training as it is done on a computer by the medical coding specialist. The medical coding specialist enters the necessary codes into the patient management system, with diagnosis and services rendered information, so that the medical biller issues medical bills to the insurance companies. Some of the codes used in medical billing and coding include ICD-9, CPT, ICD-10, and HCPCS. Each code type has its use and requirements for filing claims with insurance companies.

 

• Communication With Patients and Insurance Staff
  A medical biller often works with patients and their doctors closely to help facilitate the revenue cycle management process. On the other hand, the medical coder usually only works with the doctors closely to ensure accurate coding is being done. A medical coder won’t necessarily have to communicate with the patients directly, mostly with insurance companies, but not with other third parties like a medical billing specialist would.