Medical Billing and Coding

Medical billing and coding play a crucial role in the health care industry and are an essential health sciences career option.

As a medical biller or coder, you will need to know how to read a patient’s medical chart. From that information, you will need to assess their medical histories. After you have gathered all of the patient’s medical information, you will transcribe their medical history using a set of authorized medical codes.

Health care providers and insurance companies use the universal, medical industry-approved medical codes to make sure a patient’s insurance claims are filed. While this might sound easy enough, you will need to study in detail the different medical codes so that you do not make any mistakes. Entering the right codes are essential since they are used to submit health insurance claims to a third-party payer. If you are interested in becoming a medical biller or coder, you will need to practice patience and be extremely detailed-oriented to make sure that all invoices are paid.

Is medical coding the same as medical billing?

It is important to know that medical coding and medical billing is not the same thing. However, the same person can hold medical coding and medical billing jobs, depending on where they work. Medical coders are more focused on the accuracy of the information they gather than on making sure the health care facility is paid, while medical billers focus more on the money, since it is their job to make sure that the health care facility they work for is paid. Regardless if one person or two do the jobs, medical coders and billers are going to have to work together to ensure that the information is added correctly and that the invoices are submitted for payment. While a medical biller and coder have many of the same job duties, they do not have the same tasks.

People performing the medical coding job act as a translator. After they receive a patient’s medical record, they review the information gathered by the patient’s physicians, nurses, therapists and other health care professionals and they translate it into universal medical codes. What kind of information are they translating? It can be anything from a patient’s health diagnosis, medical procedures and treatments, medical services and equipment. After they gather all of the information, medical coders must translate the information from the documentation they receive and assign the appropriate codes. This information, in addition to helping determine a medical bill, helps gather important data and statistics about types of treatments and issues that patients come in for.

Medical billing uses the codes to submit insurance claims for the health care provider to be paid. These insurance claims, or invoices, prove that the patient’s medical services were deemed medically necessary and that the health insurance companies must reimburse the services provided by the health care provider. Medical billers also act as a translator since they translate a health care service into an insurance claim. A medical biller must also follow-up on any unpaid insurance claims until payment is successful.

Where do medical coders and billers work?

Medical billers and coders work in health care facilities, such as hospitals, doctor’s offices, nursing facilities and laboratories. Medical billers and coders can also find employment in ambulatory surgical settings, outpatient clinics and mental health facilities. However, they can also work in non-medical settings, such as educational institutions, billing companies, suppliers of medical equipment and consulting firms. It is worth noting that health care facilities with larger health systems can not only employ more medical billers and coders but can also add more employees than smaller health care facilities.

What education do I need to work in medical billing and coding?

While it is helpful for those who work in medical billing and coding to earn an advanced degree, like a bachelor’s degree or a master’s degree, it is not necessary. However, you will want to look into getting some sort of education or certification in medical billing and coding, since employers prefer to hire candidates who are certified. Most people interested in medical coding earn a certification from the AAPC, formally known as the American Academy of Professional Coders. Alternatively, they can get certified by the American Health Information Management Association. The AACP also offers certification in medical billing. It is a separate course and requires a different certification program.

Earning a certification is a way to show that you are an outstanding candidate because of your achievements, expertise and excellent judgment. However, obtaining a certification in medical billing and coding is not easy. You must take the necessary exams and participate in the required education classes. Medical billers and coders should receive certification for many reasons. Those medical billers and coders with a certification not only receive better training than their non-certified peers do, they typically earn a higher salary.

Can I advance my career in medical billing or coding?

While it is not necessary to obtain a bachelor’s degree or a master’s degree to gain employment as a medical biller or coder, you will need a higher education if you are interested in advancing your career to obtain a management position. If a management position interests you, you will want to look into obtaining at least a bachelor’s degree. It also helps if you complete the necessary certification programs and pass the exams since this shows your dedication and experience in medical billing or coding, which will prove that you are a top candidate for a manager position.

What is the job outlook for medical billing and coding?

Currently, medical billers and coders are in high demand. Medical records and health information technicians, the field that includes medical billing and coding, is projected to increase significantly during the next decade. There will be more positions available for medical billers and coders for many reasons, which includes the increase of an aging population. Not only will a large aging population add more jobs for medical billers and coders, but also for the overall employees in the health information technicians field and other health care professionals. As long as health care facilities who offer medically necessary health care services receive payments form health insurance companies, medical coding and medical billing jobs will be crucial to any health care facility.

It might also interest you: