Medical Billing and Coding – Learn More

Medical Billing and Coding

Medical Billing and Coding are the single most important elements to guarantee reimbursement. Even the smallest mistake can cause an insurance company to reject a claim, causing a long resubmission process and a delay in payment. To best decide on the right medical billing services for you, it helps to understand what medical billing and coding truly are.

Medical Coding heads off the medical billing process by translating the information recorded on a patient's visit into a code that can be read by insurance companies. The International Classification of Diseases, Tenth Edition, also known as ICD-10, is the current edition of the cataloging system for diseases and treatments in use for coding medical claims. Everything recorded on a patient's charts; from symptoms, to medical tests, prescriptions, diagnosis, and more; are translated into specific codes with specific rules, all of which medical coders must keep up with. The more accurate the coding, the better a claim will be able to transition through the billing process and provide a full reimbursement for services rendered.

Medical Billing is the process of taking the information from medical coders and transforming it into a claim to be submitted to insurance companies. The medical biller acts as an intermediary between patients, healthcare providers, and insurance companies. Making the process of submitting claims smoother and more accurate. The medical billing process may include claim scrubbing, meaning checking the claim for errors, as well as making sure the claim is compatible with the payer's software. If there are any errors in coding, the claim, or any incompatibilities, a claim can be sent back, delaying payment and generating additional work. Accurate coding and submittal is a keystone in an effective medical billing system.

Once the claim is scrubbed and sent to the insurance companies, the insurance companies analyze the claim and make decisions on payments, with each insurance company having its own set of standards and rules. If these standards aren't met, this is another potential point for a claim to be denied and returned for resubmission.

The medical billing and coding process is complex, but ultimately rewards accuracy and diligence. Utilizing a medical billing and coding company with dedicated experts, such as Right Medical Billing, improves the speed and accuracy of your claims, which in turn improves the cash flow of a medical facility. If you seek the freedom to focus on your patients and not on billing and coding, then call the experts!

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