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Here is How Medical Billing is Different From Medical Coding

The world has witnessed a sudden spike in the demand for healthcare services along with the need for healthcare professionals across the globe. From nurses to physiologists, from medical coders to medical administrators, every part of medical employment is currently booming. But the ones who are somehow related to the medical field know how challenging these jobs can turn out to be. 

Even those professions that don’t require direct involvement with patients like medical billers and coders have stressors and pressures on the job. Right now, you might have started wondering are medical billers and coders are the same. Well, this is the most asked question even when healthcare providers decide to opt for physical therapy billing services

Doesn’t matter whether you are planning on working with a medical billing service provider offering physical therapy billing services or planning to keep medical billing in-house, it is necessary to know the difference between medical billers and coders and this is what we are going to do in this blog post. 

What are the roles and responsibilities of medical billers and medical coders?

The main responsibility of medical coders is to collect all the important data from the patients and then translate them into universally accepted, alphanumeric codes that are used by all other medical systems and professionals. The same coded bill is then used by medical billers to create insurance claims for ensuring the patient gets reimbursed for their claims. 

Because of the specific nature of the job, a medical biller and coder needs to have special skills in data organization, communication, detailed orientation, and organization. Even companies providing physical therapy billing services have a team of medical billers and coders who are assigned to every client. 

What are the main differences between a medical biller and a medical coder?

As discussed above, medical coding involves the interpretation of the bills into codes that the system can understand. There are a few basic types of medical codes that are used by medical coders like the International Classification of Diseases, Tenth Revision (ICD-10) codes, and Current Procedural Terminology (CPT). 

For using the right codes for the right diagnosis, the medical coder must have sound knowledge of the terminology and adherence to CPT coding standards. On the other hand, medical billing involves using coded bills for filing insurance claims and then posting payments to accounts. For clearing the claims, the information provided in it must be accurate. 

This is the main reason why all medical billers always work with insurance companies to work out rejections or denials. They also work on finalizing the details and then settling the claim. 

  • So, on one side, medical billing involves dealing with patients, medical coding is just the entry of data. We can say that medical billing is a more extroverted type of job in comparison to medical coding. 
  • The major part of medical billing involves following up with insurance companies, and patients for ensuring all the claims are paid while the other side, a major part of medical coding involves entering data by using EMR and EHR software solutions. 
  • A medical biller manages payments and accounts while a medical coder examines all the operative reports used during the entire process of surgery for using the right codes. 
  • Medical billing involves proper investigation of denied claims so that they can be submitted while on the other hand, a medical coder performs medical chart audits whenever a claim is denied
  • Another main aspect of the medical billing job is to make sure that the patient and the physicians get reimbursed for their claims while in the case of medical coder jobs, it is about staying updated with the latest revision of coding changes and federal regulations. 

Many people think that they should know about the details of medical billers and medical coders only while keeping the medical billing in-house but that’s not the right approach as even while using the physical therapy billing services, one should be aware of the differences as it can come in handy. 

Both medical billers and medical coders have different roles and responsibilities but they both are an integral part of the billing cycle. 

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