Medical Coding Vs Medical Billing - The Difference

Do you think Medical billing and Medical coding are the same? You are not the first one to think so. Medical coding and Medical billing are two different processes working with each other to meet one goal that is to increase the revenue of the healthcare organization.

Before jumping to the straight difference. Let us first understand each one by one.

Medical Billing - Medical billing is a process to seek the reimbursement to which a healthcare provider is entitled to as a return to the service they have provided to the patients.?

In other words, Medical billing is the process of submitting a claim by filling in required data and keeping following up with health insurance companies until and unless the claims get settled and the healthcare professional gets paid for their service.?

They are the ones who talk to the insurance companies, patients in order to settle the insurance claims so that money keeps flowing into the healthcare organization. If the claims get denied, you would need a medical biller to look into it.

In order to meet the claim, they should know about various and different insurance policies, filling processes, filling time duration, when to submit an appeal if a claim gets denied etc.

On the other hand,

Medical coding, if I put it in simple words, is basically translating the medical document like diagnosis, prescription, the procedure of the treatment, medical report, equipment that have been used in the medication, etc into codes.

Medical coders need to be familiar with the different medical terminology in order to understand the anatomy, pathology, surgical records, different findings etc so they can be aware of what is going on with a patient's care so that they could translate all these medical records in clear code.

Now do these services look the same to you any longer?

Let us come to the differences.

Medical Coding Job Requirement

Medical coding deals with medical documentation, medical records. Medical coding is the primary job. How one would pay if what services have been provided are not clear to them. Medical coding gives that clarity in clear codes.

Medical Billing Job Requirement

Medical billing deals with the submission of claims of the services rendered by the healthcare organization and making sure they get paid. Medical billing is the second step after the medical coding to meet the ultimate goal which is Revenue.

Medical Coding Communication

Medical coders need to talk to the physician, nurses, lab managers to get clarification of what services have been provided.

Medical Billing Communication

The medical biller needs to talk to the coder to make sure the claims are correct, then talk to different health insurance providers for the settlement of the claims and patients if a claim gets denied for any reason.

Medical Coder's Salary

The salary definitely depends on the geographic location, employer, experience, certification etc. Their annual average salary is 42630 USD to 50089 USD. It of course varies.

Medical Biller's Salary

Their salary also depends on the location, experience, employer and certification. Their annual average salary is $33,582 to $40,790 which again varies. But it is of course a bit lesser than the medical coders.

Medical Coding Key Points

Accuracy here is the most important factor. Anything incorrectly coded will result in an incorrect claim, which can be a cause of the claim denial and stress for the medical biller.

Medical Billing Key Points

If you see they are the one who gets the money in. Keeping track of claim submission’s date and time period is important along with investigating why a claim gets denied and what should be done to rectify the denial and have the money flowing in is their important job role.??

In large organizations, the medical billers can be designated for different insurance policies and companies and a medical coder can be designated for different specialities of a medical department. In small organizations, a medical coder and a medical biller can be the same person.

P.S. - When we talk about medical coding it is not the same as computer coding. Computer coding and medical coding are two different things. We would touch on this point in our coming articles.

These two job functions play a large role in the revenue cycle management of a healthcare organization. Every healthcare organization must have an efficient team of medical coders and medical billers so that the physicians, doctors, nurses can focus on the main job that is patient's care.

Syanthy Healthcare Services do provide that support and bridge the gap between you and your healthcare organizations revenue.

That was all for today's topic. Thank you for investing your time in reading this article. I hope you find it insightful. If yes, please do share the article.