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What You Need to Know About Medical Billing & Coding

Third Party Admin

It’s incredibly important to know everything that you can about medical billing, especially in light of the increase in uninsured people across the United States. Between 2015 and 2017 alone, the percentage of uninsured people under the age of 19 increased by .6%, up to 5.5% of the population in total. Naturally, people without medical insurance will have needs that are different from those with insurance; but all of us deal with them in some form or the other. What’s important is that you know everything you can about medical billing or coding as it is handled by a third party admin. With that being said, let’s look into some of the things you should be aware of regarding medical billing.

What Is The Difference Between Medical Billing and Medical Coding?

On the surface, medical billing and medical coding mays seem like the same thing. But they are actually two separate processes and must be handled differently. With medical coding, the billable information is actually extracted from the medical record and clinical documentation. With medical billing, those codes are used to create claims and bills for patients. Essentially, both are needed in order for the medical industry to collect revenue. One cannot exist without the other, and both can be utilized by third-party admin services.

Medical coding is reliant on the accurate input of information. Essentially, the coding process begins when the patient enters the doctor’s office, and the information regarding their case is initially input into the system. It’s incredibly important that the information collected is accurate, as any errors can result in issues with the medical coding itself. The main concern is that patients are not being pilled for services that they did not request. Errors in medical coding could result in providers being charged with fraud.

What Are The Types of Medical Billing?

Medical billing comes in two forms: front-end billing, which occurs when the patient makes an appointment and fills out the necessary paperwork, and back-end billing, which combines coding and billing. The resulting superbill not only includes what the patient is being billed for, but the reasons behind the procedures and equipment used. This is incredibly useful for third party admin providers.

There is much to be concerned with regarding medical billing. But the more you know, the easier it is to stay organized.