Medical Coding vs. Medical Billing: What’s the Difference?

medical coding vs medical billing

Both medical coding and medical billing play crucial roles in the healthcare revenue cycle. They help healthcare providers maintain accurate records and get accurate compensation for their services.  

In this post, the experts at PracticeForces delve into the intricacies of medical coding vs. medical billing and their importance to the overall functioning of a healthcare organization. Keep reading to understand the distinction between medical coding and billing.  

 

What Is Medical Coding?  

Medical coding involves converting medical diagnoses, treatments, and procedures into universally understood alphanumeric codes. Healthcare providers, insurance companies, and government agencies use these standardized codes to collect, analyze, and report data.  

Medical coders review patient medical records and assign codes that reflect patient diagnoses, procedures performed, equipment used, and more. Besides payment processing, medical codes help to track the quality of care and performance of physicians.

 

What Is Medical Billing?  

Medical billing refers to the process of preparing bills and generating claims with insurance companies to receive payment for medical services provided to patients.   

This includes ensuring each claim has all the necessary patient information, tracing the status of those claims, and recording payments made by patients or other payers.  

 

Comparison of Medical Coding and Billing 

In healthcare administration, it helps to understand the distinction between medical coding vs. medical billing. While both medical billing and coding help to reduce denials in medical billing, they do so in different ways.  

Medical coders assign appropriate codes to patient data to ensure that insurance companies process each claim accurately. Medical billers, on the other hand, help to facilitate payment from patients and insurance companies.  

 

Medical Coding and Billing Differences  

Understanding medical coding and billing disparities matters. Besides differences in purpose, healthcare coding versus billing vary in several ways.

 

Education and Training Requirements 

Medical billers typically need at least a high school diploma or general education equivalent. You require at least an associate degree in a medical coding and billing program to get a job as a medical coder.  

Nonetheless, both jobs require an in-depth understanding of medical billing and coding terminology.

 

Job Duties and Skills  

Medical billers usually engage directly with patients and insurance firms to handle claims, while medical coders usually work independently.  

 

The Bottom Line  

Medical coders and billers have separate roles in the healthcare industry, but they both aim to ensure hospitals, doctor’s offices, or clinics receive payment for their services.  

Some of their roles overlap, and they rely on each other to complete the billing process. Moreover, both have direct and indirect effects on various aspects of healthcare operations, from revenue cycle management to patient scheduling.

 

Hire a Professional for Medical Billing in Florida  

Now that you understand the difference between coding versus billing in healthcare, you can’t afford to hire just anyone to do your medical billing or coding. Look no further than PracticeForces for all your revenue cycle needs.   

Call PracticeForces at (727) 499-0355 to get a quote for medical billing services and get started toward increasing your practice revenue. Reach out for more information about medical coding vs. medical billing or explore our blog to learn about the benefits of medical billing.

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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