Billing and Coding
Billing and Coding
What is Billing and Coding?
Medical coding involves extracting billable information from the medical record and clinical documentation, while medical billing uses those codes to create insurance claims and bills for patients. Creating claims is where medical billing and coding intersect to form the backbone of the healthcare revenue cycle.
Billing and coding are separate processes, but both are necessary for providers to receive payment for healthcare services.
MEDICAL CODING
- Mainly involves communicating with physicians, nurses, & other healthcare professionals to categorize services a patient has received
- Applying CPT, HCPCS, and ICD-10 CM standardized codes to patient records to accurately reflect the services received
- Entering data through Electronic Health Record & Electronic Medical Record (EMR) software used in hospitals and physicians' offices
- Examining operative reports used during surgery to apply procedure codes
- Performing medical chart audits when a claim is denie
- Staying updated with latest revisions of coding standards & federal regulations
- Examining patient charts and histories to ensure coding accurately reflects a patient's medical care
MEDICAL BILLING
- Mainly involves entering data with the help of a billing software
- Submitting insurance claims to insurance companies
- Following-up with patients, healthcare professionals, and insurance providers to make sure the claims are paid for
- Managing account payments and invoices
- Investigating denied or rejected claims
- Ensuring the physicians and patients receive reimbursements from insurers
- Verifying the accuracy of standard healthcare codes used by medical coders to classify services and products
Our Services
WHAT WE OFFER
Medical Billing
Services
Medical billing is the process of generating healthcare claims to submit to insurance companies for the purpose of obtaining payment for medical services..
Medical Coding
Services
Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.
Medical Coding Audit
Services
A Coding Audit is an internal or external review of a medical office’s coding practices conducted by reviewing patient medical records.
Medical Coding Analysis
Services
Medical coding analysis minimizes risk in the billing procedure and proves to streamline strategies for the future.
Billing
Medical Billing Services
Medical billing is the process of generating healthcare claims to submit to insurance companies for the purpose of obtaining payment for medical services rendered by providers and provider organizations. After translating a healthcare service into a billing claim, the medical biller follows the claim to ensure the organization receives reimbursement for the work the provider performed.
- Claims Denial Management
- Insurance Verification
- Patient Information Entry
Coding
Medical Coding Services
Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.
The diagnoses and procedure codes are taken from medical record documentation, such as transcription of physician’s notes, laboratory and radiologic results. This documentation is not only the patient’s ongoing record, it’s how the healthcare provider gets paid.
- Reduced Operational Costs
- Pre-coding
- ICD and CPT Coding
- Quality Check
Audit
Medical Coding Audit Services
A Coding Audit is an internal or external review of a medical office’s coding practices conducted by reviewing patient medical records. Medical record audits target and evaluates procedural and diagnosis code selection as
determined by physician documentation for completeness and accuracy.
- Recognize that an auditor is a partner
- Identify an auditor
- Identify an auditor
- Look for irregularities
Analysis
Medical coding analysis minimizes risk in the billing procedure and proves to streamline strategies for the future.
- Receiving files
- Pre-coding
- Coding
- Quality Control
