Medical Reimbursement - Aspect To Getting The Most Out Of Coding And Billing

Medical coding and medical billing are often lumped together. Many people think they are the same or are combined in one field, industry or profession.

Florida, FL (prHWY.com) September 14, 2012 - Florida, Sep 13, 2012 - Medical coding and medical billing are often lumped together. Many people think they are the same or are combined in one field, industry or profession. However, they are very separate functions. People work as billers or coders - and often not for the same type of company.

With medical billing the Medical Billing Specialist uses the medical report that has already been coded by the medical coder and uses the codes to bill health insurance companies. Sometimes billers also will do some basic medical coding, especially if they work in a doctor's office or clinic. Primarily they need knowledge of the health insurance industry rules and regulations.

Medical Reimbursement - Medical coders are like private detectives or investigators. They assign various codes to the patient's signs, symptoms. diagnosis or diagnoses and procedures, including any lab work. By assigning these codes, it helps get payment or reimbursement from the health insurance companies for the doctors or other health professionals.

Simply put, the medical coder takes the doctors notes and converts data into codes. Billers submit the coded claims to the health insurance companies and the insurance companies pay the doctors.

Along with all of the other good advice that medical billing consultants can give physician practices, one of the most common parts of an innovative revenue cycle strategy is to make sure that patients who visit a practice understand the costs of the services and their potential share. This is a tricky subject that a lot of doctors shy away from, because traditionally, it has been so much easier to just assume that insurance will pay a big enough part of the bill to keep things running smoothly.

Revenue Cycle Management - Doctors who have seen overwhelmed patients simply "dine and dash" with regard to their medical care are now realizing that it may be helpful to have some kind of conversation with the patient at the time or even before the time of service. Now, many offices are doing better at recording the patient's insurance situation, but often, even this is not enough. That's why some doctors are getting more money up front from patients, explaining that if insurance does not pay, the patient may need to cover more of the cost.

However, with the right approach to patient education, this doesn't have to happen and can result in a better patient experience. Doctors need to have a frank internal dialogue with leadership about how much a patient should be told about their potential billing amounts, just to make sure that they have an understanding of what to do when they eventually receive their bill.


About the Author:

Medical Reimbursement - National Medical Billing Inc. Services concentrates strictly on providing billing and coding solutions and is the fastest growing company in the industry.

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