Arguably the most important part to a practice is its medical billing and coding operation. After all, what’s the point of working and starting your own practice if you’re NOT going to earn a profit?

Medical Billing –

The medical biller acts as a liaison between the facility and payment parties. If the claim is denied by the third-party payer, the medical billing specialist must investigate the claim, verify its information, and update the database.

Medical Billing services include but are not limited to:

• Reviewing medical procedures as documented by doctors
• Translating medical procedures into codes that can be translated by payers, other medical coders, and other medical facilities
• Transmitting coded patient treatment information to payers and other recipients
• Coordinating insurance reimbursement of care providers
• Handling patient billing

Medical Coding –

Every medical service is assigned a numeric code to define diagnostics, treatments and procedures. It is the medical coder’s job to enter this information into the clinic or facility’s database using medical coding protocol to produce a statement or claim.

Medical coding specialists are responsible for job duties such as:

• Reviewing patient medical records
• Coding treatment information using Common Procedure Terminology (CPT) codes
• Communicating with medical billing specialists to ensure treatment codes are accurately received