The medical biller takes the codes, which show what kind of visit this is, what symptoms the patient shows, what the doctor’s diagnosis is, and what the doctor prescribes, and creates a claim out of these using a form or a type of software. It’s here that the medical billing process begins. This patient calls the doctor and schedules an appointment. Our same patient has a cough, a fever, and is producing lots of mucus. To get a better look at medical billing, let’s rewind the example we used earlier. Of course, as with everything related to the health care system, this process isn’t as simple as it seems. On one level, medical billing is as simple as it sounds: medical billers take the information from the medical coder and make a bill for the insurance company, called a claim. FEATURED ONLINE MEDICAL CODING PROGRAMS Medical Billing Once the report is coded, it’s passed on to the medical biller.
#Medical billings software#
The coding process ends when the medical coder enters the appropriate codes into a form or software program.
#Medical billings code#
Coding accurately and within the specific guidelines for each code will affect the status of a claim. Certain codes, like ones that signify a pre-existing condition, need to be placed in a very particular order. There’s a specific code for what kind of visit this is, the symptoms that patient is showing, what tests the doctor does, and what the doctor diagnoses the patient with.Įvery code set has its own set of guidelines and rules. The coder reads the healthcare provider’s report of the patient’s visit and then translates each bit of information into a code. These codes act as the universal language between doctors, hospitals, insurance companies, insurance clearinghouses, government agencies, and other health-specific organizations.
There are a number of sets and subsets of code that a medical coder must be familiar with, but for this example we’ll focus on two: the International Classification of Diseases, or ICD, codes, which correspond to a patient’s injury or sickness, and Current Procedure Terminology, or CPT, codes, which relate to what functions and services the healthcare provider performed on or for the patient. It’s the medical coder’s job to translate every bit of relevant information in that patient’s visit into numeric and alphanumeric codes, which can then be used in the billing process. The doctor then prescribes medication to the patient.Įvery part of this visit is recorded by the doctor or someone in the healthcare provider’s office. A nurse asks the patient their symptoms and performs some initial tests, and then the doctor examines the patient and diagnoses bronchitis. Let’s start with a quick example of medical coding in action.Ī patient walks into a doctor’s office with a hacking cough, high production of mucus or sputum, and a fever. There are thousands and thousands of codes for medical procedures, outpatient procedures, and diagnoses.
For every injury, diagnosis, and medical procedure, there is a corresponding code.
It’s the coder’s job to take something that’s written one way (a doctor’s diagnosis, for example, or a prescription for a certain medication) and translate it as accurately as possible into a numeric or alphanumeric code. Medical coding, at it’s most basic, is a little like translation. Search our directory of all medical billing and coding schools Compare Programs
#Medical billings download#
Download SlidesĮxpand your medical billing and coding education with the MB&CC E-book. Review and keep track of what you've learned by downloading the slides for this lesson. Section 1.05 Medical Billing Certification
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