Even those who work in the medical field may not understand the difference between medical billing and coding management. While the two are similar, they are quite different. Medical coding refers to a specific step within the process of medical billing services where information is obtained and proper codes are applied to a patient’s account based on the services that they received. These services can be at a hospital, clinic, surgery center or at a medical office. The code is used to create a claim to be paid by a provider or the patient.
Medical coding is just a part of the overall practice of medical billing. While the person who does the coding just might also be the person responsible for billing within the same office or department, the two responsibilities are quite different. Sometimes the person responsible for coding is different from the person responsible for medical billing, however they would work closely together as a team to make sure that the patient invoices get paid. The job of the medical coder would be to assign the proper coding on the medical claims.
Why Billing and Coding Management is Important
When you work in a medical office of any kind, one of the most important administrative jobs is with regard to medical billing services. The team within this department works together to ensure that the physicians and the practice receive payment for their services. Fast and accurate credentialing is important to ensure that the work is done properly and, knowledge of and preparation for the upcoming ICD-10 implementation is also essential. Because of all the changes, pressure and new rules regarding billing and coding management within the medical field, many practices are turning to medical billing consultants and are outsourcing their medical billing services to get it all under control.
When the ICD-10 implementation is complete and medical practices are expected to know and apply the new codes within their medical billing services department, some will get caught off guard. Not applying the proper codes to the medical claims could result in invoices not getting paid and claims not being approved for patients. It is the job of the coder to check through the patient’s medical records, laboratory tests and other related sources to verify all of the work that was done. Then they assign the CPT codes, HCPCS codes and the codes from the ICD-10 implementation to provide the person in charge of medical billing with the necessary data to process the claim accurately and completely.
The job of the medical coder and medical billing services is very important to the success of a practice, clinic, surgery center or hospital. There are many different codes and accounts that must be processed on a daily basis. The increased volume of codes that will come with the October 2015 ICD-10 implementation will complicate the job of the medical coder by expanding the individual codes that are used. Even in an ENT practice, there are many changes to the codes that medical coders will have to learn.
Why Medical Coders are Needed
For those who want to become a medical coder in today’s industry, there is a lot of education and training required in order to become certified. Fast and accurate credentialing is essential to the success of the practice, so hiring persons to work with coding and medical billing services who are knowledgeable, experienced and properly trained is important. The cost to hire a medical coder who can handle the code changes of the ICD-10 implementation can be prohibitive to some practices, which is why many are turning to professional outsourced medical billing services to help them become compliant.
While the healthcare industry has undergone many changes in recent years, the ICD-10 implementation has been the most stressful and controversial. The last time the ICD was update was in 1977, so the upgrade to the new ICD-10 will increase the number of codes being used exponentially. The transition from ICD-9 to the ICD-10 implementation will affect billing and coding management across the board, greatly affecting the medical industry. While some welcome the change, others are in a state of panic, which is why there have been so many delays already for the release of the new ICD-10 implementation.
How MD Pro Solutions Can Help
Doctors and clinics that focus on providing patients with otolaryngology or Ear, Nose and Throat (ENT) services can count on MD Pro Solutions to help them with medical billing services, billing and coding management, fast and accurate credentialing and even ICD-10 implementation. We provide a wide range of services to our clients, relying on our over 45 years of specialized experience working in the billing, coding and collection industry to help practices generate revenue and be in compliance with the law.
Our team has developed a series of solutions that have been specifically designed for ENT physicians and practices. It is our goal to work directly with our clients to help them boost their revenue and improve medical billing services by improving the tools, support and education available to your in-house employees. We can also get your practice set up with medical billing services, however switching your billing services is not a requirement associated with working with MD Pro Solutions.
Give us a call today at 508-946-1665 or use our online contact form to request additional information about our consultation and medical billing services. Our team will be happy to answer any questions that you might have, provide you with fast and accurate credentialing and offer a full line of billing and coding management services.