Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. Basically, medical billing translates a healthcare service into a billing claim. The medical biller follows the claim to ensure the practice receives reimbursement for the work the providers perform.
Medical billing vs medical coding: The main responsibility of a medical coder is to review clinical statements and assign standard codes using CPT®, ICD-10-CM, and HCPCS Level II classification systems. Medical billers, on the other hand, process and follow up on claims sent to health insurance companies for reimbursement of services rendered by a healthcare provider.
Topics covered in training for medical billing include:
Basics
Ethics in coding Medical terminology Pharmacology HCFA documentation guidelines Evaluation and management auditing
Industry History & the Codes ICD Codes CPT Codes HCPCS Codes
The Coder Private Physician Practice Hospital Services Background & Experience of the Coder
ICD Coding How reference books are used, coding guidelines, Outpatient & Physician Office Coding and much more.
CPT Coding The guidelines for CPT coding from the evolution to a thorough understanding of symbols, modifiers, evaluation, management services and much more.
Liability and Legal Issues In this section, the specialists are trained in the various liability and legal issues.
Also: The medical record as a source document Medical abbreviations Diagnostic and laboratory testing Inpatient reimbursement process
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