Why Medical Billers and Coders are Vital to the Healthcare Industry

When people think of the healthcare industry, they often think about physicians, specialists, or hospitals first. While of course the healthcare industry wouldn’t exist without medical providers, there are also countless healthcare professionals who work behind-the-scenes. Medical billing and medical coding are two separate tasks. Ideally, these are handled by different individuals, but in some cases like a small private practice, a single individual may manage both.

Medical Coding

The main role of a medical coding specialist is to decode services or procedures from the patient documentation provided by the healthcare provider. Using that information, they submit the appropriate procedure (current procedural terminology or CPT) and diagnosis codes. This role is critical to the accuracy of the billing procedure.

Medical Billing

Using the appropriate codes determined by the medical coding specialist, the medical biller inputs and submits claims to the insurance company for billing. This often requires follow up to make sure the claim has been approved. If a claim has been denied, the medical biller will work to resolve discrepancies or provide any missing information.

In-House or Outsource

Historically, medical billing and coding were kept in-house to maintain control over these essential functions. In recent years, advancements in technology have made it possible to outsource them resulting in greater emphasis on patient care, reduced labor costs, fewer errors and decreases in the amount denied claims. Outsourcing to a third-party provider also helps ensure that your healthcare organization is compliant with rapidly changing regulations and up-to-date with coding terminology.

How We Can Help

The medical billing and coding services from Applied Medical Systems can help you process claims more quickly and with greater accuracy. You’ll see an increase in continuous cash flow that can help you grow your practice and focus on what truly matters— the patient experience. To find out if outsourcing these services can save your practice time and money, contact us today at (919) 477-5152 or complete our online contact form.