What is Medical Billing and Coding?

Video Transcript

Host Question:
What is medical billing and coding? What does that mean?

Guest Answer:
Health care providers see patients. They write down what they do. We take that documentation using our medical terminology, anatomy and physiology information. We translate it into understandable information that we then put into code, translated into medical coding. And then we take those medical codes and we put them into insurance claims using some other data manipulation. And we work with the insurance companies and there are policies and procedures and other regulatory agencies to get money from those insurance claims. And then we do some accounting to make sure that all the patient’s claims are paid, and we report back about our progress in drawing that revenue stream for our organizations.

Guest Answer:
Well, we’re looking primarily at is the revenue cycle. And there’s 10 steps to the revenue cycle which billing and coding is all part of all that is taking the doctors chart notes and ensuring that what the doctor says is was related in the codes. You come in for a fever, that is a diagnosis code. If he removed a hangnail, then that’s a procedural code. So those are all alphanumeric codes that translate into either a dollar or into a diagnosis.

Guest Answer:
So the medical billing portion is more dealing with the insurance side of things. And you would be working from a list of rejections and that type of thing, getting the coding fixed so that the insurance companies will pay it for your practice or hospital. And the coding side is more reading what the physician has actually done or said in their office visits or procedures and inputting a diagnosis code or a CBT or ICD-10 PQRS procedure code with what he’s actually done.

Guest Answer:
So medical billing and coding is extracting billable information from the medical documentation. And then the billing aspect of that is using those same codes to create insurance claims. And they’re kind of the backbone of the health care revenue cycle.

Guest Answer:
Medical billing and coding is the practice of actually getting the claims, you know. Correct giving them at the door. And so a provider, making sure that the codes that a provider has selected are occurring. And it’s basically just the knowledge of all of that entails like to do coding and billing there one that can happen without.