Role of Medical Coders and Billers in the healthcare industry!

Posted on Oct 06, 2017 by Coding

Many people are still unaware of who are medical billers and coders. The name also seems an alien word to a lot of us but they are really an important part of health care industry and tend to reduce a lot stress and complications of the physicians as well as patients. They work behind and scene to ensure the smooth functioning in the frontend. Coding Materials is a platform that serves these experts by providing them the necessary resources for their work. 

Let us look what exactly is the role of Medical coder and how does their contribution add up to medical industry.

Medical degree isn’t required to become a medical billing or coding expert. All you need to do is an year training and you can start your career in the same path. When you go to a physician, he diagnosis your problem, makes prescription note, assigns medicine so on and so forth, which makes it a bulk data. This bulk data needs to be stored for further purpose too. What medical coder does is that they assign certain digit code to each medical record and then record it on the insurance claim. Their work involves the following steps: 

• With the help of Current Procedural Terminology (CPT), select the correct procedure codes. 

• Through ICD-10-CM determine the accurate diagnostic codes.

• Fill in the procedure and diagnosis codes in patient’s chart and insurance form.

• Comply codes along with patient data into EHR system.

• Make sure the claim in complete and accurate.

• Update patient files and medical history.

• In case any code is incorrect then co-ordinate with the other staff members and take necessary steps.

• If not satisfied, then request further information from healthcare provider.

 Looking further what does a medical biller do?

Although many of the people have a perception that medical billing and coding is same and are done by a single person; to their surprise they are entirely different and are taken care of by different authorities. Medical billers are on the second step of the reimbursement procedure and their work starts once a medical coder has sent them a proper report based on codes. They are responsible for sending bills to the patient and to check weather their payments and reimbursement are processed on time. They work in the following way:

• They use specialized billing software to process and submit insurance claims.

• They make a proper arrangement to review that their claims are accurate. 

• Have a word with the patient regarding policies and coverage. 

• Follow-up on each record of reimbursement process. 

• Securing a patient’s medical records for privacy standards. 

Both medical coders and billers need few resources to make their work easier. Coding Materials is a platform that provides medical Coding Companion, all medical coding books, EBooks and other resources at best prices along with additional savings option. 


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