Upon diagnosis and treatment of a patient, the doctor is responsible to document the details as part of paperwork. All this information is later utilized in the processes for medical coding, billing and ultimately translated into payment. Although this is a process normally conducted away from the public eye, back office employees who perform the task of medical coding are specialists in selecting medical codes to match the doctors’ diagnoses of patients’ ailments. These codes are important details of reference when it comes to requesting payment from insurance companies and private payers. If a patient has an existing health insurance policy, these coding experts also check to verify whether claims can be made against the policy.
In order to comprehend what medical coding and billing is about, individuals interested in this field need to receive proper training. They can opt to enroll in courses from local educational establishments or distance learning providers. Since certification is required for active practice, it is best to check that the course selected is certified by the medical authorities. A certified coding expert is responsible to check and organize a patient’s records, bills and statements before proceeding for medical coding. Billing is then generated based on correct codes entered into the system. Utilizing computer systems to carry out this task has taken a considerable load off as the coding and billing process is more efficient and effective. Reports on statistics, billing, mortality, morbidity and others are easily produced for submission to relevant authorities as well as for internal scrutiny where required.
In line with constant change in the medical industry, those involved in medical coding and billing are expected to keep themselves updated through continuing medical education. Changes are constantly imposed on billing procedures, insurance schemes offered on a public and private scale, workers’ compensation, disease and diagnosis coding systems, procedure and treatment codes, physicians’ fee scale and many more.
Since these experts are a required workforce by healthcare institutions and practitioners, they can either work within large institutions or offer themselves as outsourced service providers to smaller establishments or clinics.