What is the Difference Between Medical Billing and Medical Coding?

Feb 12 2018

Medical billers and medical coders both work with patient records in medical offices. Medical coders review patient records and code the information on it to be sent to insurance companies for billing. Medical billers are the ones responsible for sending the coded bills to insurance companies and following through on receiving payment.

What is Medical Billing

Medical billers are responsible for taking the coded patient information and using it to bill insurance agencies for services offered. This role often requires personal interaction more than medical coding does. Billers work with both insurance agencies and patients to ensure that all payments are processed properly. They are required to have a deeper understanding of insurance policies and procedures.

What is Medical Coding?

Medical coders are responsible for converting patient information into easily identified codes that insurance companies can interpret at a glance. This is to help the billing process with insurance companies to go more smoothly. There are multiple different coding systems used to designate patient information:

  • Current Procedural Terminology (CPT) – This set of codes is used for procedures performed in physicians offices or outpatient services.
  • Healthcare Common Procedure Coding System (HCPCS) – These codes are used to designate procedures covered by Medicaid and Medicare.
  • International Classification of Diseases (ICD-9) – This is an set of disease diagnosis codes for quick identification.

Medical coding professionals learn to be proficient in these different coding procedures. If a medical coder does their job well, it makes it easy for medical billers to succeed in their jobs. This is especially helpful when they’re the ones who will be doing the billing as well.

Why Learn Both?

Medical coding and billing may technically be different jobs, but it is very common for medical facilities to combine the two roles into a single job position. It is often more efficient for a single person to do both coding and billing. Larger medical facilities are more likely to separate the two roles, but being proficient in both would make you more hireable by smaller businesses.

What Training is Required?

There are many options for training to become a medical coder or biller. Most employers require a high school diploma and certification for each billing and coding as a bare minimum. The applicants who are successful more often are those that have a more robust education in both coding and billing. Pittsburgh Career Institute offers a medical billing and coding program that is designed to give you the advantage you need to pursue this career!

Learn More!

Are you interested in learning more about medical coding and billing? Our program at PCI helps graduates to be more prepared for the workforce. Contact us to learn more information about a medical coding and billing education at Pittsburgh Career Institute!

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