Medical billing and coding are two essential aspects of healthcare services. Perfection in both the components is most critical for smooth cashflow and effective operations.
Medical coding is alphanumeric codes providing information about diagnoses, treatments, procedures, medications, and equipment. Sources of these information are transcriptions, medical notes, electronic records and diagnostic reports. Medical coding starts with a patient visit to hospital, or other healthcare service provider location.
Medical billing begins with patients' registration at practices office or hospital and schedules an appointment. Front-end medical billing requires most accurate information up front starts with patient scheduling and patient registration. Accurate medical billing ensure smooth operation of the revenue cycle. Medical billers should have knowledge of various medical regulations and private and public insurance plan policies, claim follow-up, claim denial resolution, posting payments and bill adjustments, appeal submissions, and collections management. The efficient medical billing and coding ensures improved revenue flow.
Similarly, accurate medical coding is essential to obtain insurance reimbursement and maintenance of records of patients. Over coding can cause serious problems, when reporting medical codes resulting in higher payment being made by the insurance company. It is considered as fraud, resulting in legal and financial penalties.
Medical coders and back-end medical billers use codes and patient information to create a bill that is an itemized form to create a claim.
There are various State as well as Federal guidelines controlling medical billing and coding. Most important of those guidelines is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA protects patient confidentiality. It also stipulates medical practice or hospital to protect confidential patient information. HIPAA also applicable to the electronic medical records and the International Classification of Diseases (ICD-10).
Medical billing and coding are very essential healthcare revenue cycle processes. When your staff have other responsibilities within your practice, leaving them in charge of medical billing and coding is not the best idea. It is also difficult for them to be up to date with frequent coding and regulations changes.
By outsourcing, practice/ provider ensure that their medical billing and coding cycle run smoothly. and get paid for services delivered.
Consider X-Factor Healthcare Solutions LLC as your Medical & Dental Billing Partner
You are at the right place for a Medical & Dental Billing Partner who can focus on your Revenue Cycle Management and make the technology and implementation just as simple.