Information on Medical Billing and Coding

Below we have provided some information on medical billing and coding to enable you to get an idea of what is involved in these processes. 

Medical billing is a process by which claims are issued to insurance companies or the U.S. government to ensure that a doctor is paid for his services to a patient. A person involved in medical billing should have knowledge of medical terminology, claims processing procedures, HIPAA regulations, diagnostic terminology, insurance forms and related details. The medical billing process consists of insurance verifications, authorization, reauthorization, billing, coding, follow-up, re-submissions, patient billing and so on. The software used for medical billing includes EMR (Electronic Medical Records), EPM (Electronic Practice Management) Lytec, Medic, and United among others. 

Medical coding (insurance coding) is a process by which codes are assigned to the diagnoses of diseases and medical procedures. The codes have numeric or alphanumeric designations. Medical coding ensures that the doctor or health service provider gets compensation from insurance agencies or consulting firms for his services. Through medical coding, the insurance provider will get an idea of the entire medical history of the patient, the health services received by him and also the medical insurance claims. Based on descriptions given by the provider, diagnosis codes as well as numerical codes for CPT (Current Procedural Terminology) are allocated. CPT is the list maintained by the American Billing Association which provides for unique billing codes for services provided.  

There are two types of coding problems-under coding and over coding. Under-coding leads to loss in revenues, and over coding results in denials and reviews. Outsourcing of medical billing and coding is becoming increasingly common in the present scenario.

Outsource Strategies International (OSI) provides world class medical billing and coding services. Our services are characterized by affordability, reliability, customer-orientation and 100% accuracy. We make use of EPM and EMR software which greatly increases efficiency, saves time, reduces back office expenses and reduces the need for paperwork. Our highly professional staffs are well-versed in medical terminology, claims processing procedures, HIPAA regulations, insurance forms, CPT codes, etc. We have a 24hr claim processing system. We also offer flexibility in the delivery of medical reports. Some part of our medical billing and coding processes is outsourced to our offshore sites in India and the Philippines.

For more information on medical billing and coding services provided by OSI, please visit our website or contact us or call us or  at 1-800-670-2809.