Medical billing and coding are the backbone of the healthcare revenue cycle, ensuring payers and patients reimburse providers for services delivered.
Medical billing and coding translate a patient encounter into the languages used for claims submission and reimbursement.
Billing and coding are separate processes, but both are crucial to receiving payment for healthcare services.
Medical coding involves extracting billable information from the medical record and clinical documentation, while medical billing uses those codes to create insurance claims and bills for patients. Creating claims is where medical billing and coding intersect to form the backbone of the healthcare revenue cycle.
The process starts with patient registration and ends when the provider receives full payment for all services delivered to patients.
The medical billing and coding cycle can take anywhere from a few days to several months, depending on the complexity of services rendered, management of any claim denials, and how organizations collect a patient’s financial responsibility.
Ensuring provider organizations understand the fundamentals of medical billing and coding can help providers and other staff operate a smooth revenue cycle and recoup all of the reimbursement allowable for the delivery of quality care.
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