All About Medical Billing

All About Medical Billing

The medical field is a complex and large system that includes not only many positions, but also many layers of care and many pieces that contribute to making the system function.  To fully understand the medical field, we are going to take a look at a key piece that it is necessary to all medical care. That is medical billing

Medical billing is how the medical provider gets paid for the service(s) they provide to the patient.  This is a consistent element of all care and is important to understand, because it impacts all medical care.  In addition to the medical provider and patient, there is the medical biller who is responsible for creating a claim for the service provided and sending it to a patient’s insurer.  A claim consists of the patient’s demographic information and medical history along with the insurance information and what services were provided to the patient and the reason for the service(s).  The service(s) provided and why the service(s) was provided is written in the form of codes, which are universal, and are compiled by a medical coder. Medical coders use the same coding system that other medical providers use and these codes are called ICD codes.  These codes represent diagnoses, procedures, services, equipment and more. The medical biller then takes these codes and compiles the claim of the service to send to the insurer. Medical billers communicate with the patient and with insurance companies and act as a mediator to ensure the claims are paid.

 Medical billers are essential to ensuring accuracy of reported services and so that medical providers are paid in a timely manner. As you can see, medical billing and medical coders are essential parts to ensuring the completion of a medical service. Later this week we will take a closer look at the role of a medical coder.


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