Coding & Billing

Coding & Billing (Pricing)

(Pricing) – Medical coding and billing are two closely related aspects of the modern health care industry. Both practices are involved in the reimbursement cycle, which ensures that health care providers are paid for the services they perform. The medical coder’s job is to take the doctor’s diagnosis, for example, or a prescription for a certain medication, and translate it into a numeric or alphanumeric code. For every injury, diagnosis, and medical procedure, there is an AMA approved CPT/HCPCS categorization. The medical biller takes the codes and creates a claim. The biller then sends this claim to the insurance company, which evaluates and returns it. The biller then evaluates this returned claim and determines the responsibility of the patient.