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Medical Billing and Medical Coding
Home » Healthcare Administration » Medical Billing » Medical Billing and Medical CodingThe medical clinic’s reimbursement for care offered to patients ultimately depends on numbers, called medical codes. Here’s how the process unfolds: When a patient is seen in a clinic, the doctor gets all kinds of information about the person’s medical history and present medical problems or concerns. The doctor may choose to run tests whether it is a simple test like a CBC, a complete blood count, helps the doctor see signals of infection in the body, or something much more complicated like a MRI, a high-tech image of a specific part of the body. Either way, these types of tests and many others help the doctor determine a diagnosis. In the patient’s medical record and on a sheet of paper designated for medical charges, the doctor identifies the complaints of the patient, the procedures of the office visit and some sort of diagnosis, bearing mind that a more complete diagnosis may be made later. A person in the office, usually a medical coder or a medical biller, takes the document and fills out a claim for the insurance company. In the claim, the biller makes sure that proper medical codes are recorded for the procedures, tests and diagnosis that the doctor makes. A proper code means the doctor will get reimbursed, hopefully quickly. An improper code will mean delays in the doctor or clinic receiving payment. Entering a code for an office visit may seem like a simple task, but sometimes there are hundreds of codes for similar issues. Much of this is being done electronically, thus eliminating the waste of paper and postage costs.
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