New Techniques for Billing and Coding Service Providers

Heath care industry is at large today. We require treatment at least once in a year and we make sure that our insurance covers it. The same things are for our doctors or health care service provider. They also want to make sure that they get billed properly for the services they have provided. In today’s world physicians mostly are joining the physician practice management companies or any other bigger group, hospital in order to innovate and grow. However there are also physicians who are still practicing on their own. The key to survive in this industry without joining hands with any group is to expand their practice and take over other practices nearby. However surviving without a little bit of help alone can be rough. Practicing all day and then managing your finances can be pretty tough. Here physicians can ask for help from the medical billing companies. These companies look after billing in an efficient and cost effective manner.

Some might wonder how this work does. Well many doctors they don’t do their own billing and the insurance company or the patient pay them based on their own terms and conditions. The insurance companies make sure that have to pay the minimum amount. So when the doctor sends the bill they do their calculation and pay the passable amount. Medical billing companies help both the physicians and doctors and make the billing process less stressful and manageable.

It might seem that medical billers and coders are same however they are not. Medical coders they check the sources on the patient’s reports and analyze doctor’s notes, Laboratory paper work, tests prescribed by the doctor. They verify if the work has been done and then assign them to ICD-9 codes, HCPCS codes and CPT codes to report the procedures and let the medical biller know so that they can go ahead and process the medical reimbursement from the insurance company.

These medical billers and coders use different kinds of software’s. There are new techniques discovered every now and then in this industry. Below are mentioned few of the technique and software’s used:

• American Medical Association published the CPT (Current Procedural Terminology) codes and presently there are about 7,800 CPT codes ranging from 00100 - 99499, currently in practice. The fourth edition is being used by U.S and some other countries and was designed in such a way that they can provide a uniform data set which will describe medical, surgical, and diagnostic facilities rendered to patients.
• The ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) coding system, links health concerns that show up in patients, by using 3- 5 digit alphanumeric codes to specify signs, diseases, situations, injuries and symptoms to payers injuries, diseases, and conditions. These codes are used in combination with CPT (procedural) codes to record facilities rendered by a health care provider to a patient and is stored in the medical record and then described to a payer for compensation.

These are how general physicians and patients gets help from the medical billers and coders. Likewise the same thing can be done for the ambulatory service centers. Ambulatory service center billings use a single HCPCS code. Ambulatory service center billings use it for a single procedure and each HCPCS code is allocated a set amount of payment to cover all expenditures.

More and more people are opting for medical billers and coders and with the help with these different software’s and techniques they have been able to get patients and doctors get reimbursed properly on time. To make this process more flawless different techniques are in the pipeline.

Harry Lee is senior medical coder who has many years of experience of working in this field.