Medical billing vs. medical coding


You have probably been doing some online research about medical billing schools (in fact, that’s most likely how you ended up on this site). If so, you might have noticed that some schools offer certificates in medical billing and some offer certificates in medical billing and coding. What is the difference between the two types of programs and what kind of jobs will each one prepare you to do? Medical billing and medical coding are related, but there are some important differences between them.

Medical billers oversee the billing process, from taking a patient’s information through to making sure the clinic or hospital gets paid and the patient gets reimbursed. They spend a majority of their time talking with patients, doctors, and insurance companies to help the billing process run smoothly. It rarely does, however, and insurance claims are often rejected. When that happens, the medical biller follows up and works to resolve the case. Medical billers may work for patient care offices, hospitals, insurance companies, or third-party billing agencies.

Medical coders assign codes for diagnoses and treatments according to standardized coding systems used throughout the health care industry. They may also work in patient care offices, hospitals, or outside agencies. They analyze patient data and assign the codes that are then used on the insurance forms that the medical billers later submit. Medical coders spend most of their time working with codes and coding software, rather than interacting directly with people.

As you can see, medical billing and medical coding are highly related, but the jobs are fundamentally different, as are the skills required to do them. Thus, vocational programs in medical billing and medical coding are also different. Pure medical billing programs often concentrate more on office management, data management, documentation, insurance claims, and communications than combined billing and coding programs. All medical billers need to have some knowledge of medical terminology and coding, but in offices where the billing and coding functions are separate, medical billers may spend considerably less time with the codes themselves.

On the other hand, pure medical coding programs focus specifically on the codes and how to use them, rather than on topics like office management. Although coders can benefit from these skills, they are not the main focus of coding schools.

Combined medical billing and coding programs offer the best of both worlds—fundamentals of office management and insurance claim processing and intensive coding training. Many of the diplomas and certificates offered by accredited institutions are combination programs, and graduates of these programs have more job opportunities than graduates of one program or the other. If you want to earn a versatile degree that can lead to a position as either a medical biller or a medical coder, consider enrolling in a combination program.

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