Medical billing and coding are two similar occupations. Often mentioned in the same breath, vocational schools teach both skills in a single diploma program. But what’s the difference between billing and coding? Are they one job or two? Let’s take a closer look at this growing field and how medical billing and coding are comparable yet distinct.
What is Medical Billing and Coding?
Most healthcare bills in our country are paid for by private or government insurers. Medical billing and coding is the process of transcribing patient data into a billable form. Medical billing and coding specialists research charts and gather information for insurance claims forms so that physicians and facilities can receive payment for the services they provide.
What’s the Difference Between a Medical Biller and a Medical Coder?
Most medical billers and medical coders have a diploma in billing and coding. Why? Because the two fields, though different, overlap significantly. As a medical billing and coding specialist, you can choose from jobs that focus more on billing or coding, but the two roles are typically integrated because competency in both is essential to do some tasks. The difference between the two jobs lies in:
Core Responsibilities
Coders assign alphanumeric sequences to symptoms, diagnoses, procedures, and equipment for billing purposes. Without medical codes, health insurance claims forms could be chapters long. Coding reduces the volume of data to a more digestible amount.
Medical billers take it from there, completing claims forms, troubleshooting rejected claims and assisting in other parts of the billing process from invoicing patients to collections.
Work Environments
Medical billing and coding specialists work in similar environments, but there are unique opportunities for each.
Medical coders are more likely to work in clinical settings where they have easy access to patient charts and their medical team. When the documentation doesn’t contain all the information required for a claim, coders reach out to the clinicians involved in the case for additional data or clarifications.
Those working exclusively as billers are more likely to focus on financial tasks, ensuring payments are received and posted promptly. They research reimbursement issues and calculate the balance patients are responsible for paying, tracking money as it comes in. When billers discover data-related problems, they turn them over to coders for follow-up.
Because medical codes are also used by public health officials to track disease trends, coders may be employed by the government to gather and analyze data. Billers, meanwhile, are tapped for positions with an accounting emphasis. You’ll find more medical billers than coders working for independent healthcare billing companies.
Professional Colleagues
Because medical coders work more in clinical settings, they collaborate with other coders and billing specialists plus doctors, nurses, medical assistants, and other medical staff.
Billing specialists have casual contact with clinical professionals but are more likely to work with other billers, accountants, auditors and other financial or business management professionals.
Public Contact
Medical coders are the bookworms of the healthcare field. Their job is data driven, but the answers to their questions are rarely found with patients, so direct contact with the public is limited.
Medical billers, in contrast, work closely with patients. Patients are ultimately responsible for bills not covered by their insurance policies, so they may collaborate with billing specialists on inquiries and to resolve balances. Billers help set up payment plans when patients can’t pay what they owe. To work exclusively in a billing department, it’s helpful to be a people person.
What’s the Easiest Way to Become a Medical Biller or Coder?
Medical billing and coding can be too complicated to learn on the job. Did you know that some billing and coding specialists have bachelor’s degrees? But you don’t need to spend years in school to break into the field. Graduating from a vocational school diploma program qualifies you for many of the same jobs in a fraction of the time. You’ll be workforce-ready in a few short months.
What’s the Curriculum Like in a Medical Billing and Coding Program?
Vocational school programs are designed for those with limit medical backgrounds. Many students are drawn to the field because they have a background in healthcare or business. Programs prepare you for an entry-level position. Courses include:
Medical Terminology
Billing and coding specialists research medical charts for the data insurers require. You’ll review doctor’s notes, phone call transcripts, diagnostic results, and operative reports. Understanding medical jargon is a must.
The medical terminology course familiarizes you with terms and their parts, prefixes, suffixes, and roots, so that you can determine their meaning without constantly reaching for a dictionary.
Health Information Technology
The same medical records once stored in filing cabinets are now digitized and accessed via computer. Medical billing and coding programs cover the use of electronic health records (EHR) and the associated technology, from servers to databases.
Students learn how data is accessed, shared, and stored for billing purposes. Other topics include auditing, fraud detection and insurer interfaces.
Billing Procedures
Doctors are paid differently than other professionals. There are no intermediaries, for example, between attorneys or plumbers and their patients. For most students, medical reimbursement models are a whole new world.
This course is intense and covers the full range of financial issues you’ll encounter in a healthcare setting. Students get an overview of medical finance, so they understand their role and how it fits into the revenue cycle.
Topics include the types of commercial and government-sponsored insurance programs plus social programs that protect low-income patients and injured workers. You’ll learn how to handle the legal and ethical dilemmas inherent in medical billing, including patient privacy, rights and responsibilities, and collection guidelines.
Medical Coding Systems
There are three sets of commonly used medical codes describing everything from physical symptoms to disorders, surgical procedures, and ancillary services. Each is used for a different purpose and in different settings.
ICD-10 – the tenth iteration of the International Statistical Classification of Diseases and Related Health Problems, contains codes for all medical disorders. Codes are used for billing and by the government to monitor community health.
CPT – Common Procedural Terminology codes, pertain only to medical treatments and diagnostics like x-rays. They’re not only used for reimbursement purposes but also by the government and insurance companies to assess the quality of care.
HCPCS – the Common Procedure Coding System was developed specifically for the US government. It’s a combination of CPT codes and a second set of codes for services that are challenging to classify, such as infusion services, chemotherapy, and ambulance transport.
Why Attend a Vocational School Diploma Program?
Vocational schools offer students many advantages, including:
Short Training Programs
Getting a college degree is an impressive achievement, but not every student can afford to spend 4 years in school, it just doesn’t make sense for everyone. So why not attend a vocational school program? Learning is focused but no less comprehensive, and graduates qualify for most of the same jobs. It’s a great value.
A Competitive Edge
In the past, you could have gotten into the medical billing field without higher education, but practically speaking, jobs are hard to come by without a diploma. The industry is complex and highly regulated, so employers prefer applicants with standardized training. A diploma stands out on your resume and gives you a competitive edge in a tight job market, even amongst more experienced candidates.
A diploma also demonstrates commitment, showing that you take your role seriously and want to advance professionally. A diploma makes you a better investment as an employee.
Small Class Sizes
Medical billing and coding is a popular field for adults who want a second career. But far removed from the college experience, older students find the busy university life intimidating. By contrast, the small class sizes vocational schools offer is much more relaxed and creative. Instructors have more time to work with students one-on-one and peers get to know each other better.
Hands-on Learning
Book learning is valuable, but most students prefer hands-on educational opportunities. Vocational schools blend classroom learning with real-world practice using the same tools and equipment that are common in the field.
You’ll perform case studies on a computer using mock charts and sample insurance forms so nothing will seem new or unusual on your first day at work. It’s a confidence booster.
Seasoned Instructors
There’s a distinct advantage to learning from industry-seasoned instructors. Most have worked their way through the ranks and have a thorough understanding of the field. They’ve been there and can tell you how to get ahead.
Most vocational school professors have years of experience under their belts, and many are still working in the field. Impressing them by working hard and you may earn a job reference.
Career Services
Medical billing and coding specialists are in demand, but why settle for any position when vocational school career advisers can help you find your dream job? There’s no guarantee, but they work hard to match graduates with good employers. Some schools offer lifetime placement benefits, an ace in the hole when the job market is tough.
Certification Preparation
Becoming certified in any field is the best way to demonstrate your professional accomplishments. Vocational schools help medical billing and coding students prepare for the exam by “teaching to the test.” Certification is an important step forward in your career.
Final Thoughts
Whether you have an aptitude for finance or research, you’ll thrive in a medical billing and coding career. Let a vocational school show you how.
Did learning about medical office protocol of a medical billing specialist interest you? Ready to attend Medical Insurance Billing & Coding program at Meridian College? Medical Billing and Coding professionals are responsible for keeping the records, charts, and bills in a medical office in order. In addition to the classroom experiences, students will also complete an externship for on-the-job training that will bring them further expertise. Contact us to learn more about.
Contact Meridian College today to learn more about becoming a medical billing and coding specialist.