7 Clear Differences Between Medical Billing and Coding

What is the difference between medical billing and medical coding? Here, we differentiate these two closely-related careers.

Medical billing and medical coding are two closely linked professions that often confuse people interested in picking or choosing a study path.

There are several possible reasons for that, one being the similarities of what they address.

Medical Biller vs. Medical Coder

As closely related aspects of the modern health care industry, medical billing and coding help identify diagnoses, medical tests, treatments, and procedures in clinical documentation.

Such patient data is then transcribed into standardized codes for purposes of billing. Such billing is targeted at commercial and government payers for physician reimbursement.

Our discussion’s primary focus will be on identifying and stating the main differences between medical billing and medical coding.

Are you interested in medical billing or coding, your doubts should be fully addressed soon.

  • Medical Billing isn’t the same as Medical Coding

To provide answers, we must start by stating the obvious; medical billing isn’t the same as medical coding for several reasons.

While both career paths play crucial roles in ensuring health care providers are adequately paid or reimbursed for services provided, fundamental differences exist.

These are two separate professions with distinct areas of focus or specializations. The rest of this article dwells on highlighting what these differences are.

Even with some educational programs offering combined courses, you still need to know that there are apparent differences, as shown below.

Difference Between Medical Coding and Billing

To highlight the differences, we start by providing the basic definition of each profession.

Medical billing is the act or process of submitting and following up on claims with health insurance companies to receive payment for services rendered by a health provider.

In a nutshell, medical billers make use of patient records to ensure medical service providers and facilities are adequately reimbursed in a timely fashion.

Other roles performed by medical billers include communicating with patients and providers to follow up on claims and payments.

Medical coding, on the other hand, is defined as the practice of translating medical reports into a code used within the healthcare industry.

These codes help summarize patient conditions, treatments, and supplies used in the process.

Coders communicate with healthcare practitioners to clarify information, ask questions, and address errors.

Medical Billing vs. Medical Coding

Having defined both career paths, we’ll shift our focus to the reasons medical billing differs from medical coding.

These reasons include the personality required for the job, the different responsibilities of professionals, and split or distinct duties in more extensive health facilities.

More differences include working with patients, education & certification, mode of operation, and salary.

i. Personality Required for the Job

One of the key differences between medical billers and coders is the personality type required for the job.

Medical coding will be a more suitable specialization or career path for introverted persons as it only involves occasional interaction with other healthcare professionals.

Also, medical coding will be more suitable for detail-oriented persons.

Medical coding will be ideal if you’re drawn to a specialization that enables you to be fully immersed in your job with occasional interaction.

Persons with extroverted personalities will find medical billing more comfortable. This involves a lot of interaction with insurance companies and patients.

You’ll be involved in resolving related issues as part of your job description. However, this isn’t a fast rule as each position has mixed personality types.

ii. Different Responsibilities

Medical billing and coding can be differentiated by the different responsibilities that demand varying skill sets.

For example, medical billers use data provided by coders to file insurance claims and post payments to accounts. Here, working with insurance companies is expected.

On the other hand, medical coders first translate or interpret the care offered to patients.

These are coded in a way that the system understands. Code types include the International Classification of Diseases Tenth Revision (ICD-10) and Current Procedural Terminology (CPT).

Using these guidelines, medical coders are about to assign the correct diagnosis and procedure codes.

iii. Split or Distinct Duties in Larger Health Facilities

The functions of medical billers and coders tend to be a lot more distinct in more extensive health facilities.

That is because specialized coders and billers are employed to perform their unique or individual responsibilities.

This differs from smaller health facilities that primarily seek to minimize operational expenses by hiring individuals to handle billing and coding responsibilities.

iv. Relationship with Patients

Not all medical professionals work directly with patients. This is one area that differentiates medical billers from coders. Medical billers constantly communicate with patients.

In other words, they often have face-to-face interactions with patients.

v. Education & Certification

While there may be lots of similarities in terms of the educational requirements needed for studying both professions, industry certifications differ.

For medical billers, certification is issued by the National Health Association. You become a Certified Billing & Coding Specialist (CBCS).

In the case of medical coding, the American Health Information Management Association (AHIMA) issues certifications. A Certified Coding Associate (CCA) is the title for certified medical coders.

vi. Mode of Operation

We’ve stated earlier that medical billing and coding experts have different modes of operation.

In other words, one is alliance-inclined, while the other involves a more autonomous role. Medical billers have a more autonomous function, while medical coders work in alliance with other professionals.

To illustrate better, the autonomous roles of medical billers give them more freedom to interact with different parties relevant to a more effective billing process.

On the other hand, medical coders work in alliance with other professionals like administrators and physicians.

vii. Salary

Salary variation is another area where medical billing and medical coding differ. Although both of these professions are closely related, you’d notice that they attract different salary averages.

According to the Bureau of Labor Statistics, medical billers earn an average annual salary of $39,520, which translates to around $19.00 per hour.

The same source provides information on the average salary of medical coders to be around $44,010 per year, translating to about $21.16 per hour.

The differences between medical billing and medical coding discussed above give you a broad understanding of critical distinctions.

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