Coordinating with Medical Billing Colleagues
Medical coders and billers work hard for their doctor's and their patients. Their close relationship between
coding and billing personnel is undeniable and inescapable! While they are well respected and highly regarded (and
rewarded!) they often face adversities from insurance companies, such as inappropriate denials, poor payments and
other obstacles and disservices to the doctors and patients that the must resolve working hand in hand with each
other to coordinate their efforts. Their mutual goal is to meet patient and health insurance billing needs of
doctors, clinics, hospitals, home health care service agencies, and similar businesses in the health care network.
Although regarded as two different disciplines, medical coding and billing professionals work hand-in-hand to
assure health care providers get paid for all procedures and materials rendered.
Medical Coder's and Biller's Shared Goals...
The medical billing and coding professions fall into the 'customer service
department' category. In smaller medical offices the medical biller and coder often are one
and the same person, but if you are in a large facility doing strictly coding, then your main focus will be on
pinning down specific codes for diagnoses, procedures, and materials provided and then a medical biller takes over
and generates the claims for the services.
It is the medical coder who reviews the medical records and locates the right diagnostic and
procedure codes, while the medical biller assures that health insurance companies and patients are accurately
billed, and that the provider gets paid. If a claim is dined, the medical biller pin-points and addresses any
issues to appeal a claim denial. Medical billing must be prepared communicate with the medical coding department
effectively and precisely without becoming confused or snappy when questioned, or challenged. It all ultimately
boils down to working together to pinpoint the date, place and type of service, diagnosis, procedures and supplies
provided, and submitting the appropriate charges for reimbursement to government and private health insurance
Each time health and medical care has been provided the medical coder converts these medical
procedures, diagnoses, or symptoms into specific standardized codes, which then go to the medical biller for
verification and processing a claim for reimbursement. The medical biller reviews superbills and spots coding
errors and refers questionable entries back to the provider in a timely and professional manner. The financial
success of entire industries depends on their skills and cooperation. What ties both occupations firmly
together is their shared focus on the health care provider, the patient, and ultimately the medical facility's