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Medical Insurance Billing and Coding


Medical insurance billing and coding is the subject of much discourse lately. Just what exactly is it? And why is everyone talking about it?

Well, before we go right ahead and answer these questions for you, let us first consider a few things about medical insurance billing and coding:

1. That medical insurance billing and coding is in great demand

It is true that the need for trained professionals who specialize in medical insurance billing and coding has steadily grown for the past few decades. The cause may be the emergence of more medical coverage plans, such as Fee for Service Plans, Health Maintenance Organizations or HMOs, Point of Service Plans or POS, and Preferred Provider Plans or PPOs. Aside from that, federal regulations and health insurance policies have also contributed to this strong demand for experienced medical insurance billing and coding professionals.

2. That medical insurance billing and coding is one of the top twenty healthcare occupations

According to the US Bureau of Labor Statistics or BLS, medical insurance billing and coding specialists are one of the twenty fastest growing allied health occupations in the healthcare industry. Every doctor will agree when we say that medical insurance billing and coding are their key to getting paid for the services they provide to their patients.

3. That there are two types of medical insurance billing and coding

The first type and the most popular is the electronic type of medical insurance billing and coding. In this form, claims are often processed electronically and sent to insurance companies via the Internet, fax, or a combination of both. This is much preferred in the medical community today because it is faster. Electronic claims can be processed in ten to fourteen days while paper claims can take up to thirty days to get approved.

So what is it?

Well, the phrase is actually composed of two elements. There is medical insurance billing and then there is medical coding. They are two very related but very distinct fields in the healthcare industry. Where one deals primarily with converting codes into billing records, the other deals with making decisions for the financial benefit of the medical practice.

Medical insurance billing and coding are often described as practice management. They are the doctor’s key to getting paid. Medical insurance billing and coding services are indispensable to a medical office because they are a type of “defensive medicine” to help reduce liability costs of a practice.


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