What is Medical Billing and Insurance Coding? (Answered)
When you visit a hospital or medical office, have you ever wondered how the billing works – how physicians, clinics, and other healthcare facilities track delivery of care, assign costs to the services they provide, then bill out to insurance companies and patients?
As a patient, this may not be the issue most on your mind at the time of your visit. However, healthcare can no doubt be expensive, and few like to dwell on the costs associated with instances that compelled them to seek medical care.
But, for healthcare providers to keep doing what they’re doing – offering patients top-notch diagnostic, testing, treatment check-up, and other specialized medical services – they must be compensated. And, it’s the task of medical billing and insurance coding professionals is to coordinate this process.
From applying the proper codes to all healthcare services rendered to working with insurance companies, patients, and other payers to ensure maximum reimbursement, medical billing, and insurance coding serve as one of the main lynchpins that hold the healthcare industry together.
This level of importance, mixed with the medical field’s continual demand for quality medical billers and coders, is the basis for which UEI developed our Medical Billing and Insurance Coding (MBIC) program. And now, students of this program can train for a new career and earn their MBIC diplomas through online learning! So, what exactly is medical billing and coding? This post thoroughly explains what medical billing and coding are below.
If you're interested in becoming a medical biller and insurance coder, consider enrolling in our Online Medical Billing and Coding Program. The program can be completed, and you can earn your diploma in as few as 10 months, placing you on the fast track to becoming a medical biller and insurance coder.
What is Medical Billing and Coding?
Medical Billing and Insurance Coding is the process of converting patient health information into a numeric code that makes it possible for healthcare providers to seek reimbursement for services rendered to patients by insurance companies or directly from patients.
That said, medical billing and insurance coding are two separate processes, so let’s take a closer look at each separately.
What is Medical Billing?
Medical billing is the process of submitting and following up on claims with insurance companies and other payers for healthcare providers to receive optimal reimbursement (a.k.a., get paid) for services rendered to patients.
While on the surface, this job may seem pretty straightforward, it’s more challenging than you may initially think.
Do you know the notes physicians, nurses, or medical assistants take when you visit the doctor, specialist, or other medical professionals? It’s up to the medical billing professional to translate these notes into an insurance claim, one that provides insurance companies with all the information they need to approve the claim and make the fullest possible payment to the healthcare provider and/or clinic.
To get the optimal payment from insurers and other payers, such as Medicare, medical billing professionals often must follow-up and, at times, resubmit claims based on questions, concerns, and requirements of the insurance company. The process can seem tedious at times, but proper training, experience, accuracy, organization, and strong attention to detail are required to help increase success rates (and cut down on the tedium) for medical billing professionals.
What is Insurance Coding?
For optimal reimbursement to happen, communication must be strong – and consistent – between healthcare providers and payers, such as insurance companies. In other words, they need to speak the same language.
This is the basis for insurance coding. The process of insurance coding is to translate healthcare services, diagnoses, treatments, medications, and other important patient details into a language (a code) that’s both universal and precise.
Different classification systems exist from which medical coding professionals assign specific codes. The most standard coding systems used include CPT (Current Procedural Terminology), ICD (International Classification of Diseases), and HCPCS (Healthcare Common Procedure Coding System).
Medical insurance coding professionals are trained in the various coding types and when to use them, and how to apply them for medical billing purposes. The most successful medical coders understand medical terminology, have keen attention to detail, are good with numbers, and are comfortable using computers.
Why is Medical Billing and Insurance Coding Important?
The role medical billing and insurance coding play in maintaining the stability and growth of the healthcare industry – from small, private practice clinics to large hospital networks – cannot be overstated.
The work of medical billing and insurance coding professionals is essential in ensuring healthcare professionals are paid for their services. Medical billing and coding also help ensure medical facilities can invest in both people and equipment, which help them improve the diagnosis, treatment, and long-term health and vitality of patients within their communities.
Is it Difficult to Enter into the Medical Billing and Insurance Coding Field?
Becoming a medical billing and/or insurance coding professionsal is not easy, but that doesn’t mean it’s not worth it to strive to earn a successful career in the field.
To become a medical billing and insurance coding professional takes both education and training. And, while it’s possible to do this on the job, a more expedient way is to seek career-specific education through a college or vocation program, like the Medical Billing and Insurance Coding (MBIC) at UEI College.
(See more below.)
It’s important to note that once you’ve completed such a program and earned your first entry-level career in medical billing and/or insurance coding, your education and training are not over. The healthcare field is huge -- $3.9 trillion was spent on healthcare in the U.S. in 2019 alone, and it’s constantly changing. This means it could take years to achieve the level of true expertise within a segment of the MBIC field … and you’ll still need to keep up with critical changes in the industry.
How Can You Become a Medical Billing and Insurance Coding Professional?
Again, some long-time medical billing and insurance coding professionals have been fortunate enough to enter the field by simply growing within the job. While this is possible, it can take years to learn all the moving parts and merely achieve comfort within the job.
Instead of getting hired on in a position at a clinic or billing center, then hoping you might absorb the ins and outs of the job as you await future opportunities, enrolling in a career-specific program is often more desirable. Plus, doing so can put you on a faster track toward a billing and coding career.
A reputable, career-focused program, such as that offered at UEI College –through online learning– will strive to help you build a wealth of knowledge in insurance practices, medical law and ethics, documentation and records, billing and collections, and general healthcare terminology.
In the meantime, instructors within the program should also teach you to develop skills in insurance coding, translating medical records, filing and tracking claims, and using industry-specific computer software applications.
How Long Does it Take to Become a Medical Billing and Insurance Coding Professional?
Depending on the route you choose, becoming a medical billing and insurance coding professional can take several years or just a few months. At UEI College, our students can finish the Medical Billing and Insurance Coding (MBIC) program in as few as 10 months, qualifying them for entry-level career opportunities throughout the MBIC field.
Can Medical Billing and Insurance Coding Professionals Work from Home?
Yes! An increasing number of people working in medical billing and insurance coding are working from home, either in a full-time capacity or through a hybrid arrangement with their employers.
To work from home, medical billing and insurance coding professionals often must first demonstrate to employers that they’re self-starters who work well alone and are accurate, detail-oriented, and have developed a successful track record with payers.
Does UEI Offer Online Medical Billing and Insurance Coding Courses?
Yes. UEI offers a complete Medical Billing and Insurance Coding diploma Program – through both in-person classes and online courses – that trains students to develop the knowledge, skills, and experience to earn entry-level positions within the healthcare field.
The program teaches students the ins and outs of the insurance industry, how to complete insurance claim forms, ways to access patient records for claims reimbursements, and skills around how to code for medical procedures and diagnoses.
Through a curriculum designed to be completed in as few as 10 months under the instruction of seasoned professionals in the billing and coding industry, the program strives to prepare graduates for roles in hospitals, clinics, private practices, and even designated billing and coding companies. To learn more about UEI’s Medical Billing and Insurance Coding (MBIC) program, including how you may potentially earn your diploma through UEI’s online learning option, contact your admissions team today. A dedicated admissions professional will be happy to speak with you and answer any questions you might have about enrolling in the program.