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What is medical coding and billing

Medical billing employs the codes obtained from medical records and clinical documentation to generate insurance claims and patient bills. Medical coding is the process of obtaining information that can be billed. The core of the healthcare revenue cycle is formed at the intersection of medical billing and coding when claims are created.

Medical billing and coding are essential components of the healthcare revenue cycle, working together to ensure accurate billing and reimbursement for healthcare services. Medical coding involves translating patient diagnoses, treatments, and procedures into standardized alphanumeric codes obtained from medical records and clinical documentation. These codes are meticulously assigned by coders to accurately represent the services provided, following coding guidelines and regulatory requirements. On the other hand, medical billing utilizes the coded information to generate insurance claims and patient bills. Billing specialists compile the coded data into claim formats acceptable to insurance companies, seeking reimbursement for the services rendered. The intersection of medical billing and coding forms the core of the revenue cycle, where accurate coding is crucial for successful billing. Collaboration between coders and billing specialists is essential to resolve discrepancies and ensure smooth revenue cycle management. Overall, effective coordination between medical billing and coding facilitates efficient revenue cycle operations and enables healthcare providers to focus on delivering quality patient care.

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