Medical Billing

Exploring the Fundamentals of Medical Billing and Coding

Medical coding and medical billing are different but closely related processes that are essential for the financial and operational aspects of all healthcare organizations, including dermatologists.

Ensuring that your staff have an in-depth understanding of the differences between these two areas is very important, as these two areas are very complex, and regulations frequently get updated or changed.

Both coding and billing are integral components of your revenue cycle, as incorrect coding and improper billing can prevent your practice from earning revenue for services provided.

Let’s look at the fundamentals of these two areas and some of the key differences between medical coding and medical billing:

  • Medical Coding:

    In order to ensure that information about patient diagnoses and services provided is properly classified and documented, healthcare providers use universal alphanumeric medical codes. Correct coding is crucial for medical records, billing, and insurance claims.

    The codes are standardized, like Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes. Each medical condition has its own code and often a modifier. Correct coding requires a clear and highly detailed description of skin lesions, including the size, the number, and the precise location. If a dermatologist does not properly capture all of these details, then the patient’s claims could possibly be denied, and revenue will not be earned for the services provided.

    It can be very challenging for staff to stay up to date on codes, modifiers, and regulatory changes. Using the correct codes helps a healthcare provider maintain detailed records about patient encounters so that insurance providers can clearly see what treatment was given and why and so that claims can be processed quickly.

  • Medical Billing:
    If Medical Coding refers to the correct use of highly specific codes to document patient encounters, Medical Billing refers to the process of submitting claims to insurance providers in order to receive payment for healthcare services provided.

    Much like the coding process, medical billing documentation is highly detailed, requiring specific information about the dermatology procedure performed, like biopsies, excisions, and lesion removal or destruction.

    Medical Billing covers tasks like preparing and submitting claims, verifying insurance coverage, following up on claims, and dealing with any denials or problems that come up during the reimbursement process. This typically involves communication between healthcare providers, patients and insurance companies in order to facilitate timely payment.

How to Streamline Your Coding and Billing Processes

If your staff is struggling with coding and billing processes, or you have a high rate of denied claims, your practice could benefit from outsourcing both coding and billing to a professional like Derm Care Billing Consultants.

We specialize in dermatology coding, ensuring you and your dermatology practice get paid for your services quickly and efficiently. We take care of front desk training, soft collections, and denial management. Our goal is to help dermatologists maximize their potential earnings by using automated software that makes coding and billing significantly easier and faster.

Whether you need help with medical coding or the medical billing process, reach out today to find out how Derm Care Billing Consultants can help your practice thrive.