Medical Billing vs. Medical Coding Differences Explained

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  • čas přidán 16. 03. 2015
  • Medical Billing vs. Medical Coding Differences Explained
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    Alicia: Q: Medical Billing versus Medical Coding. “What's the difference between Medical Billing versus Medical Coding?”
    A: Well, if I can answer that question. Let’s see here. OK there we go. Do you like that little graphic I found of the gears of the brain? Isn't that great?
    Medical Billing is really all about reimbursement, first of all. Think of the Billing as reimbursement. It’s much more than that but when you think of billing, that’s the first thing that’s probably going to come to your mind.
    It’s about obtaining the reimbursement for the work that was done to the patient by the provider and that usually is the E/M -- the Evaluation and the Management of the patient. Whether they did any procedures on the patient or not, he is evaluating and he is managing the care of the patient, maybe it’s the disease process of the patient.
    Now, Medical Coding is really just the language in which the transaction is carried out. Coding is literally a code that the actions are translated into. Let’s explain that a little bit differently. Your physician sees a patient. Let’s say our patient’s name is Judy. So, Judy comes in and the doctor does an Evaluation and Management of Judy. By what he does to her with the Evaluation and Management, CPT codes and ICD codes are assigned by the coder.
    • Medical Billing vs. Me...
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    More Information about Carve Out Time Observation Coding and Billing:
    Medical billing - Wikipedia, the free encyclopedia
    en.wikipedia.org/wiki/Medical...
    Wikipedia
    Once the procedure and diagnosis codes are determined, the medical biller will transmit the claim to the insurance company (payer). This is usually done ...
    Clinical coder - Wikipedia, the free encyclopedia
    en.wikipedia.org/wiki/Clinica...
    Wikipedia
    For example, a clinical coder may use a set of published codes on medical .... for those wishing to teach medical billing or coding at a college or university, ...
    Medical classification - Wikipedia, the free encyclopedia
    en.wikipedia.org/wiki/Medical...
    Wikipedia
    Medical classification, or medical coding, is the process of transforming descriptions of ... (e.g., to process claims in medical billing based on diagnosis-related groups) ... 4.3 SNOMED CT vs ICD; 4.4 Data Mapping of SNOMED and ICD.
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Komentáře • 16

  • @deidrajnay4697
    @deidrajnay4697 Před 4 lety +2

    I had absolutely no interest in medical billing and coding until I watched this video that came up on random auto play. I now have a strange desire to learn more....

  • @chellzgrady4765
    @chellzgrady4765 Před 8 lety +5

    I haven't even finished the video and your helping me already !! love you for this

  • @djmadnez
    @djmadnez Před 7 lety +2

    Thank you very much!!!

  • @la9229
    @la9229 Před 7 lety

    thanku!!!im about to start my internship private college ,seeing if I want to advance for health administration and go all the way. online schooling of course. if you have any tips?lmk.nervous about hands but excited to learn . very helpful!!!

  • @MedicalBillingMaven
    @MedicalBillingMaven Před 8 lety

    If you are sure that Medicare will not cover a service can you have the patient sign the ABN and pay upfront in full?

  • @hesterboygames8322
    @hesterboygames8322 Před 3 lety

    Do bills have different codes?

  • @JoseGarcia-ww1bn
    @JoseGarcia-ww1bn Před 6 lety

    Why does it sound so easy

    • @mr.g_fpv3292
      @mr.g_fpv3292 Před 4 lety +1

      Its not this lady isnt explaining everything in detail like she needs to be.

  • @azppmd
    @azppmd Před 7 lety

    "Paid." Not "reimbursed."

    • @lbradley1841
      @lbradley1841 Před 5 lety +1

      It's called reimbursing because they see the patient first before being paid..the doctors are using their time [which equals money] and then later gets reimbursed for their time.

  • @mr.g_fpv3292
    @mr.g_fpv3292 Před 4 lety +1

    As a current medical coder for a Mental/Behavioral health I can tell you that the words you use are very vague and some of your information isnt correct. 1. CPT and ICD are practically the same thing it just comes down to what medical profession and what the doctor feels their services more relate to. For example I work in a therapist's office and we only use CPT codes for the services we provide. Number 2. when you submit claims to an insurance company and they come back denied or rejected you dont simply make the corrections and resubmit cause then its going to be denied AGAIN!!!!! you need to make your corrections and then you also need to include the original claim number along with that insurance company's corrected claims code that needs to be with the newly corrected claim. PLEASE DO YOUR RESEARCH AND CORRECT YOU VIDEOS.

    • @sandrabrooks4176
      @sandrabrooks4176 Před 4 lety

      No, the information you are giving is incorrect. I am a Certified Professional Coder (CPC) and a Certified Risk Adjustment Coder CRC) and I have been coding and billing for more than 9 years. this lady trained me for my Risk Adjustment certification and she definitely knows her coding. You are speaking on two separate things - 1st- CPT stands for the Current Procedural Terminology which are the codes for the surgical procedures performed by the physician in an outpatient setting. ICD stands for the International Classification of Diseases which are the codes for the medical issues or conditions (ailments) the physician has tested the patient for and diagnoses the patient for having. These two sets of codes are very much different and they are NOT the same thing across any Medical Profession. 2nd-Medical Billing is the reimbursement for services rendered. For an outpatient claim, such as the therapist's office, you will submit a CMS-1500 claim form. If you send a claim, there are many scenerios as to why that claim can be rejected or denied. Making corrections does not result in a second denial and if it does, then the 1st correction was not made properly. There is a difference in Rejected and Denied claims and the reasons are very different. Rejected claims result from basic informational errors missing or numbers transposed and these never make it to the insurance company. These errors are caught by the clearinghouse and returned to the sender for correction. Denied claims actually make it to the insurance company and processes. The insurance company will sent the remittance advice they send with payment explains why certain claims were not paid. You may want to seek more medical coding training.

    • @robinwilson1333
      @robinwilson1333 Před 4 lety +1

      @@sandrabrooks4176 do you do training? I just learned a lot from your message just now! lol Thanks!

  • @tehagan37
    @tehagan37 Před 6 lety

    Make more money coding