Have you ever thought of how the hospital comes up with a conclusive bill for your treatment? Well, it all depends on how the whole process was documented from the moment you set foot in the hospital, consulted the doctor, received your treatment, and finally handed over the bill. Perhaps, you often wonder why the healthcare practitioners are always asking questions before administering any medication; besides identifying the root cause of the problem, it also helps them bill you the right amount.

What is medical coding and billing?

Medical coding refers to the process of deriving medical information from the documents and medical records. Billing on the other hand refers to the use of the medical codes to come up with the payable amount for the whole treatment. The two processes are entirely dependable on each other as poor coding definitely results in inaccurate billing, which might, in turn, lead the hospital in serious trouble.

Medical coding and billing involve a lot of processes which need you to be very particular when choosing a medical biller or coder for your healthcare facility. You have the option of either outsourcing or having in house professionals.

Factors to consider when choosing a medical coder and biller

  1. Licensing

Does the medical coder and the biller have the right license to perform their job? As a rule of thumb, any person that offers any services which are classified as part of their business needs to have the right license to do so. Lack of a license means that you might be giving out crucial information to third parties, which is not acceptable. Be very keen when it comes to scrutinizing the license they show you as even the scammers have almost similar licenses with little alterations.

  1. Experience
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For how long has the coder and biller been on the job? Some codes are used in the hospital that only an experienced and certified coder or biller can be able to understand. Ask them of their experience before entrusting them with the job to ensure that the coding and billing process is seamless. They also need to be up to date with any software that will be used in the process as well as insurance policies that change regularly.

  1. Budget

Every professional coder and biller request for different salaries. Note that when choosing these two professionals, you need to factor in other elements besides cost. For example, consider the number of patients you work with, the workload, and the software used among many other factors. Remember, cheap is expensive, and you will always get what you pay for. Ensure that you come up with a well thought through budget before hiring any of these two professionals.

  1. Reputation

What are other people saying about the coder or biller? Some of them might have the right certifications and all, but you might find that their customer services are bad, which means that they might not be well fit for the job. Gather referrals from other medical institutions and go ahead and read the reviews on the codes and billers sites to ascertain that they are fit for the job.