Medical billing and coding can be described as the process of presenting and following up on claims to health insurance companies for the purpose of obtaining payment for services provided by the healthcare provider. Regardless of whether an insurance company is government-owned or privately owned company, the process for medical billing and coding is similar for many companies. For an individual to become a specialist in medical billing and coding, he/she is usually encouraged to become certified through taking an exam. While such individuals are not compelled by the law to do so, certification schools have been established as avenues for theoretical foundation for students entering this field.
What is Medical Billing and Coding?
Generally, the medical billing and coding process is an interaction between the insurance company that caters for the health expenses and the health care provider. Medical coding involves the allocation of either a numeric or alphanumeric code to a clinical procedure, diagnosis, or treatment. This process facilitates the easy, fast, and precise retrieval of information for review of the medical billing and the patient's health information or record. This process is important in the medical field because it can be used in collection of data to carry out health studies, analyze outcomes on patients, and in health care planning.
While billing and coding are used interchangeably in the medical field, coding basically entails translating clinical documentation into numeric or alphanumeric codes. This clinical documentation...
On the contrary, billing involves the management and filing of claims, preparation of insurance forms, processing of working denials and payments. This process usually requires the transfer of necessary information from coded data to reimbursement claims (Becker, 2009).
History of Medical Billing and Coding in America:
Medical billing and coding is a concept that has existed in the medical field for approximately 500 years. However, the history of these practices can be traced back to early 1900s when doctors began to organize themselves into the American Medical Association and other local brands. During the same period, medical billing and coding emerged following the discovery that health care industry needed to establish a standardized approach to tracking patients' diagnosis and treatment. This was also accompanied by the need to offer uniform standards to billing insurance companies for health care services.
In the early 1900s, physicians received their payments for the services they provided when they were called out as hospitals were regarded as separate entities. Consequently, these physicians were no longer anticipated to offer free hospital services with the first insurance policies being provided in 1910. In America, people with medical insurance during this time had received them from industries like railroads. The initial attempts towards a medical insurance were in 1913 when the American Association for Labor Legislation had…
