Education
Fact-checked

At WiseGEEK, we're committed to delivering accurate, trustworthy information. Our expert-authored content is rigorously fact-checked and sourced from credible authorities. Discover how we uphold the highest standards in providing you with reliable knowledge.

Learn more...

What is Medical Insurance Billing and Coding?

Jason C. Chavis
Jason C. Chavis

Medical insurance billing and coding is the portion of the health care industry that handles the administrative aspects of the field. The majority of people who work in this industry do not interact with patients; rather, they deal with other people responsible for the vast paperwork and information related to the processing and request for payments. Both billing and coding are considered distinct fields within the medical insurance industry.

The individuals in charge of medical insurance billing make sure that the required parties, both patients and companies, are properly billed for services rendered by medical practitioners. They generally keep track of payments made from insurance companies and individual patients. Medical insurance billing and coding come together through this process in that the medical billing agent must understand how the coding language works and what it means when placed on a medical invoice.

Professionals in medical insurance billing and coding handle the administrative side of a medical practice.
Professionals in medical insurance billing and coding handle the administrative side of a medical practice.

Coders working in the medical industry perform a different task, usually unassociated with actual patients or insurance companies. Individuals working with coding spend most of their time analyzing and coding various data forms. Each of these data forms represent a specific medical procedure or service. The point of coding is to itemize the information into records. This information is then sent to insurance companies and patients so each party understands what has been done and why the charge is placed on the account. Medical billing and coding are associated with each other, however, the people performing the tasks are generally separate.

After a medical service is provided and recorded with the appropriate code, a bill needs to be created so that the health care provider or facility can get paid.
After a medical service is provided and recorded with the appropriate code, a bill needs to be created so that the health care provider or facility can get paid.

If someone is interested in acquiring a job in the medical insurance billing and coding field, either with a medical insurance company or hospital, a certain amount of training is required. Schooling can consist of a simple certification or require the acquisition of a degree. The best places to acquire this training is either from a vocational school or community college with classes and programs in the field. Working conditions generally exist within the confines of an office environment and usually feature full-time employment.

A major concern for the industry of medical insurance billing and coding is a variety of scams both on the Internet and in person. Many of these programs claim that training can be obtained in a short period of time and then an individual can simply work from home. According to a 2004 report from the U.S. Department of Labor, only three percent of medical billing agent and coders work from home.

The U.S. Department of Labor has also reported that individuals operating in this field earn on average twice the minimum wage. Some of the most experienced people working in this field earn as much as three times minimum wage. In addition to standard employment, once a person is trained in the system, these skills can be transferred to a number of different jobs such as payroll, bookkeeping, accounting and medical assistance.

Discuss this Article

Post your comments
Login:
Forgot password?
Register:
    • Professionals in medical insurance billing and coding handle the administrative side of a medical practice.
      By: contrastwerkstatt
      Professionals in medical insurance billing and coding handle the administrative side of a medical practice.
    • After a medical service is provided and recorded with the appropriate code, a bill needs to be created so that the health care provider or facility can get paid.
      By: Gina Sanders
      After a medical service is provided and recorded with the appropriate code, a bill needs to be created so that the health care provider or facility can get paid.