To ensure timely payments by insurance companies, medical claims must be processed in a timely manner and submitted to the appropriate insurance companies for consideration.

Some facilities employ medical billers and coders. Other facilities employ individuals who handle both aspects of the claim process simultaneously. A medical biller and coder will generally earn more than a medical biller or coder does. That is because he or she is performing double duties and eliminating the need for the health care facility to hire two different people.

Medical coders provide the diagnostic codes and procedure codes that apply to the patient’s visit. If the codes do not match, a claim may be denied. The insurance company

will more than likely say that the treatment was not medically necessary. That is why it is so important for a medical coder to be precise.

A medical biller obtains the correct codes from the medical coder. He or she uses the codes to fill out a claim form. The claim is submitted to the insurance company, generally in the form of an electronic claim. It is important that the medical biller comply with the requirements of each insurance company. Many have specific guidelines that must be followed. The claim could be delayed or denied, if the claim form is not filled out properly and according to the insurance company’s regulations.

Medical billing software is often used in medical claims processing. The software saves time and eliminates common mistakes. Medical billing software allows medical coders to look up diagnostic codes and procedure codes via the software rather than in a manual. The software also checks databases to ensure that the diagnostic codes and procedure codes match up, eliminating the denial of claims based on discrepancies.

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