Medical billers and coders provide essential functions that help keep today’s healthcare system running smoothly. But what is medical billing and coding exactly? Medical billing and coding refers to the set of practices used to categorize the healthcare services that are provided to patients., and impacts everything from patient billing to the quality of care that patients receive.
Those in a medical billing and coding career play an important role in not only the operational side of the healthcare industry, but in the hospitality side as well. How? As an advocate for both the patient and the provider, medical billing and coding specialists help to create a seamless experience throughout the life of the health claim. By accurately processing and coding claims, medical billers and medical coders help ensure that patients aren’t overcharged and help providers deliver high-quality administrative care.1
Learn more about the multi-faceted role of someone in medical billing and coding and why it may be the profession for you:
What Is Medical Billing?
Medical billing is the review of medical records to identify, code and bill for theany diagnoses and procedures a patient receives while at a care facility. Once a medical billing professional identifies this information, they submit claims to insurance providers, government programs and/or patients in order to receive reimbursement for services rendered2. Interested in learning more? Read our article, "What is Medical Billing?
What Is Medical Coding?
Medical coding the process of assigning codes to medical procedures, equipment and diagnoses in order to accurately track patient data. Certified medical coders must understand anatomy and physiology, the disease process and clinical procedures so they can apply the correct codes to health records and claims2. Read our article, "What is Medical Coding?", to learn more.
Is Medical Billing Different From Medical Coding?
Medical billing and medical coding two distinct, but related, parts of the healthcare system. Medical coding, which is generally the first part of the medical billing and coding process, involves applying the correct codes to health records and claims. Medical billing, which is usually the second part of the process, involves submitting claims to those covering the cost of the service or treatment, such as patients and insurance agencies. While medical billers and medical coders are two distinct careers with different skillsets, they may at times share similar duties or professional requirements, and may work together to solve problems.
Why Is Medical Billing and Coding Important?
Medical billing and coding is important because it helps healthcare facilities manage resources across departments, accurately track procedures and maintain a healthy bottom line.
Medical billing and coding also matters to patients because proper medical and coding procedures ensure accurate charges to the patient and their insurer. For example, an incorrectly entered code could cause the patient to be overcharged or could lead to a patient being told that the service they received is not covered by their insurance. In a situation like this, the patient has to not only deal with the stress of an incorrect bill, but the care provider also has to wait longer to receive payment.
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Is Medical Billing and Coding a Difficult Field of Healthcare to Enter?
Just like any career, breaking into the medical billing and coding profession requires the right preparation and some dedicated work. You need the ability to navigate various medical code sets and classification systems, as well as the skills to use medical software to manage patient records, submit insurance claims and handle billing to meet the requirements of many medical billing and coding job descriptions.
The good news is that you don't have to memorize thousands of codes from the various code sets. At DeVry, for example, our Medical Billing and Coding Undergraduate Certificate program can teach you how to use various codebooks and software that help streamline day-to-day billing and coding processes. Our program will also teach you the basic medical terminology, anatomy and physiology, so you have the knowledge you need to pursue a career as a medical billing and coding specialist.
Does DeVry Offer Online Medical Billing and Coding Courses?
Yes. Both of our medical billing and coding undergraduate certificate programs–Medical Billing & Coding and Medical Billing & Coding - Health Information Coding–are 100% online.
Each of our online programs offer support from professors who are not only experienced in their field, but also well-versed in online instruction. Our medical billing and coding school programs are designed with busy, working students in mind and offer a hands-on learning approach to help you get the most out of your education experience. As an online student, you’ll also have access to a wide array of resources including 24/7 tutoring, e-library resources3, career services support and more.
What Are the Advantages of Taking Medical Billing and Coding Classes at DeVry?
From flexible learning options to an array of student support resources, there are numerous reasons to choose DeVry for your medical billing and coding classes.
Hands-on Learning
Receive firsthand experience with various medical billing and coding software as you hone your skills practicing with simulated medical records.
Convenient Online Tools
Learn when and where it's convenient for you with our customized online platform. All of our courses feature robust discussion threads where you can engage and interact with your classmates and professors. You’ll also have access to tutoring, library and career services resources, just to name a few.
Flexible Programs
Class sessions start every 8 weeks so you can begin your studies when you’re ready, full-time or part-time. Our experienced Student Support Advisors can help you design a plan that works for your goals and schedule.
Stack Toward Your Future
At DeVry, our medical billing and coding program is stackable. You can start with the shorter and more affordable certificate program, then apply the credits toward a qualifying associate or bachelor's degree when you’re ready to continue your education4. With our flexible online classes, many students continue to work while they gain the knowledge and skills to pursue their medical billing and coding goals.
How Much Do Medical Billing and Coding Certificates Cost?
At DeVry, our undergraduate certificate in medical billing and coding is billed per credit hour. Your total cost of tuition and fees depends on the medical billing and coding undergraduate certificate program you choose, as well as any qualifying transfer credits you may have. Our Medical Billing and Coding Certificate program consists of 10 courses totaling 34 credit hours, whereas our Medical Billing and Coding – Health Information Coding Certificate program consists of 13 courses totaling 42 credit hours. For more information, view our current tuition rates.
How Much Do Medical Billing and Coding Certifications Cost?
After earning a medical billing and coding undergraduate certificate, many people take the next step toward the career they want by pursuing an industry certification. If your plan is to work as a medical billing and coding specialist, the Certified Coding Associate (CCA) and Certified Coding Specialist (CCS) are great options to consider. But first, you'll need to sit for the exams. At DeVry, we reimburse the cost of the fee for one exam attempt for qualifying students, depending on the program you’re enrolled in. To learn more about the latest fees and requirements for the medical billing and coding exams, visit the AHIMA website.
Can Medical Billers and Medical Coders Work from Home?
It depends. Medical billers and coders work in different environments, ranging from hospitals and physician's offices to billing companies and government agencies. Some of these employers support remote work while others may not. Since many healthcare providers outsource their billing and coding work, you can also build a career as an independent contractor and potentially work from anywhere you choose.
Working from home as a medical biller or coder may be easier when you have accumulated enough experience. Since many of the job responsibilities can be performed virtually, more and more employers are now offering remote work as an option. If remote work is something that is important to you, you can always discuss your options with the hiring manager when you are interviewing for a new role.
How Many Years of Education Does It Take to Become a Medical Biller or Medical Coder?
At DeVry, you can earn your Undergraduate Certificate in Medical Billing and Coding in as little as one year, assuming year-round, full-time enrollment with no breaks. How fast you can complete the program depends on whether you enroll full-time or part-time and whether you take courses continuously without breaks. You can also apply any qualifying transfer credits you may have which can further shorten your timeline.
What Does a Medical Biller and Coder Do?
Medical billing and coding professionals’ duties vary depending on whether they’re performing billing- or coding-related tasks.
Medical Coding
- Work in a healthcare setting identifying the treatments, services and diagnoses a patient receives
- Confirm the accuracy of medical records and keep them updated
- Remain aware of changing coding regulations, standards and classification systems
Medical Billing
- Prepare and submit claims to insurance companies
- Follow up with patients and insurance companies on payments
- Manage invoices and payments
Other Job Duties of Medical Billing and Coding Specialists
- Review medical data within the specified amount of time after the claim is made, rejected or denied
- Keep medical data & records well-organized so medical professionals can retrieve, review and report on data if needed
- Ensure accuracy and completeness of medical records
- Input medical records in format required by medical databases & registries
- Track patient outcomes for assessment of treatment quality
- Maintain patient confidentiality at all times
- Act as the liaison or mediator between healthcare offices and insurance firms
- Maintain high attention to detail
Medical billing and coding professionals also investigate rejected or denied claims. There is an important distinction between the terms denied and rejected when it comes to insurance claims. A rejected claim has errors, and can be resubmitted with the correct information within a certain timeframe.
A denied claim, on the other hand, is a claim which has already been processed but has been denied by the paying party—for example, an insurance company may deny a claim because it violates their agreement with the patient.
In both cases, a medical biller and coder must examine the claim in question and work to resolve the issue as quickly as possible. They can accomplish this by performing a thorough audit of the claim in question, and correcting any mistakes or discrepancies that they find.
How Can I Become a Medical Biller and Coder?
To become a medical biller and coder, you may start with a medical billing and coding undergraduate program from an accredited school. Upon completion of your program, consider obtaining a certification.
Three nationally recognized medical billing and coding certifications are:
- Certified Coding Specialist (CCS), offered by the American Health Information Management Association (AHIMA)
- Certified Coding Associate (CCA), offered by AHIMA
- Certified Professional Coder (CPC), offered by AAPC
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Get up to speed on today’s industry trends, career paths and education options with our latest medical billing and coding articles.
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Learn More About Medical Coding and Billing
1//www.aapc.com/medical-billing/medical-billing.aspx
2According to the AAPC.
3Each student is allotted a set number of hours of tutoring per academic session through www.Tutor.com (available 24/7). Additional tutoring services are also available through www.DeVryTutors.com.
4At the time of
application to the next credential level, an evaluation of qualifying transfer credits will occur and the most beneficial outcome will be applied.
5Upon completion of the program, DeVry University offers eligible students reimbursement for one attempt of the CCA exam, the CPC exam or the CCS exam.