Re: I Need it in a Nutshell....

[Steve Verno]

I call it as it is.

I guess Im the Walt Whitman of coding and billing. 

[Steve Verno]

They are symbiotic. 

Billers submit coded claims and statements

Claims and statement dont go unless correctly coded. 

Billers need to know coding to ensure what is billed is correct.  Billers use coding to appeal denied, downcoded or incorrectly paid coded claims.

Coders need to know billing to know how to code for specific insurance companies and per insurance company policies and applicable laws and regulations.

Again, its a symbiotic relationship and its complicated.   

[Steve Verno]

lets make it easy:

Medical Coding:  Taking the written word of a patient's medical condition at the time of the visit to the doctor and converting it to numbers or a letter and number and taking the written word of what the doctor did to the patient, based on what was wrong with the patient and converting it to numbers. The medical diagnosis must support the care provided to a patient.

Medical Billing:  Requesting payment for documented medical care provided to a patient and performing every ancillary task required to obtain payment for documented services rendered.

Ancillary Tasks:  Responding to patient/insurance company attorney requests for coding and billing information, protecting patient privacy and the patient-provider relationship, responding to medical claims denials, responding to and investigating patient complaints, poviding client with requested coding and billing reports, complying with applicable State and Federal Insurance Laws, perfoming provider financial, coding and billing audits to ensure compliance with current coding and billing guidelines, just to name a few. 

IN TWO WORDS:  "ITS COMPLICATED!"

[Steve Verno]

a.  A b*tch to do without training and experience.

b  See a.