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Medical Billing and Medical Coding  

Medical billing is a process where the medical billing specialist submits claims to health insurance companies to ensure payment for the services provided to a patient by a doctor or another healthcare provider. Medical billing process is an interaction between a health care provider and the insurance company. Medical billing specialists are also responsible for contacting insurance companies. Medical billing specialist use same procedures to private and government insurance company and can take several days or several months to complete and require several interactions before a resolution is reached. Specialists frequently correspond with insurance companies to verify policy information and obtain payment for patient services.

Medical Coding is a process where coders assign universal medical codes, in numeric, alphanumeric form, to medical procedures and diagnoses. Medical coders may refer to the patient's medical record, lab results or doctors notes. These codes are used to track diseases and injuries and the procedures used to treat medical problems. Coding involves taking the diseases and diagnoses recorded by physicians and transcribing them into a format recognized across the entire health care industry. Medical coder is primarily responsible for abstracting and assigning the appropriate coding on the claims. In order to accomplish this, the coder checks a variety of sources within the patient’s medical record. Medical codes are used on claim forms submitted to insurance companies.

Responsibilities and Duties of Medical Billing and Coding Specialist

1. Obtaining medical information from a patient’s physical examination.

2. Determining the level of service to be used to treat the patient from the physician’s files.

3. Translating the level of service into a 5 digit Current Procedural Terminology (CPT) code.

4. Recording codes for communicating to insurance companies, patients and other healthcare     professionals.

5. Interpreting the code and assessing the patient’s eligibility to claim.



Professionals in this field are employed in government and private hospitals, pharmacies, dental practices, laboratories and other healthcare industries. Medical billing and coding specialists play an important role in the healthcare industry, with medical coders ensuring the proper classification of patient diagnoses and procedures and medical billers ensuring that insurance companies. Graduates in this field have a great career in India and also in abroad.

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