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How Much Do Medical Coding Services Cost?


Making sure that you receive the appropriate payment for medical services provided is a challenge that all healthcare providers face. The complexities of legislative mandates and number of self-paying patients are only increasing, which can put your facility at risk of compliance issues and loss of revenue. However, with dedicated medical coding specialists handling all of this, you can ensure that your practice remains properly functioning and healthy. Successful practices require accurate, thorough medical coding. What Is Medical Coding? Simply put, medical coding is the universal alphanumeric code assigned to diagnoses, equipment, medical services, and procedures. These codes are taken directly from medical documentation and records such as doctor's notes, lab notes, and test results.

Medical coding services ensure that all codes are correctly applied throughout the medical billing process to help prevent mistakes that can lead to incorrect bills and rejected claims. Medical coders review statements and apply the the CPT, ICD-10-CM, and HCPCS Level II classification systems to assign the appropriate codes.

In order for the entire process to be as smooth as possible, coders check a patient's medical record to verify what work was done. It is important that these codes are specific and cover everything to do with a patient's visit with a healthcare professional in order for the claim to be approved and the appropriate payment received.

Medical coders can also audit and re-file appeals of any denied claims, as well as speak for the patient and insurance provider on any issues. Medical coding services come with the added benefit that coders are regularly tested using a variety of assessments. This ensures the coder consistently meets the requirements of professional medical coding.

Difference Between Medical Billing and Medical Coding

Though medical billing and medical coding may seem like roughly the same thing, they are actually drastically different procedures, each with its own methods and processes. The two are intertwined, though, as one cannot move smoothly without the other, but it is important that you know that the two are not interchangeable.

Medical billing is a focus on the billing aspect of the medical practice, ensuring that the correct payments are received in a timely manner. Whether it is done in-house or outsourced to a medical billing service, the function of medical billing really only has to do with medical claims between insurance companies or other agencies for any services or treatments provided to a patient.

Medical coding is a focus on a patient's medical records, ensuring that the proper codes are used in order to prevent any misleading diagnosis, notes, or charges.

In essence, medical billers mainly work with insurance companies and patients on claims, while medical coders work more with healthcare professionals to ensure that any services provided to the patient are categorized correctly.

How Much Does Medical Coding Cost?

The cost of medical coding services varies depending on the number of patients seen per day, the number of physicians, and the vendor you choose.

Typically, coding services charge by the hour, at an average rate of around $36 per hour. This may vary greatly, though, depending on where you operate, as some areas are much more expensive and others much more affordable.

It also depends on whether the coding service also performs billing services. Because the two are so closely linked, and the law requires it, medical billing services employ coders as well. If you're paying for both services, you typically pay either a flat rate for billing or a percentage of the collections. The average per-bill flat rate is $5, with costs starting as low as $1 and going as high as $8. Services that charge a percentage only get paid when you do, so they typically charge between 5 and 15 percent of the amount collected.

Always make sure to ask for any available references and read all available reviews before making any final purchasing decisions.

The Benefits of Medical Coding Services

Medical coding is essentially translation and must be done whether you hire a medical coding service or keep the function in-house. Accurate medical coding is vital to the operation of your practice and delays or discrepancies can lead to major issues. Hiring a coding service provides your practice with improved coding accuracy, cleaner claims, fewer denials, and more detailed reports. Plus, it leaves your staff able to focus on other tasks instead of spending time on coding.

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