What is Medical Coding? (Medical Billing Tip)

medical billing and codingIn general, people understand what medical billing is. However, many people don’t understand what medical coding is! If you are a healthcare professional, looking for a simple (general) answer, here goes:  

Medical billing is simply taking a medical service that a health provider offers (for example, a 45 minute psychotherapy session) and converting it into a code so that insurance companies can process the service, and pay the provider correctly (in this case, the code is 90806).

For some specialties, such as in behavioral health, there are very few codes that are billed. For example, a psychologist running a practice will bill (90801, 90806, 90847,90846, and a just a few more–under 10 in almost all instances). However, some general practitioners, or physicians that provide services for a multitude of conditions could bill many codes–that’s when someone with a lot of training and experience in medical coding is important in the medical billing process.

UPDATE 09/2014: To focus on providing excellent medical billing to Thriveworks franchises, we are no longer providing billing services to non-Thriveworks practices.

Learn more about the exciting benefits of opening a Thriveworks Counseling center in your area, here: Counseling Franchise.


Your Friends at Thriveworks Medical Billing

Medical Billing Tip: All Sessions Must be Authorized

medical billingAcross the USA, healthcare providers are stressing because they’re not getting their claims for services paid. And they should be! There are many practices that haven’t been paid for over a year, or who have outstanding Accounts Receivable in the hundreds of thousands.

While there are many reasons medical billing claims can be denied (we listed 17 reasons in a previous article), perhaps the most common problem realtes to “Patient/Client Authorization.”

Good Medical Billing starts with getting authorizations. This means, for every single patient, someone must contact the client’s insurance company, prior to his/her first appointment, and get the service authorized. 

Sound like a pain? It’s not fun, but it’s a small effort up front compared to the headache and heartache one can experience is authorization isn’t obtained. Claims will reject. Claims will need to be appealed. And often those appeals are declined for “Lack of authorization.”

You can do this yourself by calling each patients insurance provider! Or, if you’d rather focus on patient care, at Thriveworks Medical Billing, our billing experts will make sure each of your patients is authorized prior to their first appointment with you. 

Be well,

Your Thriveworks Medical Billing Team