Busting Medical Billing Myths: The Importance of Transparency

Medical billing is an essential aspect of the healthcare provider and patient experience. Even if you do everything correctly except billing, your patients may choose to go elsewhere. When you’re upfront about the costs of treatments, medicines, and procedures, then why not be transparent about when and how the patients are billed? In fact, it can only help to strengthen the relationship and instill trust. If you wish to practice transparency, you must be clear—clear about your inclusion and exclusion of the billing, the price to be quoted, and most importantly, the facts about medical billing. Let’s unveil the medical billing myths to take the maximum advantage:

Myth #1: Medical Billing & Coding are the Same


Medical billing and coding are frequently used interchangeably, but they are two distinct parts of the same procedure. The same person may perform these two tasks in some medical offices, but they are different skills and processes.

Medical coders gather information from a patient visit and transcribe it into universally recognized codes that comprise the patient’s medical record. This information will be given to the medical biller, who will submit it to the insurance company. In fact, medical coding demands detailed requirements of injuries, symptoms, diagnoses, treatments, medications, and procedures. For compliance, the codes must be correct and detail the visit.

This information is entered into the patient’s electronic health records and is utilized by the insurance provider to process the claim and pay the hospital on the patient’s behalf. Accuracy is critical for the insurance claim to be paid correctly.

Medical billers enter information from the coded transcript of the patient’s visit into specific software. This information is sent as a claim to the patient’s insurance carrier. The remaining amount is billed to the patient after the insurance company has paid their half. This revised cost includes all co-pays and deductibles. Medical billing, like coding, depends on precision and attention to detail.

Myth #2: Medical Billing is Easy – Anyone can do it!


Medical coding and billing is a technical task that necessitates close attention to detail and strong communication and problem-solving abilities. Medical billing includes an intricate process of submitting and following up on claims with insurers to get reimbursement for services given by a healthcare provider. This task also entails analyzing and resubmitting denied claims, as well as tracking payments and ensuring the healthcare provider receives the exact amount for the services provided.

Furthermore, medical coding necessitates current knowledge of ICD-10 and the ability to interpret the patient’s condition and visit into the appropriate codes. In fact, to properly train staff for just entry-level medical coding, the training typically takes several months to a year.

Not only this, but medical coders and billers must comprehend physiology, medical terminology, anatomy, and coding standards, in addition to navigating insurance processes for various payers. They must finish this billing and coding task swiftly and precisely as no mistakes and errors can be tolerated.

Myth #3: In-house Medical Billing is Better than Outsourcing


The most compelling grounds for recruiting an in-house team rather than outsourcing billing and coding include:

  • Outsourcing is more expensive than doing things in-house.
  • Revenue is more easily controlled when done in-house.
  • Outsourcing is less accurate and has a lower quality.

Some healthcare providers may prefer an in-house medical billing and coding team, but this is not necessarily the most cost-effective alternative. In-house coders and billers necessitate hiring them regularly, usually from 9 to 5, and paying taxes and benefits for each employee. Whereas third-party medical billing companies often charge a flat fee, you may save money by hiring in-house. The outsourced company may also be able to cut operational costs and boost monthly patient and insurance collections for medical practices.

But what about the revenue control? Many hospitals believe that having the billing and coding team in-house gives them better oversight. However, this monitoring might have a cost in terms of employee turnover, training, supervision, and hiring. One reason hospitals, doctors, and physicians may outsource billing and coding is to delegate those tasks to experienced outsourced medical billing and coding providers. They can concentrate on communication with insurance companies, submitting claims, and reporting.

How can 24/7 Medical Billing Services Help?

Medical practices of all sizes should outsource a professional medical billing company such as 24/7 Medical Billing Services. We allow you to reduce administrative costs while raising reimbursement numbers by always keeping a billing item. Whether you require our assistance for counseling or consistent billing services, a professional billing company like 24/7 Medical Billing Services consistently outperforms doing billing in-house.

See also: Personalized Patient Billing: A Tailored Approach To Medical Billing

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