Foundation Elements of a Solid Medical Billing and Coding Process

Foundation Elements of a Solid Medical Billing and Coding Process

There are specific foundation elements that are essential to any medical billing and coding process. Medical billing and coding is a highly complex field, as insurance payments are based on one’s ability to provide detailed data and information concerning a patient, including proper identification of the patient, correct codes related to diagnoses and treatment, and other physicians billing servicerequired documentation.

With the October 2015 rollout of ICD-10, the highly complex and new medical coding system, the need for a comprehensive and clearly defined medical claims process has become even more important.

Here are the foundation elements that comprise sound medical billing and coding procedures. If these are utilized, your medical claims process should be working effectively and efficiently.


The ability to completely centralize the medical payment process is one of the huge benefits provided by medical billing and coding companies to medical practitioners. This includes the prescreening of patients and their medical insurance, the collection of all data related to their treatment and insurance, and access to and utilization of all data bases required to successfully complete a medical claim form and submit it to a payer.

Timely Reporting

A solid medical billing company requires that medical practices report all information related to a claim in a timely manner, and that they then process such information as quickly as possible. Also, the company would request that payers report back to them in a manner that would be free of unnecessary delays. Finally, any appeals related to rejected claims, requests for audits, and other such data and information needs would be handled in a manner that allows for ICD-10 Consultantsaccuracy and timeliness.

Proper Coding

With the advent of ICD-10, which includes approximately 68,000 codes, the ability to properly code an insurance claim has become even more challenging. Every medical billing and coding company should be conversant in new ICD-10 codes, as well as old ICD-9 codes. This is an area in which professional billers and coders will define their true worth in the next few years, as the new coding system is to be implemented by October 1, 2015.


A resourceful medical billing and coding company is able to offer personalized and individualized service to its clients, can adapt to specific insurance provider demands, knows how to work with Medicare, and is overall adaptable. At the same time, they are able to meet a high level of performance and comply with industry standards.

Corrective Measures

Finally, medical billing and coding companies that can take corrective measures regarding claims prior to that claim being submitted and rejected are a true asset to a medical practice or hospital. Of course, if a claim is denied, that billing company should be able to help with any appeals process, giving you the best possible chance of securing your payment.

Communication is Key

Each of the elements discussed here is connected to one major attribute, the ability to communicate with a wide range of people and organizations. A premium medical billing and coding company can connect with everyone involved in the process, generating optimum benefits for the medical provider and their patients.

MPMR is the top medical billing company and they can help you with ICD-10 implementation. In addition to offering the best medical billing and coding personnel in America, they offer practice management consulting. Call (951) 757-2056 today!

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