Physician Practice or Billing Company – What Coders Prefer Joining?


Coding professionals play a key role in the medical billing process. Every time a patient comes in to get them treated, the provider must document the services provided. The coder then abstracts the information from the documentation, assigns appropriate codes to them and then finally creates the claim which is to be paid. It could either be paid by a commercial payer, the patient or CMS.

Coding and billing are actually two different aspects and while the coding and billing may be done by the same individual or the two might work closely a coder is primarily responsible for abstracting and assigning the appropriate codes on the claims. To assign the codes the coder needs to check a variety of sources within the patient’s medical record; which includes going through the transcription of the doctor’s notes, lab tests, imaging studies and so on to verify the work that was done. After this the coder assigns codes to report the procedures that were performed which also aids in providing the biller with the necessary information to process the claim.

Another important aspect that needs to be highlighted here is from October 1, 2015  ICD–10 comes in to effect, which means that the codes which were approximately at 13,600 will now increase to more than 60,000.

Coding for a Physician Practice

A lot depends on if the practice is a small practice or a large practice. Moreover a lot also depends on the specialty of the physician as well. In general a coder has to have an idea about anatomy and medical terminology. Moreover, they have to be familiar with different insurance plans, compliance and so on. If the coder is working for a cardiologist or an ophthalmologist or a dentist and so on then he would be coming across codes which are similar to the specialty. Due to this the coder might feel hemmed in as he does not get a chance to work with different codes.

In a scenario where the practice is small the coder will have to double up and perform other duties as well apart from auditing and refiling appeals of denied claims. In a particular scenario a coder might have to don several hats where they perform myriad tasks like scrubbing bills, verifying diagnosis codes, flagging questions for physicians and so on.

Coding for a Billing Company
However, when a coder works for a billing company the story is entirely different. The reason for this is a billing company will have clients and the client could be a small or a large practice or a multi–specialty hospital and so on. In such a scenario the coder gets a variety of cases to work on. They might be assigned to a small practice for some time after which they could be transferred to a multi–specialty and then they might have to work for a physician with a larger and established practice.

Even if they work for physicians they can get a chance to work with different specialists. This helps them in exercising their knowledge completely. They have to have complete understanding of all codes and when they keep on using them for their clients, they can keep in touch with what they have learnt.

Hence, once feels that a coder would want to join a billing company where he meets more challenges and gets varied work which would be a welcome change to the monotony of a physicians’ practice.