American Business Systems’ medical billing franchise model aims to secure outsourcing that providers can rely on for their medical coding and billing. Whether it occurs in-house or via a medical billing franchise, medical coding is integral to this nation’s healthcare system. It ensures consistency in busy providers documenting their billing, reimbursement, and statistical analysis.
Still, with at least three major medical coding systems in play, it’s important to understand how each platform works to provide a foundation for accurate, streamlined billing.
3 Major Medical Coding and Classification Systems
While individual codes correspond with specific medical diagnoses, procedures, or care, there are standardized coding systems that span all parties, such as:
- Healthcare providers
- Hospitals
- Government programs like Medicare and Medicaid
- Insurance companies
- Researchers
Using these codes, providers track a patient’s condition and the medical services they receive. Service providers also use codes to submit claims for reimbursement from insurance companies and government programs while accurately billing their patients. However, hundreds of thousands of coders and billers must navigate several medical coding systems to categorize diagnoses and procedures, so they need to understand each one’s purpose and function.
These three major medical coding systems are:
- ICD-11: The International Classification of Diseases classifies symptoms and diseases as the global standard for all diagnostic codes.
- CPT: The CPT editorial panel of the American Medical Association maintains the Current Procedural Technology codes. This system describes the medical services and procedures that patients receive from healthcare providers (for medical billing and reimbursement).
- HCPCS: The Centers for Medicare & Medicaid Services maintain a Healthcare Common Procedural Coding System. This system combines the existing code from CPT with a separate national code. It classifies medical equipment, prescriptions, and services by non-healthcare providers.
Implementing Medical Coding Systems With Help From American Business Systems
Understandably, three systems create complexities for medical coding in healthcare overall. The billing process means there’s a great deal of room for error, denied claims, or reimbursement reductions. It also takes time to prepare accurate claims, which means many providers wait months to receive a fair payment.
For medical billers to grow their businesses, a simplified electronic billing system seems essential. In response, organizations like American Business Systems now provide solutions, including its secure web-based electronic medical billing system. This platform simplifies code selection for:
- Faster, more accurate claims
- Code Compliance
- Seamless connections between electronic medical records and nationwide billing systems
Those interested in navigating medical coding systems to reduce rejected or denied claims may call American Business Systems at (866) 565-8413. It’s also an opportunity to become a leader in medical billing.
