Medical billing is the practice of submitting and managing claims with health insurance companies to receive payment for healthcare services provided.
The American healthcare industry is largely private and profit-driven, with a complex system involving insurance companies, employers, and government programs like Medicare and Medicaid. In contrast, the Indian healthcare industry is a mix of public and private providers, with a larger role played by out-of-pocket expenses due to lower insurance penetration. Additionally, healthcare costs tend to be higher in the U.S., while India has a more affordable healthcare system but with challenges related to access and quality in certain areas.
Medical coding involves translating medical services and diagnoses into universal codes, while medical billing is the process of submitting these codes to insurance companies for reimbursement of healthcare services.
Medical billing is a leading industry in India due to its cost-effective services, skilled workforce, and English proficiency, making it a preferred destination for outsourcing by healthcare providers in countries like the United States. Additionally, India's adoption of international coding standards like ICD-10 has further bolstered its position in the global medical billing market.
Medical billing involves registering patients, verifying insurance, coding diagnoses and procedures, submitting claims, and managing payments and denials to ensure healthcare providers receive proper reimbursement.