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Medical coder

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In order to be able to submit a claim to an insurance for any of the services, or items sold to a patient, there needs to be a mapping code that allows the insurance companies to map the service provider's services to their equivalent.

Insurance companies publish codes that service providers must use during the process of claim creation, without this code, service providers can certainly expect to see no reimbursed amounts for their services by the insurance companies, leaving the service providers with either of three options:

  • Resubmit the claim with the right codes.
  • Discard the claim, charge the patient for the loss, and leave the patient with the task of recover for the expected covered charges.
  • Ignore the claim, and take the loss, keeping the customer happy, and hoping that the customer will repeat business in the future.