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medical Coding

Healthcare Future and the role of medical coding

The US healthcare sector is undergoing constant change. The shift from the fee-for-service model to the value-based care model was motivated by the perception that there was no correlation between healthcare costs and quality. Healthcare decision-makers are facing a challenging environment due to a number of additional challenges, including decreasing reimbursements, rising hospital care costs due to an increase in supply costs following COVID, and a huge amount of resignations. Hospital’s profitability is at its lowest level in 20 years. However, they are having trouble hiring both clinical and administrative staff.

The revenue cycle, which refers to the intricate reimbursement processes, depends on medical billers and coders. The rules governing reimbursement are governed by the medical codes, which act as a common language for payers and providers of healthcare. As a result, skilled medical coders are constantly in demand. Medical billers, on the other hand, focus on processes related to the revenue cycle, including patient experience, claims submission, and denial management. The anchoring discipline for defining the standard of care is medical coding.

Knowing the fundamentals of medical coding

Medical coding entails the conversion of diagnoses and procedures into codes that are accepted in the industry. These industry-recognized codes act as a translator between payers and providers. The process is necessary for the healthcare payers to comprehend the illness or condition the patient has, as well as the actions taken by the doctor. Payers have a set amount of reimbursement for these procedures and illnesses. Front office service is a very specialised field requiring extensive training and certifications because it necessitates an understanding of medical terminologies.

Medical Coding Importance

Following are the important key points of medical coding.

population aging 

The need for medical care, particularly for chronic medical conditions, will increase as the US population ages. Medical billing services are in higher demand as there is a greater demand for medical services as well as provider credentialing service.

rising level of coding complexity. 

The complexity of medical coding has increased due to the growth of telehealth, hospitals in the home, and preventive care, necessitating the use of specialised coders who are up to date on the most recent standards.

delivery models’ complexity 

Complex surgeries are increasingly being performed in ASCs (Ambulatory Surgery Centers) or other outpatient settings. In ASC and Outpatient settings, back office service’ coders must be aware of these complexities and the corresponding reimbursement regulations.

Preparations: Successful Medical Career

Revenue cycle processes are managed by medical billers and coders, who move money in the healthcare industry. Medical coding is now also the driving force behind value-based reimbursements and the measurement of healthcare quality. Medical billers and coders need to be precise, quick to respond, and well-organised in order to thoroughly investigate each claim. They need to get ready for the upcoming changes that are anticipated in the sector, like the rollout of ICD-11.


Even though there are many advantages to outsourcing and offshoring medical billing, programs that are successful use seasoned suppliers with excellent delivery leaders, reliable processes, and excellent technology tools for collaboration. Optimedservices is one of the best medical billing company in the United States.



Iqra Haseeb


Organised and efficient Team leading Manager, supporting corporate level officers and senior management personnel with demonstrated expertise in financial and operational leadership. Adroit professional exemplifies multi-disciplinary managerial skills in process procedure and policy improvement initiatives. Accomplished in workflow optimization techniques implementation which increases productivity, reduces labour, and maintains business integrity and quality of service.


Extensive Client Coordination., Conducts business analysis to create value, Provide Support in creating or enhancing the business, Develop and manage strategic partnerships to grow business, Provide Insights or Conduct Studies related to Market or Business Operation related problems, Provide assistance in operating and handling the business, Develop and structure concepts, strategies, automating and scaling the business


Developed and implemented favourable pricing structures balancing firm objectives against customer targets., Education Coordinated innovative strategies to accomplish marketing objectives and boost long-term profitability., Reached out to potential customers via telephone, email and in-person inquiries., Worked with existing customers to increase productivity of  services.

Sharjeel Khan


Having 10 years of experience in the Medical Billing Industry & up to date with Government, Commercial, Automobile & Workers Compensation Payer guidelines throughout the U.S.
Strong knowledge of claims procedures and coding, account receivable/collection, Denial Management, Credentialing/EDI Enrollments and Revenue Cycle Management. Experienced in Electronic Claim (5010) Loop and Segment Editing, Creating Paper to Electronic Claims (EDI 837), Resolving EDI Rejections through Practice Management & Clearing house, creating invoices, customized provider reports, Auditing, processing insurance & patient payments, and pursuing past-due balances through unique & proven RCM process and Data Management.


ICD-10-CM, CPT, Coding Guidelines, Diagnosis Coding, Compliance, Facility/Professional Coding, Complete Revenue Cycle Management, Telehealth or Virtual Visits, Provider Education, CMS-1500, Upper hand in almost every top PM/EMR/EHR Software used, and many more...


Behavioral/Mental Health, Neurology, Family/Internal Medicine, Infectious Diseases, Pulmonary & Sleep Medicine, Pain Management, Physical/Sports Medicine and Rehabilitation (Physiatrist), Chiropractic, Podiatry, Radiology, and much more.

The Full-Service Bundle includes;
  1. Medicare for both one practice county and one provider
  2. Medicaid for both one practice location and one provider
  3. BCBS PID for both the practice and one provider
  4. RailRoad Medicare for both one practice county and one provider