Which role handles submitting claims to insurance companies?

Which role handles submitting claims to insurance companies?

• A. Medical Biller/Coder
• B. Medical Coder
• C. Health Information Administrator
• D. Dental Hygienist

Answer: (A)

Submitting claims to insurance companies is part of the medical billing process. This role translates the clinical services into coded information and uses payer guidelines to submit claims electronically or on paper, verify patient details, ensure accurate CPT and ICD-10-CM codes, and handle follow-ups on claim status and denials. In practice, medical billers manage the end-to-end submission and payment collection, coordinating with insurers to maximize reimbursement. A medical coder concentrates on assigning the correct codes based on the clinical documentation, which is essential for accurate billing but does not by itself submit the claims. A health information administrator focuses on managing and safeguarding patient records and data quality, not on submitting claims. A dental hygienist provides clinical dental care and does not handle insurance billing.

Submitting claims to insurance companies is part of the medical billing process. This role translates the clinical services into coded information and uses payer guidelines to submit claims electronically or on paper, verify patient details, ensure accurate CPT and ICD-10-CM codes, and handle follow-ups on claim status and denials. In practice, medical billers manage the end-to-end submission and payment collection, coordinating with insurers to maximize reimbursement.

A medical coder concentrates on assigning the correct codes based on the clinical documentation, which is essential for accurate billing but does not by itself submit the claims. A health information administrator focuses on managing and safeguarding patient records and data quality, not on submitting claims. A dental hygienist provides clinical dental care and does not handle insurance billing.