This report originally appeared in the March 2010 issue of DOTmed Business News

While much of the buzz in bringing health care to the digital age has lately been tied to electronic health records and electronic medical records due to the government incentives tied to implementation, a large part of the process actually rests with electronic coding.

For medical offices to contend in today's high-tech society, electronic medical billing and coding is a crucial part of the process. In its simplest terms, electronic coding deals with the relationship between physicians and insurance companies. Over the years, there has been a gradual switch from submitting paper claims to electronic claims in coding that allow for faster and more accurate reimbursements.

"On the statistical side of it, there are still 3 billion paper claims being processed every year and that's out of 12 billion total," says Bill Bartzak, president and CEO of Parsippany, NJ-based MD On-Line, Inc., which processes millions of electronic transactions each month that would otherwise be printed on paper. "The potential savings on that alone is over $11 billion a year to government and individual insurance companies if they streamline and mandate that process."

Medicaid mandated it a few years ago, but they excluded practices with 1 to 4 doctors and that's where most of the remaining 75 percent of holdouts come from.

"The crazy thing about it is that a doctor today, such as a pediatrician, who would be getting a reimbursement of $25 from the insurance company, to file on paper costs the doctor's office about $5 a claim," Bartzak explains. "If they did it electronically with our payer partners, they could do it for free."

MD On-Line is currently on 35 major player web sites, including United Health, Aetna and Cigna.

"A lot of the coding in the past was handwritten or typed and a lot of that is still being done and turning the coding to electronic process is a huge step," Bartzak says. "If they have an existing system and they are still sending paper, we can take any format and convert it into the proper format for all insurance companies so they can use their existing system and send us the file and the training is no more than 30 minutes over the phone. We really simplified the process."

Electronic coding provides a simple system. There are code numbers to identify any medical service or procedure and doctors have to make sure that these codes appear when they seek reimbursement from Medicare, Medicaid and insurers. The health care billing services need to be compliant with national medical regulatory programs like HIPAA, JCAHO and other specialized industry standards.

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