Health Information Management (HIM) and Medical Billing and Coding (MBC) are two disciplines of the healthcare industry that enable seamless handling of patient data and financial transactions. While both fields deal with health information, they provide distinct functions.

As the healthcare sector continues to evolve, the demand for skilled professionals in these areas is on the rise. According to the U.S. Bureau of Labor Statistics, employment for medical records specialists, which includes roles in medical billing and coding, will grow 9% from 2023 to 2033, a rate much faster than the average for all occupations.

This growth is driven by the increasing demand for healthcare services and the widespread adoption of electronic health records (EHRs). However, it’s important to note the differences between HIM and MBC, as each plays a distinct role in the healthcare industry.

This article explores the key differences between Health Information Management and Medical Billing and Coding, shedding light on the unique roles each plays in healthcare data management and information processing.

Understanding Health Information Management and Medical Billing and Coding

Those pursuing administrative roles in healthcare may choose between Medical Billing and Coding and Health Information Management (HIM). Let’s better understand these disciplines.

Medical Billing and Coding

Medical billing and coding act as the financial and administrative bridge between healthcare providers and insurance companies. Every diagnosis, procedure, and treatment a patient receives is converted into a standardized code, ensuring accurate billing and reimbursement. 

Coders rely on classification systems like ICD-10, CPT, and HCPCS to assign the correct codes, while billers use this information to submit claims, resolve payment disputes, and prevent delays. Without precise coding, hospitals and clinics risk revenue losses and compliance issues, making this role indispensable for smooth operations.

Health Information Management

Health Information Management (HIM) goes beyond coding and billing. It focuses on the complete lifecycle of patient records. HIM professionals ensure that medical data is accurately documented, securely stored, and easily accessible for patient care, research, and legal purposes. 

This field blends technology with healthcare, requiring expertise in data management, regulatory compliance, and privacy laws like HIPAA. Whether working with electronic health records (EHRs) or analyzing trends for better patient outcomes, HIM specialists help keep healthcare organizations efficient and legally compliant.

Roles and Responsibilities of HIM vs. Medical Billing and Coding

Both HIM and MBC carry distinct roles and responsibilities that are important for the efficiency and compliance of healthcare operations. They include: 

Medical Billing and Coding

The demand for skilled medical records specialists is on the rise. According to the U.S. Bureau of Labor Statistics, employment in this field is projected to grow 9% from 2023 to 2033, adding approximately 15,000 job openings each year. 

Professionals in medical billing and coding act as the linchpin between healthcare providers and insurance companies. Their primary duties include:

  • Accurate Coding: Translating medical procedures, diagnoses, and treatments into standardized codes using systems like ICD-10, CPT, and HCPCS.
  • Electronic Medical Records (EMR) Management: Updating and maintaining patient records within EMR systems so that all coded information is accurately reflected and accessible for ongoing patient care.​
  • Insurance Liaison: Submitting claims to insurance entities, addressing inquiries, and resolving discrepancies to facilitate timely reimbursements.
  • Payment Processing: Ensuring that healthcare providers receive appropriate compensation by verifying that all services rendered are billed correctly and payments are posted accurately.  

Health Information Management

The HIM field is growing rapidly, with a projected 16% increase in employment for health information technologists and medical registrars from 2023 to 2033, underscoring the rising importance of data management in healthcare. 

As a result, HIM professionals are instrumental in managing patient health information, focusing on:

  • Data Integrity: Guaranteeing that patient records are complete, accurate, and reliable. This involves regular audits and quality checks to maintain the highest standards of data quality.
  • Electronic Health Record (EHR) Systems Management: EHR Systems Management: Administering and optimizing EHR systems for efficient data entry, retrieval, and sharing, enhancing clinical decisions and patient outcomes.
  • Data Analysis: Evaluating health data to identify trends, support research, and inform policy decisions. HIM professionals provide insights that can lead to improved healthcare services and operational efficiencies.​
  • Regulatory Compliance: Maintaining adherence to privacy laws and regulations, such as HIPAA, to protect patient confidentiality. This includes developing and implementing policies that safeguard sensitive health information.​

At Promantra, we understand the critical nature of these roles and offer comprehensive solutions to support healthcare organizations. Our medical billing and coding services ensure accuracy and improve revenue cycles, while our expertise in data integrity, EHR optimization, and compliance supports exceptional patient care.

Read more about us here. 

Differences Between HIM vs. Medical Billing and Coding 

Educational Requirements

1. Medical Billing and Coding

A career in medical billing and coding typically begins with a high school diploma or GED. From there, individuals can pursue certificate programs or associate degrees. Certificate programs, often completed within a year, focus on coding languages such as HCPCS and ICD, preparing graduates for entry-level roles. 

Associate degrees offer a deeper understanding of medical terminology, health data requirements, and reimbursement methods. Certifications like the Certified Billing and Coding Specialist (CBCS) and Certified Professional Coder (CPC) enhance job prospects.. ​

2. Health Information Management

Health Information Management (HIM) requires a more extensive educational background. Positions often necessitate at least an associate degree, with many roles preferring candidates with a bachelor’s or master’s degree. Coursework includes health data management, IT systems, and healthcare law. 

Certifications such as the Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), and Certified Health Data Analyst (CHDA) are valued for their expertise in managing health information and ensuring data integrity. ​

Career Path Comparison

1. Educational Pathways and Role Preparation

Both fields offer structured educational pathways. Medical billing and coding programs focus on coding systems and electronic medical records. On the other hand, HIM programs provide a broader education, covering informatics, and regulatory compliance, preparing graduates for leadership positions within healthcare organizations.​

2. Transitioning Between Fields

Transitioning from medical billing and coding to HIM is feasible, especially for individuals with foundational education in health information. Credits from an associate degree can transfer towards a bachelor’s in HIM, aiding career advancement. Additionally, certifications like the CPC are recognized across both fields, providing flexibility for professionals seeking to expand their expertise​. 

3. Salary Comparison 

Salaries in both fields differ based on education, experience, certifications, and location. According to the Bureau of Labor Statistics (BLS), medical records specialists, including medical coders, earn an average salary of $48,310 annually ($23.23 per hour).

 In comparison, health information technologists and medical registrars earn an average of $65,280 annually ($31.38 per hour). Advancing into managerial roles within HIM can lead to higher earnings. Medical and health services managers earn an average of $134,440 annually ($64.64 per hour).

Technology and Data Management

1. Automation in Billing and Coding

Technology has revolutionized medical billing and coding. Artificial intelligence (AI) and machine learning algorithms automate coding processes, reducing errors and improving efficiency. AI-powered documentation platforms can record patient-provider interactions, generate summaries, and streamline billing, reducing administrative burdens on healthcare professionals. ​

2. Health Information Systems in HIM

HIM professionals oversee the implementation and maintenance of Electronic Health Records (EHRs), ensuring data accuracy, security, and accessibility. The rise of health informatics has led to advanced IT solutions that support data analysis, improve patient outcomes, and ensure compliance with healthcare regulations.

Key Challenges Faced by Coding and HIM Teams

​In healthcare revenue cycle management, coding and health information management (HIM) teams face challenges such as: ​

1. Adapting to Evolving Regulations

Continuous changes in coding standards and regulations mark the healthcare industry. Staying abreast of updates such as ICD-11 revisions and payer-specific guidelines is essential to maintain compliance and ensure accurate reimbursement. ​

Promantra’s Insight: We offer ongoing training programs and resources to keep your staff informed about the latest regulatory changes, ensuring your organization remains compliant and adept at accurate coding practices.​

2. Addressing Documentation Deficiencies

Incomplete or unclear clinical documentation poses significant hurdles for coders, leading to potential claim denials or underpayments. Ensuring comprehensive and precise documentation is vital for accurate code assignment and optimal reimbursement. 

Promantra’s Support: Promantra’s team collaborates closely with healthcare providers to enhance documentation quality, implementing best practices that facilitate accurate coding and reduce the risk of claim issues.​

3. Integrating Complex Technologies

The proliferation of healthcare technologies introduces challenges in integrating various systems seamlessly. Disparate platforms can lead to data silos and inefficiencies, complicating the coding and billing processes. ​

Promantra’s Insight: Our specialization in streamlining system integrations ensures that your Electronic Health Records (EHR) and other platforms work cohesively to support efficient data management and coding workflows.​

4. Managing Staffing and Training Demands

The demand for skilled coding and HIM professionals often outpaces supply, resulting in staffing shortages that can affect productivity and accuracy. Continuous education is necessary to keep pace with industry advancements. ​

Promantra’s Insight: We provide comprehensive staffing solutions, including access to experienced professionals and tailored training programs, to ensure your team remains proficient and well-equipped to handle the complexities of modern healthcare coding and information management.​

By addressing these challenges proactively, healthcare organizations can improve their revenue cycle efficiency, maintain compliance, and deliver better patient outcomes.

To Wrap Up

Both health Information Management (HIM) and Medical Billing and Coding (MBC) prove their importance by providing unique functions to healthcare operations. 

Both career paths are prerequisites for the smooth functioning of healthcare systems. MBC maintains financial stability through precise billing, while HIM upholds the integrity and confidentiality of patient records, facilitating informed decision-making and adherence to regulations.​

At Promantra, we recognize the importance of these roles. Our services, which include accurate CPT/ICD coding, denial management and appeals, and compliance and audit support, are designed to enhance the efficiency and accuracy of your healthcare operations. 

Connect with us to optimize your revenue cycle and maintain the highest standards in patient information management.