Medical Billing And Coding Profession
Medical billers and coders are in high demand among the allied health occupations. According to the US Bureau of Labor Statistics (BLS), health information technicians are one of the 10 fastest-growing allied health occupations. It is a challenging, interesting career where you are compensated according to your level of skills and how effectively you use them. Medical billers and coders know this and feel good about the support they provide to physicians, clinics, hospitals, and patients. They know they play an important role in the business office where they are employed. Their work consists of submitting the proper documentation to a number of insurance companies and federal agencies for reimbursement in order for their employer to financially succeed and avoid fraud charges. Their specialized training and expertise lets them find work any place, any time. Numerous opportunities for trained individuals exist in medical offices, clinics, hospitals, insurance companies, and in form of freelance home-based businesses. Advancement opportunities are unlimited! The U.S. Department of Labor states that continued employment growth for medical coders and billers is spurred by the increased medical needs of an aging population and the number of health practitioners. The Occupational Outlook Handbook reports that earnings vary widely and pay levels are governed chiefly by experience and qualifications. Healthcare Careers Offer Job Security, Personal Satisfaction, Challenges, and Rewarding Experiences Many interested in a career in the healthcare field decide to specialize in the medical billing and coding profession. Medical billers and coders are no longer restricted to only the doctor's or dentist's office but are now working in hospitals, pharmacies, nursing homes, mental healthcare facilities, rehabilitation centers, insurance companies, health maintenance organizations (HMOs), consulting firms, and health data organizations, or even from home. These highly skilled professionals are earning impressive wages everywhere they are. Typical duties of medical billers and coders include: - Explaining insurance benefits to patients and clients
- Office bookkeeping and other administrative duties
- Accurately completing claim forms
- Explaining insurance benefits to patients
- Handling day to day medical billing procedures
- Adhering to each insurance carrier's policies and procedures
- Prompt billing of insurance companies
- Documenting all activities using correct medical terminology
- Scheduling appointments
Other job opportunities for medical billers and coders include: - Billing Specialist
- Patient Account Representativ
- Electronic Claims Processor
- Billing Coordinator
- Coding Specialist
- Claims Analyst
- Reimbursement Specialist
- Claims Assistant Professional
- Medical Collector
- Claims Processor
- Claims Reviewer
What is Medical Billing? Medical billing is better described as medical practice management and a doctor's key to getting paid. Although most doctor's offices request that payment be made at the time a medical service is provided in order to minimize billing, every medical office has a need to maintain patient financial accounts and for collecting money. In a small family practice or suburban clinic this task may be simple and assigned to the medical assistant or nurse but in bigger practices and clinics this is the medical biller's job! Medical billers and coders usually work forty regular office hours from Monday through Friday on a desk in the billing office or billing department of the professional healthcare office. They must know the different methods of billing patients, understand various collection methods, ethical and legal implications, have a good working knowledge of medical terminology, anatomy, medical billing and claims form completion, and coding. They also must understand database management, spreadsheets, electronic mail, and possess state-of-the-art word processing and accounting skills, be proficient in bookkeeping, and be able to type at a speed of at least 45 words-per-minute. The work area of medical billers and coders usually is in a separate area away from the patients and public eye. However, even though they are not involved in the actual process of doctors and healthcare professionals providing medical care they need to possess excellent customer service skills when it comes to making contact with clients, insurance companies, and often patients. Medical billers must know how to explain charges, deal with criticism, give and receive feedback, be assertive, and communicate effectively without becoming confused as the person is asking questions. Patients can quickly become frustrated when trying to deal with healthcare providers and bills over the phone. While an increasing amount of patient care is being funded through HMO related insurance, where the patient makes a small copayment at the time of service and the doctor bills the managed care company for the balance, a number of patients still need to make arrangements to pay for their medical services over a period of time. Part of the medical biller and coder's job is to contact some of these patients from time to time regarding a past due bill. Incoming calls from patients who have questions regarding a bill are also directed to the medical biller's office. The way s/he communicates over the phone can make or break business relationships. Other specialties closely related to the medical billing and coding profession are: - Medical Coders/Coding Specialists
- Patient Account Representatives
- Electronic Claims Processors
- Billing Coordinators
- Reimbursement Specialists
- Claims Assistant Professionals
- Medical Claims Analysts
- Medical Claims Processors
- Medical Claims Reviewers
- Medical Collectors
What is Medical Coding? Every healthcare provider that delivers a service receives money for these services by filing a claim with the patient's health insurance provider or managed care organization. This is also referred to as an encounter. An encounter is defined as "a face-to-face contact between a healthcare professional and an eligible beneficiary." Codes exist for all types of encounters, services, tests, treatments, and procedures provided in a medical office, clinic, or hospital. Even patient complaints such as headache, upset stomach, etc. have codes which consist of a set of numbers and combinations of sets of numbers. The combination of these codes tells the payer (health insurance companies or government entities) what was wrong with the patient and what services were performed. This makes it easier to handle these claims and to identify the provider on a predetermined basis. In addition, the services rendered (CPT) codes have to match the diagnosis (ICD) codes to justify medical necessity. To do this correctly for each third party payer choices have to be made from a combination of 3 coding systems totaling over 10000 codes, and which change annually. In addition, a completely new coding system, ICD-10, is proposed for reimbursement purposes in the near future. Tools of the Trade CPT books provide all the procedural terminology and ICD-9-CM code books have the most up-to-date information on medical diagnosis coding. The medical coder must stay current on any new ICD-9 code changes that would impact code accuracy and claims submission. HCPCS books contain the complete lists of HCPCS Level II codes with descriptions. They will guide the medical coder through current modifiers, code changes, additions and deletions. HIPAA books help to develop an effective HIPAA compliance plan and DRG books are needed for Medicare's classification of inpatient hospital services based on principal diagnosis, secondary diagnosis, surgical procedures, age, sex, and presence of complications. Training Training of the medical billers and coders can range from two to four years of college, a technical school diploma, certificates from correspondence courses, to simple home study programs. Upon completion of such training many coders may seek professional certification. Though not necessary, it is recommended and national associations are available for the certification processes. Vocational Training Professional medical billers and coders are in very high demand. Billing for services in healthcare is more complicated than in other industries. Government and private payers vary in payment for the same services and healthcare providers and organizations provide services to beneficiaries of several insurance companies at any one time. Therefore, to reach proficiency in this business, basic training, clinical supervision and continued professional development is essential! Typical Course Requirements are: - Medical Office Procedures
- Medical Keyboarding
- Medical Terminology
- Health Structure and Function
- Health Care Records Management
- Medical Insurance
- Survey of Pathology
- CPT-4 HCPCS II, III
- Healthcare Laws and Ethics
- Basic Coding ICD-9-CM
- Basic Pharmacology
- Medical Transcription
- Externship
- National Exam
- General Education Requirements
Professional Advancement Opportunities A recent American Hospital Association survey showed that about 18% of billing and coding positions remain unfilled due to a lack of qualified candidates. Most companies and practices are looking for schooling and experience mostly because of the legal ramifications of incorrect billing practices. However, medical billers and coders are also able to work independently out of their homes where they established a home based billing office. There are plenty of electronic billing programs available that can be set up through home office computers. Also, there is the possibility to become an independent insurance specialist or consultant who helps patients understand their insurance bills and what they should be paying. Opportunities also exist as patient account managers, physician office supervisors and management, various types of personnel managers in the healthcare industry, health claims examiners, and medial billing and coding instructors. The more education the individual has, the more employment options are available and advancement opportunities become virtually unlimited! Professional Certification As in so many healthcare professions certification in the medical billing and coding field is not required but highly recommended. The days of the single family practice medical assistant or nurse typing out an invoice after office hours are history. Even the smallest offices and clinics have changed to computer billing because it offers greater coding accuracy, saves time, and can be used by administrators and auditors to ensure that visits are being coded to the appropriate levels which increases revenues. Understandably, these offices and companies are looking for individuals who are certified in their field to ensure the employer that the individual whom they hire is competent and proficient. There are numerous well known and well respected organizations sponsoring these types of examinations. Intersted candidates should research each one and find the one that most suits your needs: American Association of Medical Billers (AAMB) offers Certified Medical Biller (CMB) and Certified Medical Billing Specialist (CMBS) examinations. The National Association of Claims Assistant Professionals (NACAP) offer Certified Claims Assistance Professional (CCAP) and Certified Electronic Claims Professional (CECP). The examinations for Certified Procedural Coder (CPC), Certified Coding Specialist (CPS), Accredited Record Technician (ART), and Registered Record Administrator (RRA), are administered through the American Health Information Management Association (AHIMA). The National Healthcareer Assosciation (NHA) is offering their Medical Billing and Coding (CBCS) credential. If your objective is to work for a medical office, group practice, healthcare provision network, or hospital as the medical billing and coding specialist keep in mind that most private practices, organizations and hospitals throughout the country not only prefer but often require national certification as a competency standard. To learn more about this very rewarding career visit the Medical Billing and Coding Net web site at http://www.medicalbillingandcoding.net © 2003 Danni R. of the Medical Billing & Coding Net. Reprint permission available by request. Article must be complete and must include all contact information. About The Author Danni R. is a certified medical assistant through the AAMA and NHA, and MA Instructor at such well known vocational training institutions. Her background is a unique blend of healthcare sciences and freelance web design and graphic arts, which makes her the ideal author for medical assisting articles, web sites, and various online courses. It is this fusion of contrasting disciplines that makes her work so successful on the Internet! You may also visit her web sites at http://www.certmedassistant.com, http://www.medicalassistant.net, and http://www.medicalbillingandcoding.net to get better acquainted with her work!
|
|
|
|
RELATED ARTICLES
How To Resign Gracefully
Once a new job has been accepted, you need to consider the timing of your resignation. Since two weeks' notice is considered the norm, make sure your resignation properly coincides with your start date at the new company.
Ten Great Careers For Computer ?Geeks
The universal acceptance of computers into our daily lives, both at work and at home, has decreased the image of computer users as being "geeks." The word geek itself has evolved a bit - going from meaning a socially inept person who gets along better with computers than people, to someone who is an expert with computers, a guru even. In fact, many computer service companies utilize the name geek in their nomenclature because of this new meaning.
How To Find A Job As A Copy Editor
Jobs for copy editors may seem like they are hard to find, but really you can find them and you can do so with many of the qualifications you already have. But, if you do not have any qualifications, this may be the first step in finding the copyediting job that you have been looking for. Jobs in this field are available, but it takes a good, solid portfolio and set of skills to get them. Here are some things to get you going in the right direction though.
Make The Right Career Move
It is not realistic for HR Managers to believe that there will not be any staff turnover in the organisation. Having regular staff turnover need not be a negative proposition as it may imply that the industry is very dynamic. There are also other varied reasons for this: The organisation may undergo a restructuring exercise or its headquarters may be relocated to a different country. With new talents to improve the competitiveness of the organisation, it is dependent on each employee to take full control of his career progression.
Age Discrimination is Alive and Unwelcome Here!
Common sense appears to be a rare commodity these days. Why is this so?
Preparation is Key
Interviewing for a new job, or a promotion, can be a stressful situation. However, Preparation is the KEY! When preparing for that all important interview, take time to reflect upon your career experiences; and look for at least five good examples of your accomplishments and challenges--we will call them "bragging points".
Yesterdays Hero
Wonder Woman makes it looks so easy. She gets up every morning, fights the good fight, calls it a day, and starts the whole process all over again. This is the way most of us begin our workday. We work hard, accomplish lots, and get up in the morning for an encore presentation.
Taking Job Loss Seriously
Anyone reading this article and hassuffered a job loss recently IStaking the job loss seriously. Thestages often are:
Successful Job Search: 10 Steps To Quickly Acquire Your Dream Job And Put More Money In Your Pocket
Do you want to continue your costly, time-consuming and exhausting struggle in a frustrating job search using weak, ineffective tools that are getting you nowhere? The job market today is fiercely competitive with few high-paying or desirable jobs available. With repeated downsizings, companies have learned to survive with less.
Top 10 Tips for Career Advancement
Here's a list of the top 10 tips you can use to advance your career:
How To Tap Into the Invisible Job Market
Is there a company in your area that you'd love to work for? Do you assume that, because you don't see them advertising in the classifieds or posting jobs on their website, they have no openings? That may or may not be the case. That truth is, only about one-fifth of job openings are actually advertised!
Lets Talk About Trust
I agree with Brooker T. Washington, "Few things help an individual more than to place responsibility upon him, and to let him know that you trust him." I agree with Mr. Washington because I've experienced trust. I've been on both the giving and receiving side of the equation, and I know first hand the power of trust.
How To Get Promoted - Take Control Of Your Destiny!
It Is Up To You
What Do You Want To Be When You Grow Up? Something That Hasnt Been Invented Yet!
Most of us were brought up to study hard, get good grades, choose a "practical" college major, and strive for a "good job."
10 Major Signs of Job Dissatisfaction
The New Year is a great time to analyze your job and the satisfaction you get from doing it. Running the rat race is just that, scurrying around only to find that at the end of the day or week you are still not happy about who you are and what you do. For many people they think exercise, changing their eating habits, or learning a new sport or language will make a difference in their emotional and physical well being. Fortunately for some that's all it takes, but for others a complete job makeover is the only way.
When and How to Say I Just Cant Do It!
We naturally hesitate to tell our boss when we can't do something or are feeling overwhelmed in our job. Bosses don't want to hear that, right? Well, it depends.
In many situations, your boss is so busy that he/she doesn't keep track of how much work you're doing. When your boss gives you a new project, he's not thinking about all the other projects you're already working on.
And here's the kicker -- unless you speak up and tell your boss that you can't handle the workload he's giving you, he'll assume everything is fine.
This can have bad consequences for you AND your boss. You know what will happen. Eventually things will start falling through the cracks or you'll rush through tasks and start making mistakes.
You can only do so much in a day, and deadlines will be missed. While you're stressing out, work that your boss needs you to do is NOT being done.
When this happens, your boss will not appreciate your excuse: "But I had too much to do, I was overloaded with work!" Saying that AFTER the fact will be much worse than telling your boss up front -- before mistakes occur or deadlines are missed -- that you're having trouble with your workload.
It is your responsibility to tell your boss when you are overwhelmed, and there's nothing wrong with doing this.
Of course, you don't want to tell your boss, "I can't do that; I'm too busy." But you can say, "I'll be happy to take that on, but I need your help with prioritizing the other projects you've already given me. Which jobs can I put on hold or delegate to someone else while I work on this new one?"
That's way better than keeping your mouth shut, trying to do too much, and failing miserably.
Build Your Career Decision By Decision
Do you dislike making decisions and avoid the challenge whenever you can?
Where Do I Go From Here?
Making Your Future Work Better For You
Networking - A Key Factor in a Successful Job Search
In today's economy, job seekers need an edge beyond their experience, education and specific industry and job-related skills, in order to find and secure a position. Regardless if you are looking for an opportunity as CEO, Vice President, IT Manager or Customer Service Representative, you need effective tools to compete within a market that is job-poor and candidate rich.
Ive Got the Big Bad B Word on My Job!
That "B" word---B O R E D O M.
|