| Medical billers and coders are in high demand | | | | procedures provided in a medical office, |
| among the allied health occupations. | | | | clinic, or hospital. Even patient complaints |
| According to the US Bureau of Labor | | | | such as headache, upset stomach, etc. have |
| Statistics (BLS), health information | | | | codes which consist of a set of numbers and |
| technicians are one of the 10 fastest-growing | | | | combinations of sets of numbers. The |
| allied health occupations. It is a | | | | combination of these codes tells the payer |
| challenging, interesting career where you are | | | | (health insurance companies or government |
| compensated according to your level of skills | | | | entities) what was wrong with the patient and |
| and how effectively you use them.Medical | | | | what services were performed. This makes it |
| billers and coders know this and feel good | | | | easier to handle these claims and to identify |
| about the support they provide to physicians, | | | | the provider on a predetermined basis. In |
| clinics, hospitals, and patients. They know | | | | addition, the services rendered (CPT) codes |
| they play an important role in the business | | | | have to match the diagnosis (ICD) codes to |
| office where they are employed. Their work | | | | justify medical necessity.To do this |
| consists of submitting the proper | | | | correctly for each third party payer choices |
| documentation to a number of insurance | | | | have to be made from a combination of 3 |
| companies and federal agencies for | | | | coding systems totaling over 10000 codes, and |
| reimbursement in order for their employer to | | | | which change annually. In addition, a |
| financially succeed and avoid fraud charges. | | | | completely new coding system, ICD-10, is |
| Their specialized training and expertise lets | | | | proposed for reimbursement purposes in the |
| them find work any place, any time. Numerous | | | | near future.Tools of the TradeCPT books |
| opportunities for trained individuals exist | | | | provide all the procedural terminology and |
| in medical offices, clinics, hospitals, | | | | ICD-9-CM code books have the most up-to-date |
| insurance companies, and in form of freelance | | | | information on medical diagnosis coding. The |
| home-based businesses. Advancement | | | | medical coder must stay current on any new |
| opportunities are unlimited!The U.S. | | | | ICD-9 code changes that would impact code |
| Department of Labor states that continued | | | | accuracy and claims submission. HCPCS books |
| employment growth for medical coders and | | | | contain the complete lists of HCPCS Level II |
| billers is spurred by the increased medical | | | | codes with descriptions. They will guide the |
| needs of an aging population and the number | | | | medical coder through current modifiers, code |
| of health practitioners. The Occupational | | | | changes, additions and deletions. HIPAA books |
| Outlook Handbook reports that earnings vary | | | | help to develop an effective HIPAA compliance |
| widely and pay levels are governed chiefly by | | | | plan and DRG books are needed for Medicare's |
| experience and qualifications.Healthcare | | | | classification of inpatient hospital services |
| Careers Offer Job Security, Personal | | | | based on principal diagnosis, secondary |
| Satisfaction, Challenges, and Rewarding | | | | diagnosis, surgical procedures, age, sex, and |
| ExperiencesMany interested in a career in the | | | | presence of complications.TrainingTraining of |
| healthcare field decide to specialize in the | | | | the medical billers and coders can range from |
| medical billing and coding profession. | | | | two to four years of college, a technical |
| Medical billers and coders are no longer | | | | school diploma, certificates from |
| restricted to only the doctor's or dentist's | | | | correspondence courses, to simple home study |
| office but are now working in hospitals, | | | | programs. Upon completion of such training |
| pharmacies, nursing homes, mental healthcare | | | | many coders may seek professional |
| facilities, rehabilitation centers, insurance | | | | certification.Though not necessary, it is |
| companies, health maintenance organizations | | | | recommended and national associations are |
| (HMOs), consulting firms, and health data | | | | available for the certification |
| organizations, or even from home.These highly | | | | processes.Vocational TrainingProfessional |
| skilled professionals are earning impressive | | | | medical billers and coders are in very high |
| wages everywhere they are. Typical duties of | | | | demand. Billing for services in healthcare is |
| medical billers and coders include:Explaining | | | | more complicated than in other industries. |
| insurance benefits to patients and | | | | Government and private payers vary in payment |
| clientsOffice bookkeeping and other | | | | for the same services and healthcare |
| administrative dutiesAccurately completing | | | | providers and organizations provide services |
| claim formsExplaining insurance benefits to | | | | to beneficiaries of several insurance |
| patientsHandling day to day medical billing | | | | companies at any one time.Therefore, to reach |
| proceduresAdhering to each insurance | | | | proficiency in this business, basic training, |
| carrier's policies and proceduresPrompt | | | | clinical supervision and continued |
| billing of insurance companiesDocumenting all | | | | professional development is essential!Typical |
| activities using correct medical | | | | Course Requirements are:Medical Office |
| terminologyScheduling appointmentsOther job | | | | ProceduresMedical KeyboardingMedical |
| opportunities for medical billers and coders | | | | TerminologyHealth Structure and |
| include:Billing SpecialistPatient Account | | | | FunctionHealth Care Records ManagementMedical |
| RepresentativElectronic Claims | | | | InsuranceSurvey of PathologyCPT-4 HCPCS II, |
| ProcessorBilling CoordinatorCoding | | | | IIIHealthcare Laws and EthicsBasic Coding |
| SpecialistClaims AnalystReimbursement | | | | ICD-9-CMBasic PharmacologyMedical |
| SpecialistClaims Assistant | | | | TranscriptionExternshipNational ExamGeneral |
| ProfessionalMedical CollectorClaims | | | | Education RequirementsProfessional |
| ProcessorClaims ReviewerWhat is Medical | | | | Advancement OpportunitiesA recent American |
| Billing?Medical billing is better described | | | | Hospital Association survey showed that about |
| as medical practice management and a doctor's | | | | 18% of billing and coding positions remain |
| key to getting paid. Although most doctor's | | | | unfilled due to a lack of qualified |
| offices request that payment be made at the | | | | candidates. Most companies and practices are |
| time a medical service is provided in order | | | | looking for schooling and experience mostly |
| to minimize billing, every medical office has | | | | because of the legal ramifications of |
| a need to maintain patient financial accounts | | | | incorrect billing practices.However, medical |
| and for collecting money.In a small family | | | | billers and coders are also able to work |
| practice or suburban clinic this task may be | | | | independently out of their homes where they |
| simple and assigned to the medical assistant | | | | established a home based billing office. |
| or nurse but in bigger practices and clinics | | | | There are plenty of electronic billing |
| this is the medical biller's job!Medical | | | | programs available that can be set up through |
| billers and coders usually work forty regular | | | | home office computers. Also, there is the |
| office hours from Monday through Friday on a | | | | possibility to become an independent |
| desk in the billing office or billing | | | | insurance specialist or consultant who helps |
| department of the professional healthcare | | | | patients understand their insurance bills and |
| office. They must know the different methods | | | | what they should be paying.Opportunities also |
| of billing patients, understand various | | | | exist as patient account managers, physician |
| collection methods, ethical and legal | | | | office supervisors and management, various |
| implications, have a good working knowledge | | | | types of personnel managers in the healthcare |
| of medical terminology, anatomy, medical | | | | industry, health claims examiners, and medial |
| billing and claims form completion, and | | | | billing and coding instructors. The more |
| coding. They also must understand database | | | | education the individual has, the more |
| management, spreadsheets, electronic mail, | | | | employment options are available and |
| and possess state-of-the-art word processing | | | | advancement opportunities become virtually |
| and accounting skills, be proficient in | | | | unlimited!Professional CertificationAs in so |
| bookkeeping, and be able to type at a speed | | | | many healthcare professions certification in |
| of at least 45 words-per-minute.The work area | | | | the medical billing and coding field is not |
| of medical billers and coders usually is in a | | | | required but highly recommended. The days of |
| separate area away from the patients and | | | | the single family practice medical assistant |
| public eye. However, even though they are not | | | | or nurse typing out an invoice after office |
| involved in the actual process of doctors and | | | | hours are history. Even the smallest offices |
| healthcare professionals providing medical | | | | and clinics have changed to computer billing |
| care they need to possess excellent customer | | | | because it offers greater coding accuracy, |
| service skills when it comes to making | | | | saves time, and can be used by administrators |
| contact with clients, insurance companies, | | | | and auditors to ensure that visits are being |
| and often patients. Medical billers must know | | | | coded to the appropriate levels which |
| how to explain charges, deal with criticism, | | | | increases revenues.Understandably, these |
| give and receive feedback, be assertive, and | | | | offices and companies are looking for |
| communicate effectively without becoming | | | | individuals who are certified in their field |
| confused as the person is asking questions. | | | | to ensure the employer that the individual |
| Patients can quickly become frustrated when | | | | whom they hire is competent and |
| trying to deal with healthcare providers and | | | | proficient.There are numerous well known and |
| bills over the phone.While an increasing | | | | well respected organizations sponsoring these |
| amount of patient care is being funded | | | | types of examinations. Intersted candidates |
| through HMO related insurance, where the | | | | should research each one and find the one |
| patient makes a small copayment at the time | | | | that most suits your needs: American |
| of service and the doctor bills the managed | | | | Association of Medical Billers (AAMB) offers |
| care company for the balance, a number of | | | | Certified Medical Biller (CMB) and Certified |
| patients still need to make arrangements to | | | | Medical Billing Specialist (CMBS) |
| pay for their medical services over a period | | | | examinations. The National Association of |
| of time. Part of the medical biller and | | | | Claims Assistant Professionals (NACAP) offer |
| coder's job is to contact some of these | | | | Certified Claims Assistance Professional |
| patients from time to time regarding a past | | | | (CCAP) and Certified Electronic Claims |
| due bill. Incoming calls from patients who | | | | Professional (CECP). The examinations for |
| have questions regarding a bill are also | | | | Certified Procedural Coder (CPC), Certified |
| directed to the medical biller's office. The | | | | Coding Specialist (CPS), Accredited Record |
| way s/he communicates over the phone can make | | | | Technician (ART), and Registered Record |
| or break business relationships.Other | | | | Administrator (RRA), are administered through |
| specialties closely related to the medical | | | | the American Health Information Management |
| billing and coding profession are:Medical | | | | Association (AHIMA). The National |
| Coders/Coding SpecialistsPatient Account | | | | Healthcareer Assosciation (NHA) is offering |
| RepresentativesElectronic Claims | | | | their Medical Billing and Coding (CBCS) |
| ProcessorsBilling CoordinatorsReimbursement | | | | credential.If your objective is to work for a |
| SpecialistsClaims Assistant | | | | medical office, group practice, healthcare |
| ProfessionalsMedical Claims AnalystsMedical | | | | provision network, or hospital as the medical |
| Claims ProcessorsMedical Claims | | | | billing and coding specialist keep in mind |
| ReviewersMedical CollectorsWhat is Medical | | | | that most private practices, organizations |
| Coding?Every healthcare provider that | | | | and hospitals throughout the country not only |
| delivers a service receives money for these | | | | prefer but often require national |
| services by filing a claim with the patient's | | | | certification as a competency standard.To |
| health insurance provider or managed care | | | | learn more about this very rewarding career |
| organization. This is also referred to as an | | | | visit the Medical Billing and Coding Net web |
| encounter. An encounter is defined as "a | | | | site at 2003 Danni R. of the Medical Billing |
| face-to-face contact between a healthcare | | | | & Coding Net. Reprint permission available by |
| professional and an eligible | | | | request.Article must be complete and must |
| beneficiary."Codes exist for all types of | | | | include all contact information. |
| encounters, services, tests, treatments, and | | | | |