Medical Billing and Coding

The healthcare industry requires trained professionals at all levels. Whereas working as a doctor or a registered nurse would require elaborate studying, there are fringe positions that are available following a few months of training only. The medical billing and coding positions are crucial components of the healthcare industry.  To understand the importance of proper health insurance, consider the fact that the current government shutdown perpetuated due to a lack of consensus among lawmakers regarding the provisions of health insurance. Also, with talks on making health insurance mandatory for all underway, there is a huge requirement of trained medical coding and billing experts. You can find several accredited certification courses available in the profession. You can appear for the certification training even after completing an associate degree or a bachelor degree in any field.

List of Medical Billing and Coding Schools

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Job outlook

As a medical coding and billing professional, you can find employment at any healthcare center. You can look for jobs in the general hospitals, outpatient clinics, and ambulatory surgical centers. You can also find work in private clinics of physicians. At all positions, you have to undertake the responsibility of overseeing the entire treatment history of the patient, and extracting the information from the medical documents. Then, you need to assign the appropriate standard codes in preparing the insurance paperwork for the patient.

It is a job entailing critical responsibility as a wrong code can mean thousands of dollars worth of extra expenditure for the patient. You have to work in a fast paced environment, dispensing accurate codes without delaying. This would require a thorough understanding of the various standard coding systems like the CPT codes, the ICD-9 codes and the HCPCS codes.

Several certification programs

There are several certification programs for learning medical coding. You need to find an accredited course that can furnish you with a valid certificate on completion.  The AAPC (American Association of Professional Coders), and the AHIMA (American Health Information Management Association) are two key organizations that regulate majority of the certification programs in the field. Other certification trainings include the Registered Health Information Administrator (RHIA) certification and the Registered Health Information Technician (RHIC) certification.  You can also receive specialty coding certificate from the Board of Medical Specialty Coding certification. The PAHCC or the Professional Association of Healthcare Coding Specialists also provides certifications on specialty coding. Besides these courses, many online universities also offer training on medical billing and coding.

Deciding on the right program  

  • The obvious considerations

All certification programs are as good as each other are. You can select any professional program depending on your convenience. There are a few important aspects to consider. You need to find a professional program that provides comprehensive training and has the arrangements of a qualifying test at the culmination of the training. While selecting a certification program, you must look at certain critical aspects including the obvious considerations of course fees and program duration.

  • Understanding of prescriptions

First, you have to see whether the training equips you with the knowledge of anatomical terms and the relevant codes assigned to them. Just parroting the codes would not be enough. You need to understand the various medical descriptions in the prescriptions. Only when you can correctly interpret the prescription, you would be able to fill in the right codes. You do not require having extensive medical knowledge. Just a fundamental understanding of the various common medical terms would be sufficient for the coding.

  • Specialty coding programs

Some certification programs also offer specialty coding programs where you learn in detail about the various medical procedures pertaining to a particular ailment category. So, you can specialize in pulmonary and cardiac medical coding and help out the heart and lung patients. However, always look for a comprehensive course so that your job outlook does not limit within a particular sector.

  • Latest professional knowledge

Next, you must ensure that the training system offers an up-to-date knowledge into the profession. You must be aware of the fact that October 1, 2014 is the scheduled date of updating the ICD-9 coding system to the ICD-10 system. This is a major change since 1977, and the coders must be ready to face the challenges affected by this change. The number of codes would drastically increase from 13,600 to 144,000. While memorizing all these codes is impossible, yet you must not need to refer the handbook for filling up the usual insurance paperwork.

  • Effective insurance communication

a)      Insurance providers

As a coder, you would also have to maintain communications with the insurance providers on variety of issues. Problems and discrepancies in codes may develop despite your earnest efforts to enter the right details in the paperwork. You must be able to audit the codes and rectify the discrepancies. Apart from extracting data from prescriptions, you must also have the requisite expertise in entering the details of the various diagnostic tests and pharmacy invoices into the documentation.

b)      Patients and patient families

You have to attend to patient inquiries regarding the insurance. This requires a training program in soft skills and the professional expertise to explain complicated insurance scenarios. In fact, the medical coder has to be a health insurance expert in understanding the various requirements like out-of-network treatment, primary physician treatment, co-pays, co-insurances, deductibles and other out-of-pocket expenses. Since there are so many companies offering health insurance, you must have clear-cut conceptions regarding the policies of the different companies. Find the certification program that offers you a comprehensive training on all these aspects.

The salary estimates 

The US Bureau of Labor and Statistics noted that in 2010, the average salary of a billing clerk was $32,170. As medical billers and coders, you can also earn salaries in this range, but the exact amount would vary according to the healthcare center where you are finding employment. Also, the salary varies from one state to another. Here is a list of the salaries at a few states to help you gain a perspective on the earning potential of the job.

  • Texas: $32,000
  • Louisiana: $28,000
  • Pennsylvania: $31,000
  • Colorado: $29,000
  • Maryland: $33,000
  • Washington: $32,000
  • Alabama: $33,000
  • Alaska: $26,000
  • Arizona: $28,000