Your Medical Billing Certification Online course will help you familiarize yourself with the terminologies that you will find yourself using on the job every day. As a medical billing specialist, you must know what these words refer to or it might interfere with how well you can do your job.
Besides the billing terms that you will be bandying about, words from other fields will also be a part of your vernacular. For instance, the names of medical procedures, surgical procedures, diseases will also be known to you along with the terms in accounting. Moreover, you will also be expected to have extensive knowledge of the healthcare system and the field of insurance. Lastly, your employer will also expect you to know your way around medical code sets.
Nobody can remember everything. What you can do is take a course on medical billing terminologies that will introduce you to these terms and help you understand them. The better you are at recognizing what a certain term means, the faster you will be at your job. Otherwise, you will just be dragging along a dictionary with you all day long at work!
We have gathered here just some of the terms that you will be taught in the medical billing terminology course. Additionally, we have included their definitions for better understanding:
Allowed Amount
As you study Online, you will come across this term. It refers to the amount of money an insurance company will reimburse for a procedure/service. Whatever is left after the payment will be paid by the patient. However, the allowed amount is different from co-pay or deductibles and should not be confused with either.
AMA
The American Medical Association (AMA) is the biggest consortium of doctors in the US. They also publish a journal known as the American Medical Association. It is considered to be the most widely distributed medical journal globally.
Beneficiary
Another important term taught in the Medical Billing Certification, the beneficiary is the person getting the benefits based on the coverage they signed up under their healthcare plan. It doesn’t necessarily have to be the person paying for the insurance since some parents can also be paying for their young children – the latter being the beneficiaries.
Capitation
At your Medical Technical Institute, you will also learn about capitation, which is the arrangement between an insurance payer and a healthcare provider. Depending on the amount that is decided, the former will be paying a sum to the latter for every patient they treat. Health Maintenance Organizations (HMOs) are the healthcare institutions that usually have capitated arrangements. The objective is to get patients to sign up with an HMO who will reimburse part of the money that a procedure costs. The amount that is paid will be determined by several factors, such as the condition of the patient’s health, how old they are, any family history of all illness, their race, etc.
Civilian Health and Medical Program of Uniform Services (CHAMPUS)
Civilian Health and Medical Program of Uniform Services (CHAMPUS, now known as TRICARE) is also an important term to know for those interested in obtaining a Billing Coding Certification Online. CHAMPUS is the federal health insurance program that has been designed around service members – both active and retired –, their families, and the people who survive them.
Downcoding
Medical Billing and Coding Curriculum will also include the term, Downcoding. It refers to there not being enough evidence for an insurance company to approve of a claim for a certain medical service. A coder might say the medical service was performed but without evidence, the insurance company will remove those codes thereby also reducing the amount they would be paying to reimburse a patient.
Explanation of benefits (EOB)
Billing Coding Certification also involves knowing about Explanation of benefits (EOB). This document explains which services are covered by an insurance company. It is attached to a processed claim and can be used both by the provider and patient. Often EOBs are also used to indicate the reason behind a patient’s claim being denied.
Financial Responsibility
Where to Get Medical Billing and Coding becomes important when you realize how your certification influences your career choices in the future. For instance, financial responsibility is a term that you should be familiar with. It refers to the person or entity who owes healthcare provider money for the medical services the former was rendered. That means a patient and an insurance company can be both financially responsible.
Health Insurance Portability and Accountability Act (HIPAA)
Where Can I Learn Medical Billing and Coding is a question you should spend some time answering. Your course should help know about important terms, such as Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a law that was passed in 1996 but still continues to affect the healthcare industry. It is divided into two titles, of which Title I has been designed to protect the health insurance of workers switching jobs. Title II, on the other hand, is centered on the standards and best practices that all facilities must adhere to, regarding electronic health care.
ICD-9 Codes
Knowing Where To Learn Medical Billing and Coding is important but so is knowing what the ICD-9 codes are. They are understood internationally and represent different medical condition diagnoses. They have been put in place after consultation from physicians and can be used to translate what the former says about a patient’s illness. The billing specialist will translate the diagnosis into ICD-9 codes, which are then added to a claim and processed.
ICD-10 Codes
The ICD-9 Codes were updated in 2014 and the updated version became known as the ICD-10. They work in the same way as their predecessor used to.
There are many Medical Billing and Coding Schools out there but if you want to be the best at your job, then you need to invest in the highest quality of Medical Billing Training available to you! Choose a course that covers all the essential terminologies that a billing specialist should know and you will have won half the battle!