Medical Billing Job: What You Can Expect

Dear Google,

I am preparing for a career in medical billing. I want to know how medical billers spend an average day at work.  What do they do? Who do they interact with? How much workload do they have? Do they have flexible work timings? And any other additional information that you can provide me with to help me better understand of what I can expect when I get into the workforce.

Google is reading your message and writing a reply…

Hello, Aspiring Medical Biller!

An average day in the life of a medical biller is quite exhaustive. You have plenty of claims to create. You have a lot more claims to file. And then, there are some returned rejected claims that you have to review, correct and file again, so that the patient and the doctor can be properly reimbursed.

This can be all too tiring.

But come the end of the day, knowing that you made a difference in the life of yet another patient is definitely satisfying. You get a sense of accomplishment that only medical billers can relate with.

Your job is one of the most satisfying jobs out there and it also pays quite well.

When you will join your first organization, probably the very first question that your employerwill ask youis: what shift timings will you prefer?

A medical billing job offers flexible shift timings. You can choose any schedule you want. Some medical billers are early birds; some love working in the afternoon, while others are happy to work at night.

During their shift, a medical biller is expected to complete and file a fixed number of insurance claims. This number varies from employer to employer. Before leaving for home, you should complete and file the claims assigned to you for the day. Of course, some claims take time to be created, so unless there is a pending deadline, you can take your time.

Medical billers must make sure that the claims they are creating are accurate and free of all errors. For that, a medical biller needs to be in constant communication with doctors, medical coders and the respective insurance companies.

Besides creating, filing and reviewing disputed claims, medical billers may also have other job responsibilities.

Some medical billers deal in full practice management where they handle all aspects of billing for the organization they are working. That is, from submitting claims to tracking accounts payable and receivable to billing patients.

These other responsibilities do not require the understanding of medical coding schemes, but are nevertheless detail intensive.

So, the Aspiring Medical Biller, does this answer all your questions?

Do you have some more questions to ask?

Google recommends consulting the expert team of Allied Prep Technical Institute for any further help.

For now, Google would like to take your leave.

Good luck for your future!

A BONUS read: 9 Qualities that Put You at the Top of the List for Employers After Medical Billing Certification.

 

The Advantages of Hiring an Experienced Medical Coder

For the longest time, the complicated processes of medical billing and medical coding were performed by licensed practitioners – even though they weren’t trained for the job. As the years went on, doctors and dentists alike began to realize that these two domains of healthcare are extremely complicated and should be handled by experienced billers and coders.

Thus began the migration towards outsourced medical billing and coding. If your healthcare center is late on the trend, allow us to explain how your professional practice stands to benefit from hiring an experienced medical coder.

1. Extensive Knowledge:

The best thing about getting an experienced medical coder on board is the unmatched wealth of knowledge and expertise that they possess. It’s no secret that coding is an incredibly difficult job (as the 10th rendition of the International Statistical Classification of Diseases alone boasts more than 68,000 different medical codes).

However, by hiring a medical coder, you eliminate the need to memorize these codes and can focus on offering the best healthcare services to your patients.

2. Unmatched Experience:

It goes without saying that if you run a medical or dental practice, there are going to be complications involved. After all, every coder or biller who has worked in the industry for a long period of time is no stranger to rejected claims or payment complications.

That being said, experienced medical coders who have handled complicated projects in the past know how to handle these scenarios so as to minimize the downtime and enhance the end-user experience. Therefore, by hiring them, you can significantly improve your brand image and make things easier for your patients!

3. HIPAA Compliance – Guaranteed!

Allied Prep Technical Institute

HIPAA compliance is mandatory for all medical and dental practices as any violations can leave you facing heavy sanctions and fines. What complicates proceedings is that these regulations change with time which makes it difficult for licensed practitioners to stay HIPAA compliant.

This is where an experienced medical coder comes into the picture. These highly-trained individuals know all there is to know about HIPAA compliance and can help your practice adhere to the ever-changing rules and regulations. This prevents financial losses and ensures that your practice doesn’t have to bear the brunt of lawsuits and legal proceedings.

4. Distractions Minimized:

The needlessly complicated process of medical coding can be very distracting to licensed practitioners who have little to no training in this domain of healthcare services.

In fact, medical coding can even limit their ability to care for their patients as they have to spend a significant portion of their day performing billing and coding tasks.

However, with an experienced medical coder on deck, doctors can minimize distractions and focus primarily on the quality of healthcare they provide.

This does wonders for the end-user experience and can even help you attract more patients in the future.

It’s because of these reasons (and countless others) that we’re such strong advocates of hiring experienced medical practitioners. We hope that this blog post has underlined the importance of medical billing and that your practice will only rely on experienced professionals in the future.

About Allied Prep Technical Institute:

We are a medical training institute that offers medical billing and coding training and certifications to our students on our campuses and online. Our rigorous tests and training programs arm our students with the knowledge and the expertise they need to perform their job at the highest level possible.

Contact us today to learn more about how you stand to benefit from signing up for our classes!

Mythbusting: Medical Billing Edition

There are countless medical brochures that promise a life of riches to medical billing students provided they sign up for a six weeks course. Promotional brochures take sensationalism to the next level by falsely promising lucrative incentives like short work hours, easy workload, and simple training, etc.

It goes without saying that these statements are senseless myths that don’t have a shred of truth attached to them. As such, we’ve decided to discuss and debunk a few of the most commonly heard myths about the noble profession of medical billing.

Myth #1 – Medical Coding And Billing Are The Same Profession:

The biggest misconception people have about medical billing is that it’s the same thing as medical coding. Given the fact that the aforementioned promotional brochures use the two terms interchangeably, it’s no surprise that this is one myth that just refuses to go away.

Make no mistake about it; medical coding and medical billing are two different (but complementary) professions. The former is about transforming medical records (such as prescriptions and test results, etc.) into alphanumeric codes so that they can be understood by the medical biller.

Similarly, a medical biller takes these alphanumeric codes and generates an easy-to-understand bill. However, prior to medical bill generation, the medical biller must also verify the validity of medical and insurance documents so that the patient is guaranteed a quicker and a smoother healthcare experience.

Myth #2 – Medical Billing Professionals Work From Home:

Medical Billing Edition

Although mobility may be the talk of the town in the healthcare industry, medical billing – as a job – isn’t necessarily performed from home.

Medical billing professionals, especially those who have less than 5 years of experience in their relative field, must work under the direct supervision of an industry veteran. This is done to ensure that a novice medical biller doesn’t make any errors in the process which may lead to processing delays.

However, once a billing expert has worked in their industry long enough, medical and dental practices are more than willing to let them work from home.

Myth #3 – Medical Billing Is Easy:

By far the worst thing we’ve heard about medical billing is that it’s easy. The general public (and even doctors to some extent) constantly undermine the importance of medical billing and the work done by medical billers by calling their work unimportant and simple.

Contrary to popular belief, medical billing is NOT an easy profession. First and foremost, the medical biller needs to acquaint themselves with standard medical code sets and subsets. Extensive knowledge about these domains makes it easier for the biller to convert codes into healthcare claims that must be submitted to the insurance company.

Once the claim has been processed by the insurance company, the returned claim is handed over to the medical biller for final verification. The medical biller must then draft a final bill that takes every detail into account and is in line with the claims of the insurance provider.

That being said, this doesn’t mean medical billing is rocket science as there are some simple steps you can take to improve your understanding of the noble profession. You could choose to enhance your understanding by enrolling in medical billing online classes offered by medical training institutes.

Allied Prep Technical Institute also offers comprehensive classes that will help you develop a better understanding of medical billing and give you a competitive edge over your peers. Enroll in our classes today to significantly increase your chances of succeeding in the billing industry!

ANSWERED: 5 Commonly Asked Questions at Medical Billing Job Interviews

Medical billing and coding are two booming professions that are set to expand in the near future. In fact, the United States Department of Labor has predicted that the employment rates in the industry are set to increase by 21% by 2020! Continue reading “ANSWERED: 5 Commonly Asked Questions at Medical Billing Job Interviews”

The Medical Claims Process – Courses in Medical Billing and Coding

Medical Billing Certification Online won’t be complete without a student familiarizing themselves with the medical billing insurance claims process. It is a complicated but entirely necessary procedure that begins after a healthcare provider sends a bill for the medical services they have provided to a patient to the designated payer. In most cases, the latter is a health insurance company who will be analyzing the

claim to see if it merits reimbursement.

As you take your classes Online, you will learn about processing such claims. As an expert in Medical Billing Certification, you will have to insure that before the claim is sent out, all the protocols have been followed. Additionally, there are industry standards that must also be adhered to. Only through constant vigilance will the payment be swift.

At a Medical Technical Institute, you will also be taught how to enter patient data into software and retrieve it when needed in order to prepare claims. The problem with such software is that most healthcare facilities use a different one. Therefore, there is no universal software application that you can learn and apply everywhere. Even so, the good news is that most software like that operates along the same lines. After all, the healthcare providers have to follow the standards set by Code Set Rule (TCS) and HIPAA Transactions.

While studying to receive your Billing Coding Certification Online, you will discover that the insurance claims can be delivered to the payers through two different methods. One is the standard manual method whereby the claim is on paper. The other is the electronic method, which has become the method of preference for most insurance companies and healthcare providers.

That’s because it is cheaper to process an electronic claim – the healthcare providers save $3 per claim. Moreover, electronic claims are generated in less time and lack human error to a high degree. So why should you learn how to do it manually, you ask? Since not all healthcare facilities have switched to the electronic way yet, Medical Billing and Coding Curriculum includes both.

Electronic Method

Billing Coding Certification requires students to be familiar with the electronic method of processing claims. This means that the billing specialist will use software to enter the relevant information into the institutional and non-institutional documents for claims. When this process is done manually, illegible writing, and human error could result in unreadable information. That is not the case here because a scrubbing option removes any errors that it finds in the documents. However, as a medical billing professional, you would need to remain diligent because the software can make mistakes as well.

As you decide Where to Get Medical Billing and Coding, try looking for a course that also teaches students about OCR equipment. The OCR technology is used to scan a document, so that it can separate the information needed and then fill in the relevant fields on a claims form. This makes the processing much faster and efficient. However, the OCR could make an error in reading the code for a procedure performed on the patient. A medical billing specialist must be vigilant enough to catch even a mistaken digit in a medical code and then correct it by hand.

On the flip side, you should also choose a course that teaches you more than just how to use the OCR technology when thinking of Where Can I Learn Medical Billing and Coding. That’s because you will have to convert the documents manually when the OCR equipment is not available. It will involve the use of a tool called crosswalks.

Manual Method

If you are doing the processing manually, then you would need to print out the forms and fill them first. One that is done, paper claims need to be physically mailed to the payers. Vigilance is the only way you can ensure that there is minimal room for error while you do everything manually. For instance, illegible writing or missing digits can mess up medical codes. Similarly, improperly printed documents or missing pages might take place. All such mistakes can result in payment delays.

Medical Billing and Coding Schools also include information about the two most important forms when it comes to processing claims i.e. the CMS-1500 and the UB-04 form. You will learn which form is the right one to use, depending on the conditions. Let us take a brief look at each of them:

CMS-1500

It is maintained by the National Uniform Claim Committee (NUCC). Medical Billing Training will tell you that the CMS-1500 form is universally used by non-institutional healthcare providers. That means it family healthcare physicians and other private practices make use of this form when they need to bill Medicare. If the claim is verified, the healthcare provider will be reimbursed for any services covered under Part B, as well as, certain Medicaid-covered services. Not all tax payers need to fill all the fields given on this form.

UB-04

Form UB-04 is also NUCC-maintained. However, it is used by hospitals and other institutional healthcare providers. This form is filed by a healthcare facility in response to services that are exceptions to the ones charged electronically. The Administrative Simplification Compliance Act (ASCA) mandates that physicians and other health care providers self-assess. If the services they rendered will be considered permitted exceptions, they can thus be filed through the use of manual claims. Not all tax payers need to fill all the fields given on this form.

The insurance claims process is complicated but it is also completely necessary. If you pick out the right institution to teach you the tools you will need to complete such claims on a daily basis, you will do well. That means as a medical billing professional, you need to know how to manually and electronically file a claim. You should be familiar with the industry standards and any regulations unique to the insurance company you are claiming against. Lastly, do much research on clearinghouse and adjudication processes because you will need to know them both!

Medical Billing Terminology – Courses in Medical Billing and Coding

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!