What Is Medical Billing and Coding?
Medical billing and coding is an ideal option for those who want a career in the booming healthcare industry but who don't want to spend years in school. Medical billing and coding specialists play an important role in the healthcare industry, with medical coders ensuring the proper classification of patient diagnoses and procedures and medical billers ensuring that insurance companies, workers' compensation providers, Medicare and Medicaid receive patient claim forms. Many individuals opt to have a dual career in both medical billing and medical coding, although specializing in both is not a requirement for employment.
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Medical Billing
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Medical billing is a process whereby the medical billing specialist submit claims to health insurance companies to ensure payment for the services provided to a patient by a doctor or another healthcare provider. Medical billing specialists are also responsible for contacting insurance companies, Medicare and Medicaid to follow up on unpaid claims and to deal with problem claims. The process of medical billing is generally the same regardless of whether the insurance company is privately owned or is owned by the government.
Medical Coding
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Medical coding, which is also referred to as medical classification, is the process where medical coders assign universal medical codes, in numeric or alphanumeric form, to medical procedures and diagnoses. To determine the procedures or diagnoses that must be coded, medical coders may refer to the patient's medical record, lab results or doctor's notes. These codes are used to track diseases and injuries and the procedures used to treat medical problems. Medical codes are used on claim forms submitted to insurance companies, Medicare and Medicaid for reimbursement and on diagnostic request forms. They may also be used internally at healthcare facilities for research and marketing purposes. Those organizations that use medical coding include healthcare facilities, health insurance companies, the federal government and workers' compensation providers.
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Considerations
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Every medical biller and coder must understand the Health Insurance Portability and Accountability Act, most commonly referred to as HIPAA. HIPAA, which was enacted in 1996, was designed, in part, to protect patient privacy and affects everyone who works in the healthcare industry. Included in the patient's protected health information is all medical records, contact information, birth date, research records and benefit explanations. The health information must be protected whether it is in written, electronic or spoken form. Medical billers and coders who have access to such information are responsible for keeping it private. Healthcare facilities generally provide HIPAA training for medical billers and coders, so they know what is allowed and what is not allowed under HIPAA guidelines.
Benefits
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Medical billing and coding specialists are always in demand in the healthcare industry. Those medical billing and coding specialists who have a Bachelor's degree in health information management or in a similar topic can generally find management positions even without a lot of practical work experience. However, you can enter the medical coding and billing field with a certificate or a diploma in medical billing and coding, which takes on average of nine months to a year to earn.
Some healthcare facilities and other companies also offer their medical billing and coding specialists the opportunity to work from home.
Career Options
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Medical billing and coding specialists work in a variety of settings, including hospitals, doctors' offices, pharmacies, dental practices, laboratories and other healthcare settings. Some also work from home. Instead of working solely for one facility, many medical billing and coding specialists opt to open their own businesses. If you have never worked in the industry before, you will likely find it easier to get started by getting a job that will allow you to gain experience and industry contacts. Once you have the experience and contacts, you can then branch out and start your own business.
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