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Posted on April 14, 2014 by · Leave a Comment
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Medical Billing And Coding

About Medical Billing And Coding

Qualified medical billers, who work with the finance department of the hospital, perform the billing and coding jobs. Assigning industry established codes for the medical procedures on patients for obtaining insurance claims, description of treatments received and all other aspects that pave way to pecuniary transactions during the course of treatment etc. is dealt by medical billers and coders. They are involved in the process of collecting the information from laboratories and doctor’s notes to arrive at the payments due to the insurance companies.

Medical billing and coding professionals keep records for catering to the needs of the health insurance providers and patients. These codes will be made available for calculating the amount of reimbursement provided by Medicaid and Medicare. Medical billers and coders use the industry manual and the coding knowledge for generating relevant information regarding medical procedures.

The process

When a medical procedure is done, the medical billers implement the process by making a claim. The patient authorizes and signs the claim. The document also includes a section named ‘assignment of benefits’ that asks the health insurance provider to make payments to the physician. A lot of information facilitating the claim like details of the heath care service provider, insurance provider, insurer, insured, the medical history, and the situations that lead to make a claim are included in the document.

Qualified Medical Billers

Medical Billing And Coding Procedures

Preparing a claim requires the medical billing professional to have the knowledge of Current Coding Protocol (CCP). It includes various sections like surgery, anesthesia, pathology, radiology, evaluation and management, and laboratory. It should be in the designated order so that the health insurance provider can make the reimbursement procedures as fast as possible. The health insurance company either pays the bill or rejects the claim. In case the claim is rejected, it will be reviewed. The billing professional needs to resubmit the claim to the health care provider. Until the claim has been made in full, the health care service provider and the insurance provider can negotiate for the payment of claims.

Once it is received, the medical billing professional collects, processes and posts the accounts receivables. The receivables account shows the payments made by the insurance company and the patient. The medical biller needs to attend to any queries posed by both the patient and insurance service provider during course of making claims.

Medical billing and coding jobs encompass a wide range of aspects and adhering to these principles makes the functions easier for the health care service provider, the patient and the medical biller.

Posted on February 26, 2014 by · Leave a Comment
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Medical Billing And Coding

?Š ?Š Medical Billing And Coding Professionals

Medical billing and coding program allows doctors and healthcare practitioners to devote quality time for implementing medical procedures, research and so on. Mostly, the payments on medical procedure are met through insurance providers.

In fact, the processing of medical bills consumes quite a lot of time. In order to assist health care professionals and clinics, there are several billing and coding companies handling the payment of medical bills to the insurance providers.

Usually, the health care insurance provider pays the cash for patients. Hence, the doctors, in effect, get paid by the insurance companies. With the advent of medical billing professionals, doctors began hiring them for the purpose of easy redemption of bills.

Why use a medical billing software program?

Medical billing software caters to the payment needs of doctors and health care professionals, no matter how they chose to perform. It is possible for you to hire a medical billing company or a medical biller working from home. Medical billing software handles electronic patient charts, scheduling, claims processing and much more.

Electronic medical billing allows document and billing automation. In fact, it uses practice management software and electronic medical records (EMR). The patient registry software is used to record and organize health records, patient billing and insurance claims.

Insurance Providers

Hiring Medical Billing And Coding Companies

When the patient‘«÷s records are encoded in Electronic Medical Records, the details are tied with the system automatically. The process gives the information to the related fields and it is used for claiming insurance. In fact, electronic medical billing allows completion of payments on time. EMR enables the doctors to check and verify the procedures conducted on patients and enter the bill on a real time basis.

Certain EMR facilities allow health care professionals to check the status of insurance eligibility for patients. They assure you that the information furnished by the patients is correct and can be put for verification before rendering the health care services.

It is possible for the hospital management to link the existing accounting system with the medical billing software. It acts as a cash flow program that gives a check on the financial reports and the areas of improvement required.

Before hiring a medical billing and coding service company, the hospital management needs to check if the system works flawlessly. The decision on adopting a system is to be done after verifying inventory tracking, ability in handling offices, the number of doctors and so on.

Posted on February 12, 2014 by · Leave a Comment
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Medical Billing And Coding

?Š ?Š ?Š Medical Billing

Are you interested in pursuing a career in medical billing and coding? Then, it will do you well to go through the contents of this post. There are innumerable ways through which you can avail the best education, certification or training to obtain a job as a medical insurance specialist.

How to become a medical insurance specialist

You can learn all you need to and pick up the requisite skills by means of the on-the-job training as a medical insurance specialist or certified medical biller or coder. You should be able to find employment in the billing service or healthcare facility, particularly in the department which is most apt for you. That way, you will land yourself the proper job. That will make it possible for you to make the transition to the medical billing and coding job which suits you the best.

Formal training is a prerequisite for those interested in entering this field. You will need to study diverse subjects like-anatomy and physiology, medical terminology, medical billing practices, software applications and medical coding practices. You might have to pursue additional courses in English, communications and other such educational courses, depending on the school and the training programme, or the prescribed course for the degree or certification.

Best Education

?Š ?Š ?Š ?Š Medical Coding

You can get medical billing training or medical coding training or both through different ways. That will put you on the track to becoming a medical insurance specialist. Training can be obtained through specialized online schools. Both community colleges and two-year courses will equip you with adequate training required for the field. Upon completion of the course, you will be awarded an associate degree or a certificate in medical billing and coding.

For the one-year program, you will obtain a certificate. Upon completion of the two-year program, you will be awarded an associated degree. With the associate degree, you will have to attend classes for fulfilling the requirements. In both these cases, it will be required of you to transfer credits, should other schools need it. Check this thoroughly before you proceed.

These are some of the criteria to be satisfied to become a medical insurance specialist or medical biller or coder. If you think you have what it takes and if you find the discipline appealing and challenging, take the plunge without a second thought. A fulfilling and promising career awaits you at the end of the line!

Posted on January 27, 2014 by · Leave a Comment
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Medical billing codes

?Š ?Š ?ŠMedical billing

Both medical billing and coding belongs to the group of service providers who serve doctors. These people are so much immersed in their profession that they do not have time to file for insurance claims to get paid for the services that they offer. Almost all the patients today are tied with health insurance companies and these companies pay for their health care needs. In such a situation, the doctors will have to file claims for reimbursements for the services that are rendered to their patients. It is in this situation that the medical billing codes become significant and the medical billing and coding professionals step in.

A person who knows very well about the medical billing and coding can be usually considered as an expert in the field. The remuneration of the professional who knows the medical billing codes depends on his/her training, skills, experience and the effective application of the skills. The recent reports on the salaries offered show that the medical billing or coding professional can earn anywhere between $33,370 and $415,061 per year. It is obvious that this kind of income will surely attract many individuals to this profession.

The institutions who seek the help and support from the medical coding and billing professionals include clinics, physicians, patients and hospitals. We can also include various medical offices and insurance companies to this group. It is rather an easy task to enter the medical billing and coding profession. These jobs require high skills, experience and expertise in handling numerous important and critical areas of healthcare management. This includes billing, medical office management, submitting claims, insurance claims processing etc.

Medical billing and coding

?Š ?Š ?Š ?ŠMedical coding

The complete process of medical coding and billing starts much ahead of the patient actually turning up at the medical center and the steps finish after the patient has been diagnosed and prescribed with drugs by the doctor. This is done to avoid any belay, miscommunication or inaccuracy during the filing of the insurance claims. For this reason, it is very important to verify and correct the insurance benefits much before the patient steps into the clinic. After the doctor has checked the patient, the observations of the doctor are recorded in the medical record. This medical record is then converted into the appropriate medical billing codes, which are then used for coding the insurance claim.

One of the biggest advantages of this job is that you can even work from home. All you have to do is consult your local college or education center and enquire about the details of their medical coding and billing programs.

Posted on January 20, 2014 by · Leave a Comment
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medical billing and coding

?Š ?Š ?Š ?Š ?Š Medical billing issues

Today, the success of the medical industry depends on the skills of medical coding & billing specialists to a great extent. These operatives help in maintaining and organizing the endless stream of vitally important medical information processed through hospitals and private practices.?ŠHence, this profession can be said to be part of the clerical side of the health care system, which deals with and manages the medical care revenue cycle.

What Is Medical Coding And Billing?

The fact is that every duty performed in a medical office has a particular code assigned to it, and it needs to be coded properly in order for proper billing. As the name suggests, the job of a Medical biller is to making sure that everyone is being billed correctly. This may also involve conversing with patients and the health insurance companies on a regular basis, to make sure all the bills are paid on time. However, the biller should be able to understand coding language and how to read medical invoices.

Medical coders, on the other hand, do not require too much interaction with insurance companies and patients. Instead the person needs to spend his work time in accessing the coding data.

Hence, the medical coder and biller often need to work together to make sure all invoices are paid properly.

Some of the important tasks performed by the medical billing and coding officers are:

Insurance Verification

  • It mainly involves the insurance agencies as the medical billers and coders require verification of the authenticity of insurance credentials provided by patients.

Patient Information Recording

  • The medical billers and coders gather all the necessary information of the patients to fill up their claims.

CPT And ICD-9-CM Coding

  • Once, they check the diagnosis report and other statements, they need to apply codes to make a statement.

Charge Entry And Claims Submission

  • This involves in check the services offered and booking the equivalent amount. Once the information is gathered, a detailed report is sent to the insurance agencies as a part of claim submission.

    health insurance companies

    Medical coding jobs

Payment posting

  • Here, the settlements or payments from insurance companies are checked and booked.


  • Once, the medical billing and coding officers have sent the claim application to the insurance agencies, they need to do a follow-up of the procedures.


  • This involves giving the management concrete feedback on the status of the revenue cycle.

Hence, these are some of the aspects involved in the profession of medical billing and coding officers. For more information on this, check our official website.

Posted on December 26, 2013 by · Leave a Comment
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medical billing salary

?Š ?Š ?Š ?ŠMedical billing

Most of us are aware of the fact that medical billing and coding is a part of the healthcare industry. You may also know that the healthcare industry is the sector with the highest growth percent and chances for getting jobs in US. Medical billing is the most sought after career by many people as the demand for the biller from billing services, billing companies and Doctor‘«÷s offices are always high. Even though many consider medical billing and coding as same, different codes are implemented before billing.

The job of a medical biller is to collect posts and manage the payments on accounts of medical and health related businesses. If you have long years of experience and if you pass the specified examination, you will be a certified medical billing specialist. The medical billing salary you may get depends on the experience you have and the certifications you possess. The hourly rates for medical billing specialists will be much higher than medical billing assistants or clerks. It is the job of the medical biller to claim for heath insurances and follow up with the insurance companies about the claims.

medical billing and coding

?Š ?Š ?Š ?Š ?ŠBilling salary

The medical billing salary you may get depends on the amount of education you have had in the field of medical billing and the experience in the field. The salary will increase if you have higher education or if you have higher experience. However, having more experience in the field will give you more salary rates when compared with the amount of education. The minimum education you must have to get the job of a medical biller is a high school diploma or GED. Since there is no specific educational requirement for getting medical billing jobs, you can change to this field whenever you please.

One of the major features of the medical billing industry is it is highly demand-specific job. The salary you get highly depends on the demand available in the field and the area or region in which you reside. Even though most of the billing work is in the daytime, some companies do offer evening and graveyard shifts for catering to the needs of the customers.

If you choose to work in the graveyard shifts, you will get better medical billing salary wages. So it is better for you to move to this field when you have time rather than waiting for the salary to increase.

Posted on April 11, 2011 by · Leave a Comment
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We’re already in 2011 and the need to improve the overall efficiency of our medical billing and coding software is more relevant today. The practice costs are increasing day by day, and with stagnant and receding reimbursements, the challenges before medical professionals are really daunting.

Here we are providing some suggestions that can help medical billing professionals in avoiding some common mistakes:

1. Hire the services of an experienced person to work on this software. With lots of unrecognized get-rich-quick type of courses churning out half baked professionals, you should ensure that you are hiring a best biller.

2. You should use the medical billing and coding solution to its fullest. With ever changing software and regulations they need to adhere to, you must opt for latest system and do regular updates to be in-line with latest regulations and requirements. You can solve majority of problems by opting for a close relationship with the medical billing and coding software company.

3. It is quite common to heap all abuses on insurance payers for increasing denials or write offs. Instead you must do some introspection on tackling the repetitive issues that occur with different payers. Try to keep the journals of the particular insurance companies with whom you had issues and see as to what improved the performance with them. What may work with one payer many not click with another one. Success lies in dealing with multitude of payers by addressing all external and internal issues for raising the overall performance of payers.

4. It has been seen over time that small companies with less than 70 employees are quite susceptible to internal frauds. Such companies rarely have efficient control mechanisms in place to prevent the thefts and people are put into responsible positions without checks. A single dishonest employee can cost thousands of dollars to a medical practice. By establishing requisite software solutions to control the money flow can result in huge savings within s shortest period of time.

5. We are today fortunate to have access to latest technology that has evolved with time and can take care of billing office requirements to a great extent. Offices that will fail to modernize with time will fail and become obsolete. With increased focus on medical billing software solution it is essential for physicians and their offices to shift to this solution within shortest possible time. Medical software can take care of complicated tasks like use of predictive dialer, scrubbing claims, electronic remittances, and much more.

A thorough evaluation of your medical office by a medical billing professional can assist you immensely in streamlining your office mechanism to ensure that it is running efficiently.

Posted on January 11, 2011 by · Leave a Comment
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Medical billing and coding make an exciting career option. The training to be undertaken is not too intensive nor exclusive most local community colleges and private schools offer programs in medical billing and coding. You can choose to work from the comfort of your home or on-site at a medical facility.

There are various aspects that go into making a good medical billing and coding specialist though. Apart from understanding the numeric codes that make up the billing process, you will need to learn medical terminology. To enter codes, it’s important that you understand the procedures involved. You will also have to master at least one of the many software designed to aid a medical billing and coding specialist.

An eye for detail is important in this field. The procedures involved will usually have an assortment of sub-procedures that need to be examined closely. As a technician, it is your responsibility to know exactly how these are to be coded.

A specialist should also have an insight into the ever-changing dynamics of insurance. Codes will change all of the time and you need to keep yourself updated. Flawed codes can cause needless delays and snags in the process, ultimately affecting the medical professional you work for and the patient you serve. So you are a vital cog in keeping the medical machinery running smoothly! No wonder that medical billing and coding specialists are paid well.

But once you get the hang of it, the work is pretty simple and the hours quite manageable. A specialist will find that he/she earns a pretty good living with less than a full day‘«÷s work.

Posted on October 5, 2010 by · Leave a Comment
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Medical billing and coding specialists submit claims to health insurance companies so that health care professionals can receive payment for the services they provide. Billing and coding specialists work in claims processing departments or billing departments in hospitals, clinics, doctor’s or dentist’s offices, or nursing home facilities. However, a billing and coding specialist does much more than submit bills for payment.
What Skills Do You Need To Succeed In Medical Billing And Coding?
Preparation for this career begins in high school. Courses in mathematics, biology, health, typing, and computer and office skills are recommended. In addition, a student interested in this field should have strong people skills and be able to pay attention to detail.

What Duties Are Performed?
After services are rendered at a health care professional‘«÷s office, it is the medical billing and coding specialist‘«÷s job to see that payment is collected. It is a two part process. First the specialist has to apply codes to all medical procedures and treatments. This information is then used in the billing process. The bill will be reviewed and compared against the patient‘«÷s insurance coverage. An invoice is then prepared and an invoice is submitted. But that is not all the duties of a billing and coding specialist. Bills are searched diligently for errors, and negotiations with collection agencies are performed. Patients often have inquiries about their health care plans and many hours are spent on the phone with insurance companies.

What Else Do Billing and Coding Specialists Know?
Medical billing specialists must be knowledgeable of many legal aspects of the field. There are laws pertaining to medical billing and collections. Specialists also need to know laws that pertain to the release of patient records, patient confidentiality rights, and workman‘«÷s compensation rules. Medicare regulations for reimbursement are required knowledge as well.

What Degrees Are Available?
Jobs with the highest paying salaries are awarded to employees that hold a certificate or degree. There are online degree and certificate programs available. An Associate Degree in Medical Records, Medical Coding, and Health Care Reimbursement can be earned. Certificates and diplomas are available in medical coding as well. To become certified, exams must be passed from the America Health Information and Management Association and the American Academy of Professional Coders.

What Does A Billing And Coding Specialist Earn?
Depending on where the practice is and the size of the office or hospital will determine salaries. On average, a billing and coding specialist will earn anywhere from $35,000 to $45,000. Specialists can expect to work office hours Monday through Friday. However, many work from their homes.

Many job opportunities are available for billing and coding specialists. Hospitals, clinics, and physician’s offices need specialists that are efficient and knowledgeable. As technology changes there will be a need for coders with the most current knowledge of new technology.

Posted on October 1, 2010 by · Leave a Comment
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Medical billing and coding is a field that specializes in filing insurance claims to ensure payment is received for the services that were done by the health care provider. Once the claim is filed with the insurance company, the medical billing staff is to follow up on the claim to ensure proper processing. From the start of the claim until it is completed is called the billing cycle. This cycle could take anywhere from 2 or 3 days, to 2 or 3 months. The time of the billing cycle depends on the type of claim being filed and the insurance company it is being filed with.

The billing cycle begins from the moment the patient enters the medical facility. The Medical billing and coding staff collect information from the patient such as: name, address, phone number and insurance company. This information is updated every time a patient enters the doctor’s office to keep the information up to date and ensure the billing process goes smoothly.

The patient is then seen by the doctor and the extent of the visit is broken down into a 5 digit code from the Current Procedural Terminology (CPT) database. Then the diagnosis is also translated into a code from the ICD-9-CM database. Once the correct codes are determined, the claim can be filed electronically. This is done by using the Electronic Data Interchange. The claim must first be formatted as an ANSI 837 file. Filing claims electronically is the most effective way to get the claim processed and the payment received.

Often times, claims will be rejected and the medical billing and coding office will have to start the process over from the beginning. If there are errors in the coding procedure, they will be corrected and the claim will be refilled. If there are no errors detected, the patient will be sent an Explanation of Benefits (EOB). If the patient feels there is an error, they can request the claim be filed again. Insurance companies sometimes deny claims if they believe the procedure was not medically necessary.

If the claim is not rejected, payment will be sent to the medical facility in the amount the insurance company is responsible for and a notice will be sent to the patient to pay the balance if there is any. Since 2005 Medical facilities have been urged to file all claims electronically and keep up to date records on all of their patients. This is a regulation instituted by the Health Insurance Portability and Accountability Act (HIPAA). Medical billing is always changing, but it is a very important field that will always be a necessity.

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