Defining Medical Coding And Related Terms

The term 'coding' represents the specific systems used for allotting codes to objects or things of the same kind. These codes may not be understandable for the public, but the person dealing with the specific system is well aware of these codes and identifies the objects through them. Codes may be alphanumeric, numeric or both. When maintaining a record, codes are used in place of name or detail of the objects. The term 'medical coding' stands for the transformation of description of diseases, injuries, as well as healthcare procedures in numeric or alphanumeric designations.

In other words, in the medical field, codes are the indicators of the complete record of the diagnosis, procedures, and tests to be performed. Coding in all health related clinics permit to have an access to the complete history of the patient suffering from a specific disease, illness or injury under a given code. This code is very helpful when it comes to billing and all pharmacies throughout the world that are run on the basis of these codes. Suppose, for example, that you are at a clinic; if you want to know about the history, symptoms, diagnosis and treatment of any disease, you can simply enter the corresponding medical code in the search box and all the results will be complied and displayed for you.

A person who has an education in medical coding and works in the field is known as 'medical coder'. In the current decade, medical coders are high in demand. As doctors and nurses are always needed, the demand for medical coders grows as well. The reason for this is that these professionals help doctors and nurses and other medical staff to make money and stay in business, and are very helpful in training new staff in the office or facility. In order to become a successful coder, you must have sufficient practice and should not have repetition in making errors, as wrong codes could affect the reputation and the economy of the business. For instance, different coded medicines have different prices. When a wrong code is entered in the billing data, the price of that code is included instead of the real medicine taken by the customer.

Medical coders are even beginning to start their own businesses and can earn a lot of money while sitting at home, as many healthcare facilities are outsources these needs, rather than hiring a full-time person or staff. Because of this, the spectrum of job opportunities in the field continue to become more diverse, thus appealing to an even broader market of career hopefuls.

If you're looking for information about Medical Coding Certification & Training, we have more great tools and resources on our website http://www.medicalcodingtrainingcertification.com

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Medical Billing and Coding Online Schools

Online Medical Billing and Coding Specialist Schools teach courses that focus on the administration of Medical Billing and Coding for purposes of proper categorization of medical procedures and accurate billing processes. Students of Medical Billing and Coding will be prepared with those skills essential for Medical Billing and Coding processes and for Certified Medical Coding and Billing Specialist examinations for certification.

Online Medical Billing and Coding Specialist Schools train students specifically in the universal language that was developed for the purpose of streamlining medical insurance claims that ensure correct reimbursement from insurance companies for services rendered. Every symptom, diagnosis, procedure, and treatment has been assigned a numeric code that informs the insurance company which services were administered in a hospital, a doctor's office, a clinic, or other medical facility. This numeric language is used by Medical Billing and Coding Specialists to establish the exact services provided. The Medical Billing and Coding Specialist determines these codes and makes a selection based on information provided by the care provider, then processes the claim.

Online Medical Billing and Coding students can expect to study medical terminology, anatomy and physiology, reimbursement methods, law and ethics that apply to medicine, information management, and practices of various office environments.

Additionally, courses in Medical Billing and Coding will prepare students with professional skills that will allow for management of records, preparation of insurance forms, correct filing of claims, and for billing insurance companies for services rendered.

Responsibilities of a Medical Billing and Coding Specialist involve the accurate completion of billing and medical claim forms, appropriate billing, and good understanding of individual insurance company policies and procedures. Medical Billing and Coding Specialists can expect to work for hospitals, medical practitioners, medical clinics, and physical therapists, where efficient and well-prepared Medical Billing and Coding Specialists will manage billing and coding processes.

If you are interested in learning more about Online Medical Billing and Coding Schools [http://schoolsgalore.com/categories/4/medical_billing_coding_online_schools.html] please search our site for more in-depth information and resources.

DISCLAIMER: Above is a GENERAL OVERVIEW and may or may not reflect specific practices, courses and/or services associated with ANY ONE particular school(s) that is or is not advertised on SchoolsGalore.com.

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Michael Bustamante is a staff writer for Media Positive Communications, Inc., in association with SchoolsGalore.com. Find Online Medical Assisting Schools [http://www.schoolsgalore.com/categories/4/medical_assisting_online_schools.html] and other Health Care Schools Colleges, Universities, Vocational and Trade Schools at SchoolsGalore.com, your educational resource to locate schools.

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Employment Opportunities for Medical Billing and Coding Specialists

The decision to pursue a medical billing and coding career is a very smart one because this field is growing rapidly. Though the medical billing and coding salary in general is respectable, compensation varies based on factors like geographic area, type of employer, and specialization in a certain area of medicine or type of facility. This last aspect is particularly important as having knowledge of specialized billing and coding requirements is very valuable from a compensation perspective.

Coders assign the appropriate diagnosis and treatment codes based on an analysis of patient charts. Billers assume the responsibility of getting the health care professional or facilities paid for services rendered. They enter relevant information into the software and ensure that the required documents are completed and approved. Medical billing is sometimes considered a sub-specialty of medical coding, though the same person may perform both jobs.

According to the U.S. Bureau of Labor statistics, the average 2010-2011 salary ranges from $20,850 to $51,510. Salaries for the two occupations are considered together, but medical coders can expect their earnings to be toward the higher end as they usually must undergo additional training to obtain a certification. The federal government pays the highest wages of all industries offering employment in this field, paying an average annual salary of $45,120. Average salary in a hospital environment is $35,870 and physician offices pay $28,460 on average.

The AAPC Medical Coding Salaries Survey is a good source of compensation data specific to medical coding. According to the latest survey, certified medical coders earn an average of $45,404 and non-certified coders make $37,746 annually, on average. This salary differential of more than $7,600 illustrates that becoming certified can be worth the extra time and effort. Years of experience and size of employer both positively impact annual salary for medical coders and this also holds true for medical billers.

One way that both medical billers and coders can specialize is by working within a certain type of facility. Mental health providers, nursing homes, dentists, hospice providers, and physical, speech, and occupational therapy clinics or providers are just a few of the specialized environments available. Each of these makes use of a distinctive set of medical billing diagnosis and treatment codes.

Some billing specialists begin their careers by working for a medical billing services company. This often exposes them to a variety of facilities so they can learn the ins and outs of billing and coding within each one. Workers use one or more types of software to create paper and electronic claims for submission to insurance companies.

Medical billing and coding salary figures are expected to continue their positive trending. Employment in both fields is anticipated to grow much faster than the average for other occupations. Medical coders will continue to make a higher salary than billers due to the relevant certification being preferred by employers. However, employment in either area offers opportunities to increase earnings through factors like specialization in a certain type of facility or area of medicine.

If you found this article on medical billing and coding salary useful, visit All-Things-Medical-Billing.com today! We offer information not only on all aspects of medical billing and coding salary, but also tips on how to obtain jobs in the field, job projections, small business tips, and anything else to do with medical billing and coding opportunities.

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Interview Questions to Ask a Potential Medical Billing and Coding Specialist

Although the growing field of medical billing and coding is creating many potential candidates it does not mean that they are all well trained and articulate enough to get the job done. Because of the flood of schools covering this training, many are not fully qualified to teach the entire spectrum needed by future employers. These schools can be a reputable two or even four year college program to a three to six month online course simply setup to cover the basics at a reduced tuition. To the student, some of these fast track programs look attractive but by the time they set down their resume it is apparent that they are not a viable candidate. Therefore, asking the appropriate questions will determine whether they can stand up to or surpass their resume credentials.

Please review the training you completed?

A potential medical billing and coding specialist should have no problem giving you the required list of their training experience. Although it may be on their resume it is good practice to see if they can list them to determine if they are good at recollection as well as able to construct an articulate sentence. This will include the school they attended and the course of study they completed. The basic foundation courses stated should be: medical billing I and II, coding I and II, physician and hospital based chart auditing, anatomical medical terminology, medical billing software and physician and hospital case study.

Did you sit for the national medical billing and coding certification exams?

Certification is essential for a specialist that will be advantageous to your company. Again this may be on their resume however it will continue the rapport you may be looking for as well as give you an idea of their attitude towards the entire process.

Can I see your certification and training degree?

Believe it or not some potential employees will simply hand you a resume in the hope of being hired. You must ask for copies of their degree and certification. If they do not have this at their interview then you may want to re-think their candidacy. Certification should include one or more of the following:

CHRS - Certified Healthcare Reimbursement Specialist / National Electronic Biller Alliance
CMS - Certified Billing Specialist / Med-Certification
CMBS - Certified Medical Billing Specialist / Medical Association of Billers
CBCS - Certified Billing and Coding Specialist / Med-Certification

What kind of computer will you be working on?

The last thing you want is to hire someone who does not have the required setup. If their operating system is old and slow you will most likely suffer when it comes to needed speed and accuracy. Make sure they not only have an updated system but are able to handle any additional software you may provide.

Tell me about where you have been working prior to this interview?

Obviously, the more experience a candidate has the more beneficial they will be to you. Find out where they worked and be sure to obtain contact info of these employers for a reference call. Ask them how they felt about their prior job and what, if any, would they like to experience differently when they come to work for you.

Experience Questioning

The following questions will help you assess the true knowledge of your applicant. These are simple enough for anyone with at least two years experience to answer. If they do not have two years experience then you will have to determine whether you are okay with on the job training.

If an office visit and a procedure is billed on the same day, by the same provider, but are very different from one another, what modifier would you use? Answer: 25

What is the purpose of a superbill? Answer: A superbill contains the procedures and diagnosis for a patient's medical visit. The biller uses this information to submit a claim to the proper insurance payer.

What does RA stand for? Answer: Remittance Advice

Name the code descriptions for diagnosis? Answer: ICD-9 a/k/a International Classification of Disease

What form are professional claims submitted on? Answer: HCF-1500 or CMS-1500

How open and capable are you of learning our system?

The answer you receive to this question will immediately let you know if this person is a team player or not.

Can you tell me what your responsibility is regarding HIPAA (Health Insurance Portability and Accountability Act) compliance?

This is essential for the safety of patient health information.

Hopefully these questions will help you hire the best medical billing and coding specialist you can find. Overall, you want someone who is qualified, competent and possesses an excellent work ethic.

Ph.D. Ceete Sheekels is a Certified Professional Coder (CPC) and a Certified Evaluation & Management Coder (CEMC) through the American Academy of Professional Coders (AAPC). To find out more about her visit http://aboutmedicalbillingandcoding.org.

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Five Questions to Ask About Your Fertility After a Breast Cancer Diagnosis

More than 11,000 women under 40 are diagnosed with breast cancer each year in the United States. But when a young woman receives a breast cancer diagnosis, one of the last things she may be thinking of is her future ability to have children.

But preserving future fertility is an important consideration when making treatment decisions and consulting with physicians.Thus, here are five questions women who receive a diagnosis of breast cancer should ask about their fertility before they embark on cancer treatments.

1. Will My Cancer Treatment Affect My Fertility?

Breast cancer patients treated with surgery and localized radiation may not be at risk for infertility, but those treated with chemotherapy are. It also depends on the woman's age, the type of chemotherapy and the dosage. Another thing to consider is how long your treatment may last and whether it will delay your childbearing years long enough to pose a risk to your fertility.

2. Who Do I Talk to about Fertility Preservation?

If you have been diagnosed with breast cancer, talk to your oncologist and tell him or her you want to take steps to preserve your fertility. You will need a referral to a reproductive endocrinologist (fertility doctor).

3. What Techniques Are Available to Preserve My Fertility?

There are various options for fertility preservation. If you are a woman who is married or has a partner, you may choose to freeze embryos (embryo cryopreservation). If you are single, you may want to freeze your eggs (oocyte cryopreservation) or use donor sperm to freeze embryos. Both of these techniques require daily injections of synthetic hormones to stimulate your ovaries in order to collect multiple eggs during a menstrual cycle, as well as an outpatient surgical procedure to retrieve the eggs. Other, more experimental therapies include freezing ovarian tissue (ovarian cryopreservation) by surgically removing it, freezing and reimplanting later, as well as ovarian suppression before cancer therapy, in which hormonal therapies are used to suppress ovarian function and protect eggs during cancer treatment.

4. Are Fertility Preservation Methods Successful? Embryo freezing is the most successful technique; however a newer process called vitrification has improved egg freezing dramatically. There are now more than 1,000 "frozen egg babies" born worldwide. Ovarian tissue freezing has produced approximately 15 children. The success rates of ovarian suppression treatments are unknown because there are no randomized trials that demonstrate its effectiveness.

5. How Do I Pay for Fertility Preservation? Fertility preservation techniques such as ovarian tissue preservation, egg freezing or embryo freezing can cost between $12,000 and $20,000 and will probably not be covered by insurance companies. Still, fertility preservation advocates recommend that cancer patients have their fertility doctors code and submit their treatment as cancer treatment. Ovarian suppression methods are less expensive and may be covered by insurance if they are administered in the oncologist's office. There are also organizations that can help patients with discounts and/or financial support for fertility preservation.

For more information on fertility preservation methods, visit FertilityAuthority.

Leigh Ann McDonald Woodruff is a writer for FertilityAuthority. Established in 2009, FertilityAuthority is the leading web portal dedicated to fertility, encouraging women and men to be proactive regarding their fertility and providing the tools and information to do so.

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The Origin of Medical Coding

What is medical coding and who are medical coders? Well, everyone does know about the importance of accurate medical data while providing quality healthcare service. The professional medical coder is one of the main persons involved in the capturing of this critical and accurate medical data that needs to be delivered in time. Computerization of medical billing process is done only after medically coded details specify all the various processes / procedures/ therapies/ undergone by the patient at the health care provider's premises.

During medical coding all verbal descriptions of diseases, injuries, and procedures are converted into numeric or alphanumeric designations. How did the medical coding originate? Coding was originally performed to classify mortality (cause of death), data on death certificates, besides being used to classify morbidity and procedural data. Since the early 1970's, the HCFA (Health Care Financing Administration) has asked the American Medical Association (AMA) to work with physicians of every specialty to determine appropriate definitions for the procedure codes and to try to determine accurate reimbursement amounts for each code. Such type of coding is very useful especially as it helps us today to get easy access to medical records by diagnoses and procedures so that in can be used in,

Hospitals/clinics etc


Research work


Education

The federal government introduced The Medicare Prospective Payment System (PPS) in October, 1983, for better management of medical care. Each patient was classified into a DRG (Diagnosis Related Group) depending on the information from the Medical Record that appears on the bill. Under PPS, hospitals are paid a pre-determined rate for each Medicare admission. Since then there has been a great deal more emphasis placed on medical coding.

At present assigning of medical codes is the backbone for reimbursement of claims for Medicare patients. Codes are given for diagnoses, services, and procedures provided. Thus healthcare providers today have to comply with different medical coding guidelines.

The author of this article is Ricci Mathew of Outsource Strategies International (OSI), a US based company that offers services in Search Engine Optimization, SEM, PPC advertising for clients across the US.

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Medical Coding Certificate - Proof of Excellence

Medical coding certificate is that certificate which proves that an individual has obtained essential skills both theoretically and at practical level required to practice as a professional medical coder. It is a proof of excellence and makes you marketable in the medical sector and you become highly demanded by insurance companies, hospitals and other government agencies. There are different kinds of certification available in healthcare sector and different levels to study. Career in this field is very lucrative for young individuals and has become enduring for them after rapid development of health care sector. Employment opportunities have grown rapidly in this sector and has ample of scope to gain work for health care service providers.

It is vital to do coding accurately since occurrence of errors can lead to major issues and losses to the insurance firm or medical offices. Medical coding is the procedure to translate specific medical procedures and diagnosis into standard medical codes which are further passed onto medical billers. Medical billers then prepare bills and pass them to insurance companies and receive payment for healthcare given. Medical coder specialist helps to prepare codes which are essential in making payments to the insurance companies on a predetermined basis.

Medical coding certificate is required by every firm to make recruitments. The individuals who possess it are considered to have best practical skills and expertise in the field of medical. Since coding is prone to a lot of errors therefore it is important to recruit the ones who are specialized enough to prevent such mistakes. There is controversial aspect in medical coding which deals with manipulating the codes and having monopoly in coding practices. This means only few medical specialists know it and levy heavy fees by manipulating books by making it complex.

Medical Coding Certificate can be obtained by going through various courses and certifies both beginners and those already practicing in medical field.

Dennis enjoys writing on wide range of topics such as Medical coding specialist and Billing and coding. You may visit for more details.

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Learn All About Virtual Medical Coding Jobs

Medical coders are critical to the healthcare industry, and without them, the industry would stall. They provide the much-needed codes to services and procedures and without these codes, hospitals doctors and other health professionals would not earn.

Virtual medical coding involves the transformation of narrative descriptions of injuries, diseases and other health care procedures into alphanumeric and numeric designations, or code numbers. These numbers have details that accurately describe diseases, or give a patient diagnosis, including the tests to follow and the proper treatment. Medicine is not automatically precise science, and this is the reason the codes were developed to identity all the reasons that people seek health care services.

Health institutions need to hire medical coders because the job requires high skills. On the other hand, they will specifically hire virtual medical coders because they are more affordable to hire. There are instances where someone may make an insurance claim twice, however, having correct filing on claims helps avert this problem and increases the physicians income for the long term. Having a medical coder will eliminate the need for someone to follow through charts resulting in less work for the physician and hence, they are able to attend to more patients. This is also an efficient way to maintain billing records and claims, and reduces paperwork to the minimum.

To be a medical coder, you require at least some technical training in medical coding, while having a college degree will ensure you climb up the career ladder faster and earn more. Ideally, to get a job you must have medical coding accreditation, while having a firm understanding of medical terminologies physiology anatomy and database management will ensure you find a job faster.

The average medical coder earns about $39,000 annually, however the more experienced ones earn much more up to an average of $60,000 annually. The hourly wage is an average of $25 per hour, but again this is still dependent on ones qualifications and expertise. A medical coder with a master's degree should expect to earn approximately $58,000 annually.

Hospitals, clinics, doctors' offices, nursing homes, outpatient care centers, and nursing homes hire medical coders. Ideally, you can find a job with any medical institution that has vacancies. The industry is growing and even other organizations require their services including insurance companies and agencies, medical coding and billing companies, law firms and home health care service providers.

You can find medical coding jobs by registering with medical coding companies since they are always in need of new staff. You can also find work with organizations that hire you to do medical coding for them directly, for instance, health institutions and insurance companies. While to begin with, you can register with freelancing companies and look for available opportunities.

Ideally, as a medical coder you will be required to do medical coding using stipulated guidelines on various medical conditions, injuries, and diagnosis. You will also need to do coding on different medications and dosages for the different conditions. You may also be required to do medical reviews, code updating when there are changes and taking care of other medical related records.

Brian Scott is a professional freelance writer and online virtual assistant. He welcomes you to his free website for virtual assistants, http://www.VirtualAssistantJobs101.com where he reviews and compiles virtual medical coding jobs that let you work from home.

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Benefits of Outsourcing Radiology Coding Services

Outsourcing radiology coding services assure an assortment of benefits for radiology departments, individual radiologists, imaging centers and hospitals. The most important benefit is that these services offer radiologists more time to concentrate on their core activities. Further, these services help them to competently reorganize their entire coding system, enhance the overall efficiency of their healthcare practice and reduce the workload of their staff for focus on more important tasks.

Multifarious Benefits

Several established medical coding companies in the U.S. offer their services at competitive prices. Entrusting your radiology coding jobs to these firms allows radiology practices to resolve their regular coding needs efficiently. Outsourcing radiology coding services ensure the following benefits:

• Reduces administrative responsibilities: Professional coding services significantly reduce the administrative responsibilities and workload of radiologists.

• Saves time and effort: These services save the precious time and effort that radiologists would otherwise need to complete their coding tasks. This allows them to focus better on providing timely diagnosis and treatment solutions for their patients.

• Reduces possibilities of claim denials: Assigning codes to different radiology procedures needs proper attention and a thorough knowledge of the entire coding system. Even a small error in the codes can lead to claim denials. Efficient coding helps in the submission of error-free medical bills and claims to eliminate the possibilities of claim denials or rejections.

• Ensures maximum reimbursement: Timely submission of accurate medical claims and bills maximizes reimbursements and enhances the revenue prospects of the medical practice.

• Reduces infrastructure overheads: By outsourcing their coding tasks, radiologists and medical facilities can save the expenses needed to maintain additional staff and infrastructure to perform in-house coding.

Excellent Coding Accuracy

To deliver high quality services, reputable companies are equipped with skilled AAPC certified coders and technicians with up-to-date knowledge on the coding rules. They ensure customized radiology coding solutions in minimum turnaround time. Their radiology coding services ensure:

• Completion of coding tasks within the client-specified TAT

• Excellent accuracy rates

• Compliance with HIPAA norms

• Real-time document summaries

• Stringent quality assurance at three levels

• Feedbacks and custom reports

• Coding status reports on daily, weekly and monthly basis

Well-organized radiology coding outsourcing services help radiology medical practices, individual practitioners and group practices to enhance their efficiency and revenue at the same time. If you plan to outsource your radiology medical coding tasks, it is important to locate an established company offering consistent solutions at affordable charges.

Radiology Coding Services - Outsource Strategies International (OSI) is a leading medical coding company in the US committed to providing fast and efficient radiology medical billing and coding services.

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What Is Medical Billing And Coding?

What is medical billing and coding is a question that arises foremost in the minds of those who are keen to take up a career in this industry. Medical billing is typically the process through which doctors and hospitals get their payments from any health insurance company. This process may include resolution of any disputes that may arise regarding claims which have either been rejected or delayed. Medical billing and coding is actually a series of complicated procedures which requires skilled professionals and a substantial amount of time in order to be executed properly.

The bigger hospitals typically have a separate department to deal with medical billing and coding. Through this department, claims are submitted to various insurance companies for a response. In cases, where no action is taken by these companies, the individuals in question may approach the insurance giver. It is therefore crucial to any healthcare company. The nature of the whole process will depend on the kind of insurance because companies have varying policies based on diverse requirements. Medical coding is indeed a challenging task and often companies may have to outsource this job because they do not have the necessary staff for it.

Medical Billing and Coding As a Career Option:

Those who are skilled in performing this work can make a living out of it. A visit to a doctor's chamber is followed by various tests performed as part of treatment and these medical records are essential for it to be accurate. There are electronic medical billing devices which can extract information from these medical records and assign codes automatically. This bill is then checked manually by a staff member.

Once codes are assigned, the bill is submitted to the insurance giver. This information is reviewed to see if the treatment offered is relevant to the diagnosis and whether the tests done are medically justifiable. Once the bill is approved, the payments are made to the doctor electronically. When rejected, a notice of denial is sent to him. Whatever the result, the patient is informed through an EOB (Explanation of Benefits) letter. Medical coding is complicated and errors in data entry are quite common. This means that claims may have to be submitted many times before they are approved.

What Does A Medical Billing And Coding Specialist Do?

* The medical and billing coder is responsible for recording data accurately and processing a patient's medical data like his treatment records, bills, insurance details and payments received.

* He transfers requests for payment to the insurance companies, organizes patient records, statements and bills and ensures that these are free from errors.

* Communicates with the insurance companies for policy verifications and payment processing.

* Where extra payments not covered by insurance are deemed necessary, they formulate the payment plans.

Medical billing and coding specialist are employed in hospitals, doctor's chambers, healthcare institutions and even in rehabilitation clinics. To become one, a person must have a high school diploma and in some cases, a bachelor's in business administration or associate degree qualification. They learn what is medical billing and coding through on-the-job training. To improve their qualifications, many choose to obtain certifications from reputed national organizations. Job prospects are abundant for these professionals and with computer technology being used more and more in healthcare facilities, the demand for knowledgeable, qualified, tech-savvy medical billing specialists is expected to grow.

Get all your answers regarding what is medical billing and coding at medicalbillingncoding.net. It is the process of submitting claims to insurance companies and then waiting for a response from these companies.

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What Is Medical Coding

Medical coding can be defined as assigning of codes to medical diagnosis and procedures that assist in the financial reimbursement of a patient from insurance companies and the government. The person who does this job of coding and decoding is called as an administrative medical specialist.

Medical coding is all about translating the physician or doctor?s observations about any medical procedure into alphanumerical codes that describe what type of treatment was provided to the patient and the details of the same. Insurance providers use these codes to reimburse the patient in question.

The ever-changing state of technology and procedures that are used in allopathic medicine makes it hard and complicated for laymen to understand the medical terminology used by the doctors or physicians. By giving exact codes to define procedures it becomes easier for all the parties involved to comprehend the procedures and compensate the person in question.

According to the United States Department of Labor Statistics, health information technicians such as medical coding and health insurance specialization are one of the fastest growing health occupations for the next decade. These careers are challenging, exciting and satisfying. Hospitals, health centers, doctors, insurance companies, health maintenance organizations, and government agencies engage these specialists. Some work from home as autonomous consultants using medical billing and coding programs and other computer software, and others use office space for this job.

A medical coders job is challenging because the coder has to keep pace with the changing procedures and regular advances in technology. This means that the coder has to learn new procedures and terms so that he can perform the job in an efficient manner.

Medical coders also take on huge financial responsibilities because the amounts involved may be astronomical since allopathic treatment is expensive anywhere in the world. These coding methods also provide an important function for physician reimbursement, hospital payments, benchmarking measurement and the compilation of general medical statistical data.

Medical Coding [http://www.e-MedicalCoding.com] provides detailed information on Medical Coding, Medical Coding Salaries, Medical Coding Certification, Medical Coding Specialists and more. Medical Coding is affiliated with Medical Billing Services.

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Hematology Coding - Implementing New Changes

Hematology is a branch of medical science that deals with the study of blood, blood-forming organs, and blood diseases. Medical coders who specialize in hematology coding convert the diagnosis and procedures related to hematology into medical codes according to the established standard. With a firm knowledge of the field of hematology, they are expected to have the proficiency to perform CPT, HCPCS, and ICD coding according to the guidelines.

The ICD-9 brings in updates every year and there are changes more than you can imagine of reporting a particular disorder. Hematology coding is quite demanding and when it comes to the updates, you should be able to implement the changes in a short time, or you would face denials for using deleted, obsolete or truncated codes. And without proving a medical necessity, your practice could face more denials - which you cannot afford. Realize that ICD-9 is the key to prove medical necessity.

Loopholes in medical coding for reporting newly bundled services cause concerns and coding professionals need to understand, more so when you are about to use a modifier to get paid for multiple services. For example, to indicate that codes represent separate services as opposed to unbundling, append modifier -59 to override the edit and for clinical lab tests conducted more than once a day, use modifier -91 can be used. These are just some of the scenarios concerning modifiers.

The bottom-line is that you need to work on your strategies and tricks to implement the new hematology coding changes and make sure you cash in every chance as you report your providers services with the new codes.

You can update your hematology coding skills by attending hematology coding conferences and many other specialty basis medical coding audio conferences with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.

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A Guide To Medical Coding

Medical coding can be defined as the assigning of codes to medical diagnosis and procedures that help in the financial reimbursement of patients from insurance companies and the government. The person who does this job of coding and decoding is called an administrative medical specialist.

These medical codes are complicated and coders need extensive training before they are exposed to the job market. Medical coding schools provide this training and educate students on the technicalities of the job. Medical coding is considered to be a complicated subject that requires accuracy and meticulousness on the part of the coder.

There are many guides and articles in magazines, as well as on the Internet that help a potential coder to acquire information about the subject. However, some of these articles and reviews are from companies that are trying to sell products such as coding software and these articles and guides may not always be reliable. This is because many companies try to blow their own trumpets and indulge in propaganda of their product rather than provide the correct information.

Medical coding not only requires the coders to be up-to-date with the new codes and procedures but it also demands good command of English, medical terminology and computer application skills. Correct and accurate information about this subject is available at various colleges that offer diplomas in this field and these are more reliable sources of information compared to any of the sites that offer online courses or guides to this subject.

It is advisable to investigate into any information that seems too good to be true because there are companies on the Internet that only provide information and advice for the sake of advertising only, or to promote some of their own interests. It is important to be aware of all the subjects that are taught in medical coding schools before starting the course.

Medical coding is a field that is connected to a booming industry that will definitely expand and become more and more advanced in the future. Therefore the opportunities are in abundance for the right type of candidate in this field.

Medical Coding [http://www.e-MedicalCoding.com] provides detailed information on Medical Coding, Medical Coding Salaries, Medical Coding Certification, Medical Coding Specialists and more. Medical Coding is affiliated with Medical Billing Services.

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Behind the Scenes of Medical Billing-Coding Schools

If you love helping people but would rather deal with details behind the scenes than in the waiting room, medical billing/coding schools could be just what the doctor ordered for your career.

Medical Billing and Coding Roles
Medical billing/coding schools lead to one of the health occupations in which there is little or no direct contact with patients. But it's not an easy job -- accuracy is essential, as these professionals assemble patients' health information, ensuring that medical charts are complete and that all pertinent information is in the computer.

Medical records technicians may also specialize in coding information for insurance billing purposes. They assign a code to each diagnosis and procedure, consulting classification manuals and relying on their knowledge of disease processes. Using computer software, medical billing technicians assign the patient to a diagnosis-related group (DRG), which determines the amount the hospital will be reimbursed if the patient is covered by insurance programs using the DRG system.

Staring Out at Medical Billing/Coding Schools

Once you've received medical billing and coding training from one of the 184 associate degree programs offered at medical billing/coding schools accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM), you may take the Registered Health Information Technician (RHIT) certification exam given by the American Health Information Management Association (AHIMA).

For insurance billing, you may take the Certified Medical Reimbursement Specialist exam, a national credential awarded by the Certifying Board of the American Medical Billing Association. Certifications in coding are available either from AHIMA (Certified Coding Associate, Certified Coding Specialist, and Certified Coding Specialist-Physician-based) or from the American Academy of Professional Coders (Certified Professional Coder, Certified Professional Coder-Hospital, Certified Professional Coder-Payer).

On the Job in Medical Billing and Coding
Median annual earnings in the medical billing/coding field were $25,590 in 2004, with the highest 10 percent earning more than $41,760. That same year, about 159,000 jobs were held by medical records and health information technicians.

Job prospects continue to look good for those with medical billing and coding training. In fact, according to the U.S. Bureau of Labor Statistics, employment of medical billing/coding professionals is expected to grow much faster than average for all occupations through 2014. Technicians with a strong background in medical coding will be in particularly high demand due to the increased amount of paperwork involved in filing insurance claims.

To find college and career schools near you, surf http://www.CollegeSurfing.com.

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Robyn Tellefsen is a frequent contributor to The CollegeBound Network. Learn more about finding a school or career that's right for you!

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Hotpoint Washing Machine Repairs, Error Code E10 and F10

If your hotpoint washing machine is not working and you feel it needs repairs and you are getting the E10 or F10 error code, this means there is NO cold fill and you should check and verify that the taps are on and that the hoses are not kinked.

The first thing to check is the taps, most machines will have the hot and cold fill supply plumbed via a hot and cold inlet valve placed under a sink or directly behind the machine, it is usually a silver valve with the Blue and some times a red flexible hose connected to it, the blue should be cold and if there is a red that will be the hot supply.

In the on position, the plastic switch located on the side of the in let vale should be pointed in the same direction as the arrow on the valve and in the off position it should be pointed across the valve, if it looks off, especially if your valve is under a sink where pots, pans, boxes and other item can get pushed up against it and could turn it off by accident, simply turn it back on, but do not force it, as forcing it could break it, and that could lead to a flood situation.

If the valves looks OK, but the washing machine is still not working and you still get the E10 or F10 error message, you now need to check for a kinks in the pipes, this will probably mean pulling the washing machine out from its housing to continue the repair.

At this stage you need to take in to consideration the fact that the washing machine will be heavy and connected to both the mains electrics and mains water supply and also that putting the machine back properly can often be harder than taking it out.

If you are unsure, you would be best advised to call a engineer, if you are not willing to pull the washing machine out you could still also check any part of the inlet flexible hose pipes that you can easily see, like in the cupboards and also to the side of the washer, if you see any kinks, you could try to remove the kink and test the machine again.

Error codes are usually machine specific and the diagnosis given here is for the hotpoint range only, do not relate this diagnosis or error code meanings to any other make of washing machine

David is a washing machine repairs engineer in the UK, with many years of experience, he offers free advice and an affordable fixed price repairs service. You can get a lot more free advice or a low cost repairs source by following the link below to our help web page.

hotpoint washing machine repairs

And this link will take you to our ovens repairs page

electric oven repairs

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Therapy Progression for Proper Whiplash Coding

Coding for whiplash diagnosis might be a cakewalk, however don't take it too easy. Keep looking for situations when the patient's symptoms persist in spite of conservative therapy and demand more extensive treatment. Not paying heed to these diagnoses can mean missed pay.

Watch for move from therapy to scans

When a patient presents with whiplash symptoms, your pain management specialist will carry out a thorough exam and will carry out a comprehensive exam and will often order neck x-rays to rule out fractures.

Initial steps: Once the pain specialist diagnoses whiplash (847.0, Sprains and strains of other and unspecified parts of back; neck sprain), he normally will prescribe conservative treatment. Common options cover physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants. Some patients may also stand to gain from wearing a soft cervical collar or by using a portable traction device.

If conservative treatment fails to make an impact, the physician might order additional diagnostic imaging tests.

Count trigger point injections the right way

Your physician might also administer trigger point injections to relieve the patient's pain and muscle tenderness. Report these procedures with 20552 (Injection[s]; single or multiple trigger point[s], one or two muscle[s]) or 20553 (...three or more muscles).

Note of caution: The difference between the two codes is the number of muscles the physician injects, and not the number of trigger points or the number of injections he administers.

The descriptors clarify that if your provider documents a different muscle, you can count the number of muscles to determine the difference between 20552 and 20553. However if the provider injects multiple trigger points within the same muscle, you only count one muscle, irrespective of the amount of injections.

Watch out: Owing to the 'one or two muscles' and 'three or more muscles' distinction between codes, you will report a maximum of one unit for either 20552 or 20553 for an encounter - not both codes. For instance, if your pain management physician injects trigger points in a total of four separate muscles, compliant coding would be one unit of 20553.

For more pain relief, move to nerve blocks

When more conservative treatments for whiplash fail to help the patient, your physician might administer nerve blocks to help diagnose a patient's condition and/or provide therapeutic pain relief. Common options include lidocaine and/or steroids such as methylprednisolone acetate (J1020) into cervical facet joints (such as C3-4 and C4-5).

Report it: Code the block at the first facet joint level with 64490 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], cervical or thoracic; single level). Submit blocks at additional facet joint levels on the following lines of your claim with +64491 (... second level [List separately in addition to code for primary procedure]) and +64492 (... third and any additional level[s] [List separately in addition to code for primary procedure]) as proper.

Guidance: Physicians go for fluoroscopic guidance to help ensure they inject the proper site. Earlier, you reported fluoroscopic guidance in addition to the injection procedure code. Last year, CPT introduced codes 64490-+64492, which include fluoroscopic or CT guidance. Now you can simply code the injection.

Bilateral question: Often, providers administer facet joint injections unilaterally. If your doctor administers bilateral injections, remember to add modifier 50 (bilateral procedure) to the injection codes.

Be on the lookout for add-on diagnoses

Some factors (age, gender, and pre-existing conditions like arthritis) can have an impact on the severity and prognosis of whiplash injuries. When the patient doesn't respond to more conservative treatments or if her symptoms get worse, your physician may re-evaluate her for other disorders.

In these instances, report the additional diagnoses along with whiplash.

Depend on nerve destruction as last recourse

If nerve blocks don't bring the patient long-lasting relief, your pain specialist may consider paravertebral facet joint denervation.

Document it: Prior to taking the patient's treatment to this level, your physician should have thorough documentation of other treatments. The patient's chart should cover two important details:

The proper diagnostic paravertebral facet joint block or medial branch nerve block studies that identify the specific joint level.

Documentation that the patient had significant - however not long-lasting -- pain relief from the facet joint blocks. Some payers are beginning to need actual documentation and quantification of the patient's status. For instance, the payer might want details regarding the percentage of change in pain, duration of pain relief, and changes in the patient's functional status during relief from the diagnostic blocks.

If the patient meets these criteria, your physician may use paravertebral facet joint denervation to treat back or neck pain following whiplash/post-traumatic injury and to relieve the pain of associated cervicogenic headache.

In these cases, CPT includes two codes for denervation:

64626 -- Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level

+64627 -- each additional level [list separately in addition to code for primary procedure].

Just like nerve blocks, physicians often carry out the therapeutic destructive procedures as unilateral procedures. If your specialist carries out a bilateral procedure, add modifier 50 and document which joint levels he treated.

Bottom line: With the prevalence of whiplash injury and range of treatment choices for whiplash and related disorders, physicians and codes need to know what payers cover and what they do not.

For more specialty-specific articles to assist your pain management coding, sign up for a good Medical coding resource like Coding Institute.

The Coding Institute is dedicated to offering quality products and services to help healthcare organizations succeed. We are primarily focused on providing specialty-specific content, codesets, continuing education opportunities, consulting services, and a supportive community of healthcare professionals and experts.

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Using Medical Necessity Effectively When Coding Patient Visits

Proper billing and coding practices can make or break the financial well-being of a medical practice. Understanding the rules that pertain to billing and coding can increase the revenue generated for your practice and can alleviate concerns regarding level of service requirements.

Physicians spend years obtaining the education that is necessary to practice medicine, but the billing and coding of medical claims is not a standard part of the medical curriculum. The fact of the matter is, understanding billing and coding is as crucial to the financial well-being of your practice as your medical education is to the physical well-being of your patients. Whether your practice has an in-house employee handling your billing or you outsource your billing and coding to a professional agency, you as the provider are ultimately responsible for the level of care you provide to your patients.

The evaluation and management (E/M) codes used in medical billing can be a significant source of revenue for your practice. While you, as a physician, understand the concept of Medical Necessity and you believe that you are providing your patients with necessary medical care, why is it that you are denied payment for a visit or a procedure that is considered unnecessary by someone who is not a medical professional? How is it that this person can judge whether or not the treatment was necessary when they were not there at the time of the visit?

The idea of Medical Necessity is a cloudy concept. It is described in less detail than many of the other coding definitions. Because of this, you should familiarize yourself with the concept of Medical Necessity if you hope to avoid denied claims and delays in payments to your practice. If you want to prevent denied claims and payment delays, you must ask yourself some questions...

What Constitutes Medical Necessity?

There are three components to the E/M guidelines including the patient history, physical exams and medical decision making. The determining factor in the level of care that you provide to a patient is the Medical Necessity component. This is also the deciding factor in how that level of care is billed to the patient's insurance provider.

Different insurance companies may have specific definitions of Medical Necessity. Medicare guidelines are what most insurance companies follow in regards to paying a claim. According to Section 1862(a) (1) (A) of the Social Security Act, Medicare does not pay for services that are not reasonable or necessary for the diagnosis or treatment of an injury or an illness or to improve the functioning of a malformed body member.

The AMA Model Managed Care Contract is a sample contract used to help physicians negotiate with health plan providers. This contract suggests that the definition of Medical Necessity is services or procedures that a prudent physician would provide to a patient in order to prevent, diagnose or treat an illness, injury or disease or the associated symptoms in a manner that is:

a) In accordance with the generally accepted standard of medical practice.

b) Clinically appropriate in terms of frequency, type, extent, site and duration.

c) Not for the intended for the economic benefit of the health plan or purchaser or the convenience of the patient, physician or other health care provider.

What Does Medicare Say about Medical Necessity?

According to the Medicare Claims Processing Manual, Medical Necessity is defined as "The overarching criterion for payment in addition to the individual requirements of a CPT code. It would not be medically necessary or appropriate to bill a higher level of evaluation and management service when a lower level of service is warranted. The volume of documentation should not be the primary influence upon which a specific level of service is billed. Documentation should support the level of service reported."

What this tells us is that a provider is allowed to bill as high as the Medical Necessity warrants as long as the physician properly documents the office visit and meets all of the History, Physical Exam and Medical Decision Making criteria. If, however, the care that is provided to a patient is above and beyond Medical Necessity, the physician can only bill as high as the Medical Necessity warrants.

Putting the Pieces Together

There is one determining factor when navigating the murky waters of Medical Necessity and that is having a clear medical reason to perform a service or procedure. If there is clear medical need for the service or procedure that you are performing, then the Medical Necessity requirements will be met. For example, if you have a patient who comes into your office with difficulty breathing, you would absolutely have to perform a comprehensive medical history in order to address the issue. Each component of that history, such as the ROS, HPI/CC and PMFSH would be needed to obtain clinically relevant information.

The HPI you perform would help you obtain the information needed regarding the patient's current condition including the duration and timing of the symptoms. The ROS would then help you determine which systems are being affected by the condition and which diagnoses could be considered. At this time you would also learn about risk factors that could contribute to the patients current condition. All of these components would be medically necessary in order to provide the patient with a proper diagnosis and effective treatment, thereby meeting the requirements of Medical Necessity.

Now, let's say the same patient comes back to your office for a follow-up visit a few weeks later after being treated in the hospital for pneumonia. The patient has no particular complaints and seems to be doing well. You would not be able to justify a comprehensive medical exam at this point because there would be no clear Medical Necessity to perform one.

As a rule of thumb, consider whether or not the services you perform will help you modify or contribute to a patient's current visit or therapy. If not, then it is not medically necessary and does not meet the Medical Necessity requirements.

Medical Decision Making vs. Medical Necessity

Many physicians confuse Medical Necessity with Medical Decision making. In order to eliminate this confusion, it is easiest to consider the Medical Necessity component as a part of the Medical Decision Making process.

There is no denying that Medical Necessity is a vague and poorly-defined concept. It is open to different levels of interpretation and, in the end, the final determination regarding whether or not something was medically necessary is up to an individual who is not even a medical provider and was not present at the time of the service. Because of this, it is important that you document the intensity of the visit as well as the key components in order to code your visits properly and maximize your practice's incoming revenue.

Dr. Adam L. Alpers, D.O. is a medical practice consultant and invites you to access and gain knowledge in enhancing your medical billing and coding by visiting our blog at http://www.medbillingncoding.com This program was developed for providers to gain quick and easy understanding of some of the most needed information in billing and coding. You do the work, now get paid for what you do. To Learn and Earn more. Please, check out our informative teaching today also at: http://www.medicalcodingcashsecrets.com

Copyright - Adam L. Alpers. All Rights Reserved Worldwide

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More Than Just Transcribing With a Medical Coding Certification

With a medical coding certification in hand, it opens up a new world for one to advance his career. Having this to add value to your resume, you have a choice of continuing to work with medical records in a hospital setting. Alternatively, opportunities await you in running a business from your own home whereby you provide medical coding services offsite to smaller establishments such as clinics, doctors' offices, hospices and nursing homes.

The core function of medical coding is to transcribe a patient's disease, diagnosis, treatments and procedures into matching codes according to a pre-defined set internationally accepted in the medical world. These codes then progress into the billing process for payment and claims from patients and insurance companies. However easy this may sound, it is not. At times, healthcare practitioners such as attending physicians and clinical supporting personnel document information which may be in contrary to his or another's findings. As such, an experienced medical coder is to pick up such anomalies and put it to question before entering into the system. Although this may give rise to conflicts due to questioning of one's expertise, a medical coder needs to ensure quality data is documented for correct coding. By demonstrating appropriate leadership skills, he should be able to be the glue to hold the organization in check when it comes to medical records and coding.

However precise and stringent the medical coding process may be, one or two may slip past. Once again, a medical coder relies upon his expertise and experience to resolve the problem. Occasionally he assumes a role as an arbitrator between various parties as he supposedly is the one with the level head. If his medical coding certification covers the area of auditing the coding patterns, his responsibilities include the evaluation of how coding is used by the healthcare organization. Coding needs to be appropriately used in the billing process for payment and claims. Expert coders analyze revenue streams and look for areas to plug revenue leakage. Since coding is also utilized to derive statistical analysis, it needs to be accurate in order to get a correct picture of the national and regional healthcare.

Dennis enjoys writing on wide range of topics such as Online medical coding and Medical billing courses. You may visit for more details.

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An Overview Of Medical Coding Schools

After attending Medical Coding schools an individual will enter a career that requires attention to detail and specialized knowledge. Medical coding is assigning and cataloging of the numeric codes to relevant medical data. The codes are known for being a universal language. They use Current Procedural Terminology (CPT), International Statistical Classification of Diseased and Related Health Problems (ICD), and Healthcare Common Procedure Coding System (HCPS) systems to assign the codes.

As a coder, you will be asked to look at medical documents that are all relating to an individuals symptoms, injuries, diagnosis, treatment and procedures. There are other types of information that is related to medical that you will need to look over. In the paragraphs below, you should prepare to learn some information about medical coding schools.

The pre-determined codes that you are putting help medical professionals and know what medical tests and services were provided and why. Medicare reimbursement is dependent on accurate codes used to insure payment. There are also coding specialists in the animal medical field that keep record for veterinarian offices. There are accredited two and four year programs

When you decide to go to school to become a medical coder, make sure that the school you choose is accredited. This will give you assurance that you are getting a quality education. In addition, the education you are getting meets specific requirements and guidelines to help you get the necessary skills to get a job.

The next thing you need to decide is if you want to go on campus or do your courses on line. If you choose to go on campus, make sure the school has hands-on training so you will know exactly what you are going to be doing when you get a job.

After you finish your schooling, you can apply for your certification from several organizations including the American Academy of Professional Coders and the Board of Medical Specialty Coding (BMSC). The requirements are simple. You just submit an application and take the exam.

The PAHCS requires a minimum of two years experience and current employment as a coder. Two years of experience is also required by the AAPC and the BMSC recommends three years in a specialty area. All three organizations require credential medical coders to earn continuing education credits in order to renew or maintain their certification.

The AAPC requires thirty-six units every two years of training through Medical Coding schools for its certifications, the BMSC requires between ten and twelve units each year depending on the certification, and the PAHCS requires twenty-four units of continuing education every two years. So, now that you have read an article on this topic, do you think you would like to make it a career?

Does a career as a medical coding specialist sound interesting to you? Learn everything from medical billing degrees to the education required to become a medical coder. It's all available at http://www.careertoolkits.com/medical-coding/

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Medical Billing And Coding Jobs: The Importance Of Understanding The Difference

It is often assumed that medical billing and coding jobs are one and the same, however, in actual fact the two functions, both of which are crucial to the smooth operation of a medical practice or medical facility, are quite different in nature. As a result, top notch billers and coders are highly valued and highly respected.

Individuals just entering the field of medical billing and coding, and seeking medical billing and coding jobs often wonder if both jobs can be performed at the same time, and the suggestion is generally not. Initially it is preferable to focus on either medical billing or medical coding as the training on and off the job can be intense. Naturally, being qualified and experienced in both areas improves a prospective employee's marketability and in turn, level of earnings, however, it is advisable to "walk before you run" - so to speak.

I will now provide a brief overview of each position and expand on a few of the basic job duties and look at some of the beneficial skills. The intent is to assist the reader in choosing an specific area when seeking medical billing and coding jobs.

Medical Billers

Depending on the size and scope of the medical practice or medical facility, the role of a medical biller can vary, however, in basic terms, they are responsible for managing the accounts receivables. In other words, the primary role of a biller is to ensure that the employer gets paid or reimbursed in a prompt manner.

A medical biller position is typically a 9 - 5 - five day a week type position, and is considered an accounting or administrative function. They must be proficient in typing and working with computers, particularly with Excel spread sheets, database management software programs, and medical practice accounting software.

Further, a basic understanding of medical law, medical ethics, and medical terminology is a must and is generally acquired through formal training and certification. Although medical billing and coding jobs are quite different, some exposure to medical coding is beneficial.

Most of the highest paid medical billers possess strong communication skills. Although administrative in nature, much of the role involves resolving complex issues, explaining insurance details, collecting overdue payments, and structuring repayment schedules. As a result, it is important to develop good rapport with patients, health insurance providers, doctors, other staff members, and other departments within the organization.

Medical Coders

The role of the medical coder, on the other hand, is to ensure that the proper medical codes are assigned to insurance claims submitted to healthcare insurance providers.

The process is broken down into three areas, the patient visit which is referred to as a "patient encounter" or simply "encounter", the diagnosis, which has associated with it an ICD code, and the services rendered, which has associated with it a CPT code. A medical coder must ensure that the codes are correct prior to submitting the claim forms, otherwise, reimbursement will be delayed.

A good coder must possess a strong attention to detail and have some perfectionist attributes. A basic understanding of medical terminology and a grasp of the requirements, policies, and procedures of major healthcare insurance companies are a must. In addition, a good memory and the patience to scan through coding is helpful.

In summary, although there is some overlap, medical billing and coding jobs do differ in terms of the basic job functions as well as the skill requirements. A medical biller role encompasses more interaction with people while a medical coder role is more behind the scenes. Assess your strengths, weaknesses, skills, abilities, and general personality type, and then make a decision as to which position would be the best fit for you.

The healthcare field as a whole is rapidly expanding and growing giving rise to an abundance of medical billing and coding jobs within the industry. Click here http://MedicalBillingAndCodingJobsToday.com in order to find a vast amount of quality information and useful resources to assist you in making a decision as to whether medical billing or medical coding jobs ate right for you.

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Medical Insurance Billing and Coding Explained

Medicine is an art, a science and a business. Doctors learn the artistic and scientific aspects of their profession in medical school. But the business aspect of their practice - getting paid - requires a completely different set of skills - skills most doctors have neither the time nor the interest to acquire. Even if they did, few doctors would have to time to handle the complex administrative aspects of a modern medical office. Enter Medical Insurance Billing and Coding.

Medical Insurance Billing and Coding specialists work in doctors' offices, clinics and other medical facilities. Their primary job is to submit claims to insurance companies to ensure doctors and support staff are properly reimbursed for the services they render. Medical Billing and Coding professionals tend to deal mostly with private insurance companies and the agencies of state and federal governments who pay medical claims, e.g. Medicare. The Medical Billing department is often also responsible for collecting co-payments or deductible amounts from patients directly.

Processing a Claim

To process claims, the Medical Insurance Billing and Coding specialist first deals with the patient's medical record, which contains the physician's notes on what services were performed. The specialist must then translate this information into a five-digit numerical code drawn from the American Medical Association's Current Procedural Terminology (CPT) guide. The actual diagnosis is also coded based on a government guide called the International Statistical Classification of Disease and Related Health Problems (ICD). It is very important that the CPT and ICD codes match up, or a claim will likely be rejected.

In fact, according to the Healthcare Billing and Management Association, up to one half of all medical claims are initially rejected by insurance carriers. Medical Insurance Billing and Coding specialists must therefore need to learn how to skillfully adjust and resubmit claims in a way insurance companies are more likely to accept.

Paper vs. E-Claims

In the past, virtually all medical billing and coding was done on paper, which was slow, inefficient and expensive. Today, more and more claims are being filed electronically, although paper-based billing is still very common. In the coming years, computer skills will be increasingly important to Medical Insurance Billing and Coding professionals.

Training & Certification

To become a Medical Insurance Billing and Coding professional, one should take a specialized training program in this field from a recognized and accredited college or university. Such programs can normally be completed in about a year. After that, industry certification is also recommended. The Certified Medical Reimbursement Specialist (CMRS) accreditation by the American Medical Billing Association is one of the most recognized of specialized certification in this field.

Medical Insurance Billing and Coding is a highly specialized field that is critical to the operation of modern medical offices. The need for well-trained Medical Insurance Billing and Coding specialists is likely to grow significantly as America's population - and the need for quality medical care - grows over the next few decades.

Author, Allen Ury, SEO Writer for Corinthian Colleges, Inc., specializes in instructing others on the benefits of a quality education for Everest. Find out how obtaining a quality education or degree in medical billing and coding can help jump start a career. Or, for more information, visit http://www.Everest.edu.

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Pertinent Information On Medical Coding As A Profession

Like most professions worth pursuing, you need to be adequately trained to work as a medical coder. To become a medical coder you must have a high school diploma and pass an accredited course in medical coding. In the United States, the American Academy of Professional Coders offers courses to become a Certified Professional Coder. These courses are conducted in classroom settings, as well as online. If there is a facility close to where you are located, you could attend the classroom course; if not, online may be considered. Getting certification typically costs between $1,000 - $2,000 depending on which course you decide to enroll in. You will not only be trained in punching in numeric and alphanumeric codes, but you will also be trained in the basics of medical terminology and codes used in the medical industry.

You will be taught to understand the different sets of codes that are used in the medical industry in the United States (or whatever country you are being trained in). There are different levels of training and certification programs available from which you can gain qualification in medical coding. CPC, for instance, is the certification for Outpatient Physician Office Credential. In this course you will be taught the correct usage of CPT, HCPCS level II procedures and supply codes, and ICD-9-CM codes for diagnosis; whereas the CPC-H certification is for Outpatient Hospital/Facility Credential.

This certification qualifies you to do coding and billing in an outpatient hospital. CPC-P which stands for Certified Professional Coder - Payer certifies you on the correct usage of CPT, HCPCS level II procedures and supply codes, and ICD-9-CM codes for diagnosis for coding and billing in offices from where payments are made. These include Medicare and Medicaid as well as other insurer's offices. Then, there are specialty coding credentials that you can gain. For example, if you want to work as a medical coder with a radiology and cardiovascular facility, you may opt to get the CIRCC certification.

Specialty medical coding jobs often pay more than more general medical coding jobs. In the medical coding profession you can expect to earn anywhere from $30,000 to over $50,000 annually and sometime more. Once you have proven your proficiency in your work you can also decide to work from home. If you work at a healthcare facility you will have a standard forty hour per week, Monday to Friday job. It will be like any other office job, the only difference being that you will be a specialist in the job you are doing. If a full-time job is not desired or preferred, once certified, medical coding may also be considered as a part-time profession.

If you're looking for information about Medical Coding Certification & Training, we have more great tools and resources on our website http://www.medicalcodingtrainingcertification.com

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Why You Should Select A Medical Coding Career

A Medical Coding Career can be challenging, but brings so many benefits that it often overshadows any disadvantages that may be perceived. Basically, it requires finding the key codes used by hospitals and billing entities that reflect the diagnosis and procedures used to treat patients as well as their current status. It's important that as close to 100% accuracy be maintained as significant consequences could result from errors.

These specialists code medical data from patient records received from doctors offices, hospitals, clinics, and other service provides. As a result, they play a critical role in ensuring that medical providers are reimbursed for services rendered and that accurate billing status is tracked. This is especially important when repeated visits are required but insurance limitations exist, such as for chiropractic care.

Although the position itself sounds simple, training is quite complex. Coursework often involves coding systems, insurance regulations, use of medical software, and hands-on experiences in the medical environment. The culmination of study in this field results in certification which will qualify you to work in a hospital, doctor's office, clinic, at an insurance company, or even from home.

The need for certified specialists in this field continues to grow due to the fact people are living longer and insurance processing claims procedures continue to evolve. This leaves the industry wide open for those with the desire to enter a field where you are only limited by your own motivation.

For many the advantages provide opportunities not available when one works for someone else. Outsourcing by service providers has allowed many to work from home in this profession. This is a way to start an at-home business that requires very little start-up money and has a low overhead. To start all it takes is a reliable computer, medical/coding software, and a list of potential clients.

Another huge advantage is the fact that just like many other professions, coursework in their career field can also be completed online. Schools offering this program can be either accredited or non-accredited. The difference is that credits earned from an accredited school can be transferred if one desires to continue their education at a later date. Additionally, it can usually be completed within about two to three months as opposed to years of study.

Those who elect to pursue a Medical Coding Career not only help health providers receive the money they have earned, but also serve as advocates for patients who have difficulty settling disputes on their own. It requires no physical demands, allows one to work from home, and pays well since the service is in such high demand.

Get free in-depth information on medical coding duties and medical coding salary ranges from: http://www.careertoolkits.com/medical-coding/

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Guide to Selecting a Medical Billing And Coding School

In essence, a medical billing and coding school is an institution that can grant students an education in the medical care field that concerns with tracking and record data regarding the treatment patients undergo and information regarding their insurance policy. In a nutshell, these medical professionals act as a connection between the medical facilities in charge of the treatment and the insurance corporations. However, that is only the tip of the iceberg. The fact is that they are also handling the medical account management, the coding of the diagnostics and all the payment details. Therefore, the proper functioning of the medical institution is highly dependent on the skills and the qualifications of these health care professionals.

And this is perhaps the biggest problem hospitals and clinics are faced with nowadays. From the start, it is important to note that not every medical billing and coding school is able to bestow the same level of expertise upon its students. Moreover, it has been proven that very often these learning facilities are basically handing out diplomas to students following a self-study line of courses. Consequentially, students who graduate from them are far from the level of expertise required in this field and will most likely fail to rise to the expectations of their employers.

However, this does not go to say that every medical billing and coding school is a hoax. In order to make an educated decision about the learning institution that can help you become a professional in this field, you should first understand what you should expect to learn there. In addition, it is important to note that and education in medical billing is slightly different from an education in medical coding.

To put it simple, while the medical billing personnel is in charge of verifying the invoices and clearing any misunderstandings by discussing them with the patients or the insurance companies, the medical coding staff is in charge of actually recording the data by matching the diagnosis with the code designated for it. As a side note, while in institutions with a lower number of employees the medical biller and coder are one and the same person, you cannot expect the same thing from larger medical facilities.

On the other hand, the medical billing and coding school should teach both billers and coders certain key aspects. For instance, the correct medical terminology is essential for understanding certain diagnostics and being able to correct any errors that might appear in the data recording process. Moreover, it is equally critical to learn how to operate the essential coding and billing software, as well as how to evaluate the medical documentation correctly.

Needless to say, a knowhow in administration and above basic mathematical skills are also highly important aspects. Therefore, if following the courses of a medical billing and coding school is not able to grant you these fundamental skills, then you are most likely dealing with a fraudulent learning program. Consequentially, you will need to select another educational facility in order to follow a successful career in the field of health care as a medical biller or coder.

Be sure to read more about medical billing and coding school Riverside here. My interest is in education and finding rewarding careers for working professionals. Learn more about Riverside medical billing and coding school if you enjoy my writing.

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Know Your Clinical Coding Profession Better

Your job as a clinical coding professional requires you to analyze clinical statements and assign codes to them to get reimbursement from insurance companies and/or federal agencies. The 5-digit numerical codes help the insurance companies to do the required paper work to pay your healthcare organization or physician office. To get your office its deserved reimbursement, you must understand the coding guidelines, medical terminology and diagnosis concepts.

There are a number of specialties in clinical coding which include anesthesia, cardiology, evaluation & management, emergency medicine, ophthalmology, ob-gyn, optometry, pediatrics, urology etc. As a coder, you would generally choose any one specialty, but it's always a better option to possess the knowledge of any related specialty.

The key to do precise and correct clinical coding is to know the intended use of the CPT, ICD-9 and HCPCS codes. The healthcare industry goes through rapid changes, and to keep pace with the changes, you have to remain on your toes. Training camps, seminars/ conferences, and accessing CDs and transcripts are great ways to keep yourself up-to-date. Conferences and training camps are, however, your best options as they enable you to connect with industry experts and professional coders.

Your level of expertise as a coder decides your pay-package and you can seek employment opportunities at - healthcare facilities, physician offices, insurance companies, or you can even choose to work from your home and set your own working hours, and go on an extended vacation when you wish.

If you wish to increase your earning potential further, a clinical coding certification is the best way to do that. There's a variety of courses which lead to certifications, but make sure it's recognized. Consider the courses and certifications part of your survival strategy, so choose them wisely and according to your requirements.

If you wish to increase your earning potential further, a clinical coding certification is the best way to do that. We provide you medical coding audio conferences with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.

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Important Features of Medical Billing and Coding Cycle

Medical billing and coding is the process of computer aided centralization of a coding system, accurate electronic recording and data entry processing of a patient's symptoms, diagnosis and treatment records, insurance processing, invoicing, transmittance of billings, tracking and receipt of payments and account receivable management.

For the past several years, medical billing has been utilizing the paper-based technology. However, because of the entry of the computer technology and the internet, paper processing of medical billing has evolved and transformed into electronic billing and coding. Medical software companies have developed and upgraded their medical billing software to come up, promote and market their own effective health information systems to all players involved in the medical industry.

As a patient, your billing cycle process starts with the recording of the summarized details of your personal profile. Documentation of medical history record, tests done, symptoms observation and diagnostic physical examination procedures, proposed treatments, number of appointments and visits, your current health status and all other accurate and relevant data about you are entered into the patient's profile record.

Regarding how much the health provider will bill the insurance company; here is how they do it. A professional medical staff or medical coder translates into a number coding your diagnosis record based on the CPT and ICD-9-CM. By October of 2013, these formats will be phased out by ICD-10-CM. A five digit procedural code is assigned to your level of service info from the terminology database. These codes are their basis for insurance claims processing.

As soon as procedural and diagnostic codes are finalized, the medical biller will electronically format the insurance claim to an ANSI 837 file before sending to the insurance company or a clearing house. The claim gets processed by committees depending on the amount of claim involved. To verify info about eligibility of patient and the profile of the health provider, insurance companies use the rubrics procedure. Approved claims comprise an agreed percentage of the total submitted claim. Rejected claims are transmitted electronically through a remittance advice.

If your billing is rejected, your service provider will verify, make modifications and transmits back the claim again and the process goes on in accordance with the procedures on claim processing. Statistics show that there are a high percentage of rejected claims by insurance companies for multiple reasons. Some of them are due to patient's lack of eligibility and errors in the diagnostic and procedural codes used. There is a final legal remedy to contest a rejected claim which is the filing of an appeal before the appropriate authorities who have jurisdiction when a case is elevated to them for review of the decision.

When it comes to electronic eligibility and benefit of patient inquiry, the health care service provider performs this procedure through its medical billing software. The format used is termed as X12-270 Health Care Eligibility and Benefit Inquiry. Response to the inquiry is also done electronically with the format of the X12-271 Response. As soon as you as patient are confirmed to be eligible, the healthcare services are provided. When the time for medical billing comes, the transmission is done through an X12-837 format to be responded by an X12-997. For the final adjudication of claim, the insurance company uses the response format of an X12-835.

The medical billing and coding department should be well oriented in all aspects of electronic billing and coding, all types of plans being serviced by insurance companies, and needs to be aware of the applicable laws, rules and regulatory requirements. With respect to you as a patient, it is advisable to know by heart the billing and coding process so that you can interact with the biller and payer, get involved and make a stand if it affects your rights.

My name is Jet Jones and I am an expert in physician billing software. Please visit my site at http://www.physician-billingsoftware.com to find a physician billing software that best fit your needs and budget.

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