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2012年9月23日 星期日

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.

Copyright 2007 - All Rights Reserved in association with Media Positive Communications, Inc. for SchoolsGalore.com.

Notice to Publishers: Please feel free to use this article in your Ezine or on your Website; however, ALL links must remain intact and active.




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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What is the Difference Between Medical Billing and Coding


Medical billing and coding are vital parts of the billing process. From the time a doctor sees a patient to when the paperwork is forwarded to the insurance company, there are important steps that need to be performed. Every doctor visit results in the utilization of medical coding and medical billing skills - both are necessary for doctors and health care facilities to be properly reimbursed for services.

Here's how it works:

Medical coding includes the process of using specific codes to identify procedures and services for private billing, health insurance companies, government health programs, workers' compensation carriers, and more. A coder reads all documentation, such as a medical chart or transcription of doctor's notes, and assigns the right universal code based on their coding knowledge. The codes are entered into a form on their computer system.

Medical codes are based on diagnoses and procedures. Codes exist for all types of services, tests and treatments provided by a healthcare provider in a medical office, hospital, or clinic. The diagnosis is translated into an ICD-9-CM code; while the procedure is translated into a five-digit CPT code. Medical codes can encompass anything from a stomach ache to a broken arm - there are codes for everything!

Once the diagnosis and procedure codes are determined, the medical biller transmits the claim to the insurance company for payment. Medical billing includes the process of submitting and following up on claims to insurance companies in order to receive payment for services rendered by a health care provider. A billing specialist ensures that the patient and health insurance company are properly billed for all procedures. Approved claims are reimbursed, while rejected claims are researched and amended.

Under the Health Insurance Portability and Accountability Act (HIPAA), billing specialists are required to send claims for reimbursement via electronic means. This has resulted in faster, more accurate payments from insurance companies. The use of billing software has also enabled medical billers to perform accounting duties and manage billing practices more effectively. Patient records, open claims and outstanding invoices are a mouse click away!

Medical billers and medical coders ensure that the billing cycle is smooth - from patients being billed the correct amount to doctors getting paid. Without them, there would be no way to complete, track and manage medical claims. Both billers and coders are essential to the financial well-being of an organization and the health care industry as a whole.




Heather H. Brunson is a lead marketing copywriter for Allied Medical School. Allied medical schools provides medical training programs that prepare students for medical careers in the medical billing and medical coding, and medical transcription fields.





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2012年9月22日 星期六

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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2012年9月21日 星期五

Medical Billing and Coding Courses Make You the Best in the Medical Field


Medical billing and coding courses are intended to teach the students of medical arenas the skills and practical knowledge of medical services along with in-depth preparation of the individual so as to enable them to qualify for the recognized degree. Medical billing and coding has emerged as a rapidly growing sector in medical field and has gained wide popularity throughout the world. It has attached with it ample of opportunities which are highly demanded by firms like insurance companies, hospitals etc.

There are various medical billing and coding courses available in the market. It is important for the individual desired to obtain the certification to look for the best course. He should ensure that the course opted has the advantages of both theory as well as practical training attached with it. Moreover the courses today also offer ample opportunities to practice in the real world so as to give a handy experience to the student. These courses include both billing and coding. Both these terms are different and need to be dealt through separate courses. But nowadays student gets the benefit of receiving certification in both fields.

Medical billing includes billing done by insurance companies whereas medical coding is a wide term that involves processing of vital information from the sources of patient's examination, doctor's notes, laboratory tests, X-ray data and various other related reports. Such medical information is translated into standard codes specifying the procedure, diagnosis and level of care. These codes are further used by medical billers in order to detain the billing of particular patent and then submitting it to the relevant insurance company. Both billing and coding complement each other and are usually performed by the same employees. Thus, billing and coding courses involve a great development of skills to equip the individual with essential knowledge.




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





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2012年9月19日 星期三

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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Jump On Now and Ride the Medical Billing and Coding Tsunami Out of This Gloomy Economy


Medical Billing and Coding is hot!

The United States spends over $2 Trillion a year on healthcare...10 of the 20 fastest growing job categories are healthcare related with projected growth of almost 3 million new jobs between now and 2018...and medical billers an coders are right in the middle of the action.

Medical Billing and Coding is hot right now because Healthcare - worldwide - is hot. If you listen quietly you can almost hear Healthcare sizzling as it consumes over 10% of the gross domestic products of each of the world's most developed nations.

Right Place...Right Time

Medical billing and coding are important functions in running a medical office. There are approximately 600,000 medical establishments in the United States and they differ greatly in size, personnel staffing, and management structure. Almost 80% of U.S. medical establishments are doctor offices, dentist offices, or other types of health professional offices. Although hospitals make up a negligible percentage of all healthcare establishments, they employ a whopping 35% of all healthcare employees.

Medical Administration and Medical Records Management are among the fastest growing career sectors in the healthcare industry due not only to our aging population, but also because of increased use of and reliance on information technology to store and retrieve the tidal wave medical data being collected. And we are just getting started.

The job outlook is very positive for these jobs/careers as there not enough trained professionals to fill the growing need. The healthcare industry, with encouragement and support from the government, has taken the lead in utilizing information technology in its record keeping and this has led to the need for more qualified healthcare professionals with the expertise to use the technology.

An aspiring healthcare professional who wants to work in the field of medical administration should certainly at least consider a career in this field.

But understand this, dedicated medical billers usually do not to earn as much as healthcare professionals who possess both billing and coding skills. And of course your salary will depend on a variety of factors such as the size of the organization or institution, geographic location, the individual's level of education, credentials, and of course your experience.

What Do Billers and Coders Do Anyway?

For anyone investigating Medical Administration as a career choice and not familiar with the field, medical billers and medical coders are responsible for analyzing protected patient information and assigning the most accurate diagnosis and treatment codes.

These codes come from the International Statistical Classification of Diseases (ICD)-9 codes (soon to be ICD-10) and the accompanying Current Procedural Technology (cpt) treatment code with their associated modifiers.

A medical coder's job is to scrutinize patient information, assigned by his or her employer, and apply the proper codes to these patient records. It is imperative that this information be properly recorded and coded for patient diagnosis and treatment records to be accurate. Medical coders are also involved in medical research to properly assign codes.

Regarding the medical biller, the same coding information would be given to the medical biller to be entered and submitted for claims for repayment of medical services rendered. A medical coding and billing professional is capable of performing both tasks.




Having difficulty getting your first medical billing/coding job?
I know starting out it can be tough but if you are really determined to have a career in medical billing and coding you may need to make yourself stand out from the crowd.
There is more than one path to your medical billing and coding career, and you can read about it in my free reports at Medical Coding Certification Videos





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2012年9月17日 星期一

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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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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2012年9月16日 星期日

What Is Medical Billing and Coding?


If you are asking," what is medical billing and coding?" perhaps you are interested in knowing the job opportunities related to these fields. First of all, you must know that medical billing and coding deals with the accurate recording and processing of different patients' data, including their treatment records, insurance information, bills, as well as the received payments. The medical billing and coding specialist is the one who records the patient's diagnosis, the request for payments from an insurance company, or even directly from the individual. This work is not limited to a hospital alone; it could also be done in the doctor's office, a mental rehab facility, or other health care institutions that requires such a service. From this information alone, you can see that medical invoicing and coding jobs are very promising, and if this has piqued your interest, read along to find out more.

Now that the question "what is medical billing and coding?" is answered, perhaps you'd be interested to know more about jobs related to it.

So, what is medical billing and coding specialist? It is important to know what the health care industry expects from medical coding specialists, in order for you to know how your qualifications stack up. A skilled medical billing and coding specialist is expected to accurately record and register patient information, verify their insurance policies, and keep track of patient accounts; these may seem simple, but in this job, there's no room for error. Since health care is a very important aspect for an individual regardless of the age, the gender or the job, they can't afford to have any problems with the processing of their information. As a medical billing and coding specialist, you are expected to input every information regarding the patient accurately, and as much as possible, free of errors.

Oftentimes, data entry and organization are done using computer systems, so you won't run out of useful tools to do your job properly. However, some companies do maintain paper copies of documents, so you'll also be expected to do such jobs. Since you are the one keeping tabs of patient information, you're expected to speak with them directly regarding their statements and payment options. The coding part of the job involves taking note of all the illnesses and diagnoses made by physicians and then transcribing them to a format that's recognized throughout the health care industry.

Now that the question "what is medical billing and coding specialist?" is already answered, it's important for you to know about certain qualifications for the job. You normally need to have a high school diploma, but most of the time, employers favor those who have obtained an associate or bachelor's degree in business administration, accounting, and other similar fields. Learning about job specifics are usually done through paid training for these specialists. There are also certifications given by nationally recognized organizations in order to buff up your credential. All of these efforts are well worth it though, since this job usually pays well, from $10 to $18 per hour.




Times are tough!

If you are looking for a new career and wanting to find out more about Medical Billing Jobs click on the link or go to our website about Medical Billing Schools





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2012年9月15日 星期六

Medical Billing And Coding Certification Options


Once you have completed your medical billing and coding education, it would be wise to get at least one of the certifications available for individuals in this field. Employers love to see certifications because it shows that the person they are considering hiring has at least a basic level of knowledge in the field. Most certifications require you to pass an exam and then either retake the exam or take continuing education courses in order to keep your medical billing and coding certification current.

The majority of the certifications available are administered by the American Health Information Management Association (AHIMA). Those who have completed a Bachelor's degree are eligible to test for the Registered Health Information Administrator (RHIA) certification. Those who have completed an Associate's degree can test for the Registered Health Information Technician (RHIT) certification.

AHIMA Certification

The most entry level medical billing and coding certification option available from AHIMA is the Certified Coding Associate (CSA) certification. This does not require the coder to have a lot of experience. Once the coder has a bit more experience, they can then try for the Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician Based (CCS-P) certification through taking an exam. There is also a CHPS (Certified in Healthcare Privacy and Security) credential for those who are more advanced coders.

Board of Medical Specialty Coding Certification

Medical billing and coding certification is are also available from the Board of Medical Specialty Coding. Those with at least two years of coding experience can qualify for the Specialty Coding Professional (SCP) certification, and those with three to five years experience can qualify for the Advanced Coding Specialist (ACS) certification. There is also a Home Care Coding Specialist - Diagnosis (HCS-D) certification available through this organization.

AAPC Certification

The American Academy of Professional Coders (AAPC) offers four different options for medical billing and coding certification as well, depending on the area where you work. You are usually required to have two years work experience, but those without this can get Apprentice Certification status upon passing the required exams for the certifications. The certifications are Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), Certified Professional Coder-Payer (CPC-P), and Certified Interventional Radiology Cardiovascular Coder (CIRCC).

PAHCC Certification

Finally, there is also a Professional Association of Healthcare Coding Specialists (PAHCC) that offers certifications for those who are involved in specialty coding. The options include Cardiology (CCCS), ENT (CENTCS), Family Practice (CFPCS), Gastroenterology (CGCS), General Surgery (CGSCS), Internal Medicine (CIMCS), Obstetrics & Gynecology (COBGCS), Orthopedics (COCS), Pain Management (CPMCS), Pediatrics (CPEDCS), Podiatry (CPODCS), Pulmonology (CPCS), and Urology (CUCS).




To learn more about obtaining a medical billing and coding certification, please visit http://www.medicalbillingandcodingonline.net/.





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2012年9月13日 星期四

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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2012年9月10日 星期一

Tips for Billing and Coding in Medical Offices


The current economic climate is having a negative effect on physician practices. Flat or declining reimbursement, more regulatory paperwork, health reform, and IT implementation have but pressure on small practices. The good news is that there are ways to tighten up your belt and tune-up your practice going forward.

Improving the revenue cycle starts with some simple changes to effectively manage your physician practice. The following are some things to consider:

The billing manager does not have an active performance improvement plan to achieve industry standard metrics such as days in A/R (less than 90 days), Net collection rate, and write offs as a percent of total A/R.

• Electronic remits are less than 70% of total payments posted.

• Claims payments first pass rate is less than 85%

Keep billing office tasks to these:

Charge management and Edit Resolution

Claim production and payor claims filing

Payment posting and credit balances

Self-pay follow up (collect on front end if possible)

Here are a few more tips to fine tune your practice:

• Keep your IT infrastructure updated

• Review your compliance plan annually

With the current economic climate, your physician staff should make a concerted effort to generate more revenue with the same level of physician productivity.

Another question facing physicians is trying to decide if they should outsource their billing to a professional service. Factors that will affect the decision include your practice's current situation. If your billing department is behind in accounts receivable and claims are not being processed in a timely manner, it might be wise to consider handing off this important task to a qualified company. Doing this can significantly reduce office expenses and insure that your business is receiving collections in a timely manner. Comparative staff productivity is hard to measure because each practice has its unique mix of payer, office personnel and business functions. However, MGMA surveys has some surveys that measure staff and expenses, gross charges, and accounts receivable data that reveals that outsourcing is a viable option for 3 out of 4 practices.

The data has baseline studies that measured whether billing staff workload is below or above the average. They found that staff members in a medical office rarely receive adequate training and are not using the practice management system to the maximum effectiveness.

Correct coding and complete documentation is the basis to ensure that the practice rece3ives reimbursement from services performed. It can reduce the number of denied claims as it protects the practice against malpractice suits and investigations for fraud and abuse. A chart audit should be conducted to identify problems within a practice. This will insure that the office is following best practices which are so important nowadays as the industry moves from quantity to quality reimbursement. If the coding in your office has never been audited, you may want to hire an experienced coding professional to conduct an audit.

You will have to gather a representative sample of charts for different procedures, diagnoses, and physicians to start. Then you can review the documentation and check for correct application of E & M level use of procedure codes, modifiers, and diagnosis codes. You can also benchmark the coding levels with your doctors or use the CMS data. MGMA has an online tool with E & M coding data by specialty. You can find this under member benefits at mgma.com.

Sometimes physicians tend to under code (safe-coding) especially when it involves E&M codes. Even though this might lessen the worry about being investigated, it also cuts the practice revenue and physician income. Keeping up with proper use of E&M codes is a must for all biller/coders. Remember that the physician is the one held responsible for setting CPT and diagnosis codes. Some coders simply do not have the expertise to set the codes and physicians should supervise and give direction for this important task.




Centers for Medicare and Medicaid http://www.cms.gov

MGMA http://www.mgma.com

http://www.ironcomet.com/





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2012年9月9日 星期日

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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2012年9月3日 星期一

Understanding The Relationship Between Medical Billing And Medical Coding


Coding is the process of assigning of symbols, abbreviations or numeric and alphanumeric characters to represent some of kind of information. From a consumer's point of view, it makes the whole procedure very systematic and easy to deal with. The code instills the complete data and history of the description stored. With the growing technology and coding mechanisms available, the medical field is one area in which coding is proven useful. Medical coding is the process of transforming detailed history, symptoms, diagnosis and health-related procedures of diseases in numeric or alphanumeric systems. The application serves many purposes, and the classification is universal in nature and complacent while dealing.

Medical coding is often associated with another procedure, known as medical billing. Here, coding stands for the allotment of codes to different medical objects present in a premises, and the biller uses these codes for billing purposes. He or she uses the coder's codes for creating invoices which are entered into a computer and checked for the codes. The result is the total amount of the net purchased items. Many online training schools and medical colleges are on the run which offer complete education programs for medical coding and billing. They enable a coder to do certain jobs, which include:

- Allotting codes

- Decoding

- Convincing insurance companies

Do not think that these programs are a mere waste of time and money and those who cannot be doctors or nurses join this field. If this is your line of thought, you are absolutely wrong, as coding is as important in the healthcare field for learning directions as is navigators when sailing a sea. Medical coding is primarily used for the running of healthcare programs and keeping the history of the certain diagnosis with the tests used. Patients can use these codes to know about their diagnosis, to seek the services provided by their practitioner and they can even double-check their billing, using these codes.

There are different systems of coding, one of the most common of which is CPT. CPT Stands for Current Procedural Terminology Codes. These codes are developed by the American Medical Association and go through a complete process, after which these codes are submitted to the insurance companies or the payers. Hence, these medical codes keep three parties interlinked through reliable feelings. These parties include patients, insurance companies, various medical practitioners, and any other associates in a given practice.




If you're ready to start your Medical Coding Training & Certification, we have more great tools and resources on our website http://www.medicalcodingtrainingcertification.com





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2012年9月2日 星期日

How To Follow A Medical Coding And Billing Career


Some people elect to acquire a Medical coding and billing career. Medical coders are the people who are responsible for billing patients in doctors rooms or hospitals. Their responsibilities include assessing and processing of medical claims so that doctors and hospitals are correctly remunerated for the services that they have dispensed to patients.

Every time a patient undergoes a procedure, a CPT code or number is allocated to the procedure. This code is linked to an ICD code also known as a diagnosis code. These numbers exist so that insurance companies are able to track money that has to be paid to the service providers. They are extremely helpful in avoiding errors in payment and fraudulent claims as well.

People who want to do this kind of work need to be able to work well with numbers. It is important that they are able to pay attention to detail. Interpersonal skills are important even though much of the work involves processing, reviewing and the submitting of claims. Employees may have to liaise with care givers to access extra information. Coders will liaise with administration assistants at the insurance companies as well.

The ability to work with computers and various software applications is critical if people want to do this kind of work. Successful candidates will have a high school diploma and have passed an accredited exam in coding. There are associations that issue the certificates to successful students.

Students are able to study in live classrooms or online. Studying online permits people to be able to work and earn a living while being able to study part time. These courses are available at a price of between one thousand and two thousand dollars. It is suggested that candidates pass a course in anatomy and terminology before taking the coding course.

Full time employees will earn about thirty thousand dollars per year which equates to about fifteen dollars per hour. The hourly average ranges from thirteen dollars to just over seventeen dollars. The upside is that these people with these skills are in high demand. While software is available to do much of the work, it is still necessary to have human beings to perform tasks that computer programs are unable to find.

People will find a Medical coding and billing career challenging and stimulating. This position is critical to the financial success of a hospital or a doctors practice. Working hours are the standard forty hours per week and there should be no need to work weekends or at nights however employers will discuss this with interested parties.




Thinking about a job in medical coding and billing? If you're interested in gaining the right medical coding training, then take a look at http://www.medicalbillingandcodingsalarydata.com





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Using The Right Medical Billing Code For Home Dialysis


A simple, but crucial medical billing change has recently occurred. Beginning on October 1, 2005, the Medicare durable medical equipment regional carrier (DMERC) will no longer accept the diagnosis code 585.0. Instead of using ICD-9 585.0, medical billing should be done with the ICD-9 code 585.6 for home dialysis charges.

The code 585.0 means chronic renal failure. This code has now been discontinued and the DMERC will no longer be lenient on the code. The more descriptive code, 585.6 (end stage renal disease) much more accurately describes the diagnosis for home dialysis. It is important that your medical billing staff note this change. Failure to do so will result in unpaid future claims.

Situations like this depict the necessity to hire an outside medical billing firm. Many mistakes can be avoided by hiring one of these companies. Medical billing companies employ highly skilled individuals who are trained, certified, and updated on current medical billing/coding practices. By hiring these companies you are relieving your practice from the responsibility of training and updating your own medical billing personnel on changes.

Another advantage to using a medical billing firm is the time they free up for your personnel to work one-on-one with patients. The less time your staff spends on medical billing, the more time you can focus on customer service. This is an added bonus because the essence of medical care is centered around trust. In order for your patients to trust you, you must build up a rapport.

The change to the home dialysis medical billing code may be simple, however, there are many other medical billing changes that are not so simple. It is very important to keep up with all medical billing changes to ensure proper reimbursement for the future of your practice.




Melissa Clark, CCS-P is President and Director of Medical Billing Services for Outsource Management Group, LLC, a leading national medical billing firm.





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Medical Billing and Coding Books Are Different


Documenting the various facts and figures is very much essential and unavoidable when you do a medical insurance claim. All data should be entered in a clear and precise manner. For this, the coder should be aware of the very many billing codes that are generally used during the procedural and diagnosis level.  You can see the procedural codes in the CPT code book and the diagnosis codes in the ICD9 code books. Both are updated and published in a yearly basis. The CPT codes are published by the AMA (American Medical Association) from 1963 onwards and it was started because of the necessity of a standard to coding and terminology that was urgently needed.

Now from the passing of time 'medical coding' has become a complete arena by itself and these days you will be able to find many courses for teaching all about them. Almost all the insurance companies go by the individual codes and the coding industry has become of great importance. So we can see the true value of medical boding books and the significance of these books in the present world of medical insurance billing. Every year new version is given to these books and you must understand that insurance companies won't accept out-dated codes. If you by any chance happen to quote the out-dated codes there is every possibility of your claim getting denied!

Generally four categories of coding books are available like the CPT (Current Procedural Terminology), ICD9 (International classification of Diseases, HCPCS (Healthcare Common Procedure Coding System) and RBRVS (Recourse Based Relative Value Scale). You should be familiar with at least these four books in order to be a good and successful coder.

CPT code books contain the descriptions of the various services and procedures of physicians detailed using different CPT codes listed both in numerical and alphabetical way. Under each and every code, clear-cut explanations are given so that there are no ambiguities between the different services and procedures of physicians. Every year these codes are updated and coder should be aware of this fact. The CPT code books also contain a record of 'modifiers' which specify whether a service is modified or not. These AMA notified CPT modifiers are the 'two digit' numeric codes which are listed after the procedural codes.

As far as the ICD9 code books are concerned, they give the details of the coding system relating to the grouping and classifying of various diseases and covering the actual facts regarding them. Mainly these codes are employed in registering the incidence of medical diagnoses. Here also the listing is done both alphabetically and numerically and is updated annually.

HCPCS code books will give you the codes which are to be used with respect to the products, supplies and services which are not covered in the CPT code book. Some of the areas covered in this book are the ambulance services, durable medical equipments, and prosthetics/orthotics products. This code book also gives the coder an idea about the coding of the various materials which are used outside of the treatment place. This code book will be of much help to the insurance providers, the billing service centers who are doing the billing work for the providers, and agencies which offer services or supplies to the patient.

It is the RBRVS code book that determines the true value regarding the money paid to the medical facility providers including a physician is determined. Learning the latest version of RBRVS code book and acting accordingly is really a vital part in coding jobs. You must be always familiar with the renewed version of the RBRVS code book.




Dr. Adam L. Alpers invites you to access and gain knowledge in medical billing and coding by visiting 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, check it out today: http://www.medbillingncoding.com

Copyright - Adam L. Alpers. All Rights Reserved Worldwide





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2012年8月30日 星期四

Understanding CPT Code 28510 - Billing for Fracture Care Follow-Ups


Standard Fracture Care

When a patient suffers from a fracture, the initial treatment of the injury is usually performed in the emergency room. If your patient comes to your office for their fracture follow-up care instead of seeing an orthopedic specialist, you can bill for the follow-up care as long as you use the appropriate procedure codes and the ICD-9 code that correlates with the site of the fracture. CPT code 28510 covers the follow-up care for all closed fracture sites except for a fracture that is located in the big toe. Because of this, you will not need to perform any site manipulations to bill for the follow-up care you provide to your patients. Using CPT code 28510, you can expect to receive more than $100.00 for each follow-up visit related to the fracture.

Identifying the Correct Modifier

When treating a patient for follow-up fracture care, it is not uncommon to spend significant amounts of time addressing the injury. It is also common for patients to address other ailments during the course of their follow-up visits to your office. Fortunately, you can bill for the time spent addressing these ailments separately from the follow-up fracture care. Because you are addressing issues that are separate from the fracture itself, by documenting the visit accurately, you can bill for the separate consultation in addition to the fracture follow-up.

Fracture care has a specified global period in regards to medical billing. In order to bill correctly, your diagnosis codes must match each procedure performed. You should also take care to use the appropriate modifier for the office visit code when treating your patients. This will help you in your billing procedures.

It is important to remember that there will be times when a patient suffers from multiple fractures at different sites. For example, a patient who has suffered a serious accident may face broken ribs in addition to broken bones in the arm or leg. In cases such as this, you should bill for each site separately and use the appropriate modifier to separate the treatment of each fracture site. Also make sure that you document how much time is spent addressing each fracture site when treating your patient. In some cases, you may only be able to treat one fracture at a time when dealing with patients who are suffering from multiple injuries.

Understanding Worker's Compensation & PIP Guidelines

Many of the injured patients you treat will be billed through primary insurance providers, however, other patients may suffer injuries due to work-related activities or car accidents. Because of this, you need to ensure that you thoroughly understand the guidelines and regulations pertaining to Worker's Compensation and Personal Injury Protection policies in your state.

Depending on the area of your practice, the insurance carriers you bill may not accept modifiers or they may require that you use modifiers that are different from the ones you would normally use. The goal is to be paid for your time regardless of the type of insurance you are submitting claims to. If the insurance provider does deny a claim for the initial fracture care, you will need to call and explain to the provider that you did not provide the initial fracture care to the patient.

Obtaining the Compensation You Deserve

You can expect to treat at least ten patients a year for follow-up care related to a fracture. If these patients come to your office for treatment of a single-site fracture, each patient you treat will generate over $500.00 in billable revenue in addition to the revenue received for the standard office visit. It is not uncommon for practices to receive thousands of dollars in extra revenue each year for the treatment of fracture follow-up care, even if there are only a few patients in their care receiving this treatment. Because of this, you should do everything you can to take advantage of this particular source of revenue whenever possible.




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 and free online e-course today also at: http://www.medicalcodingcashsecrets.com

Copyright - Adam L. Alpers. All Rights Reserved Worldwide





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Medical Coding Billing As Part and Parcel of Healthcare


Upon diagnosis and treatment of a patient, the doctor is responsible to document the details as part of paperwork. All this information is later utilized in the processes for medical coding, billing and ultimately translated into payment. Although this is a process normally conducted away from the public eye, back office employees who perform the task of medical coding are specialists in selecting medical codes to match the doctors' diagnoses of patients' ailments. These codes are important details of reference when it comes to requesting payment from insurance companies and private payers. If a patient has an existing health insurance policy, these coding experts also check to verify whether claims can be made against the policy.

In order to comprehend what medical coding and billing is about, individuals interested in this field need to receive proper training. They can opt to enroll in courses from local educational establishments or distance learning providers. Since certification is required for active practice, it is best to check that the course selected is certified by the medical authorities. A certified coding expert is responsible to check and organize a patient's records, bills and statements before proceeding for medical coding. Billing is then generated based on correct codes entered into the system. Utilizing computer systems to carry out this task has taken a considerable load off as the coding and billing process is more efficient and effective. Reports on statistics, billing, mortality, morbidity and others are easily produced for submission to relevant authorities as well as for internal scrutiny where required.

In line with constant change in the medical industry, those involved in medical coding and billing are expected to keep themselves updated through continuing medical education. Changes are constantly imposed on billing procedures, insurance schemes offered on a public and private scale, workers' compensation, disease and diagnosis coding systems, procedure and treatment codes, physicians' fee scale and many more.

Since these experts are a required workforce by healthcare institutions and practitioners, they can either work within large institutions or offer themselves as outsourced service providers to smaller establishments or clinics.




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





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2012年8月29日 星期三

Transition From ICD 9 Codes to ICD 10 Codes - What Concerns This Medical Billing Business Owner


The transition from ICD-9 Codes to ICD 10 scares me - and here's why.

Experience with NPI

Just judging by the adoption of NPI (National Provider Identifier) numbers and the challenges it gave our billing service, ICD-10 code implementation has the potential to be very disruptive if a practice or billing service has not planned and prepared.

And NPI was only ONE number - ICD 10 codes are much more complex. Even if you and your provider are prepared, what about clearinghouses and insurance payers? Not to mention the largest insurance payer of them all - Medicare!

When our billing service incorporated NPI, we had the cost and disruption of upgrading our practice management software, coupled with having to re-map our claim files sent to the clearinghouse. There were also problems and confusion with some insurance carriers regarding legacy ID numbers, group NPI, and individual NPI.

This resulted in many claims not getting paid on the first submission - or second - or third... In some cases claims had to be re-submitted many times over. This was a major disruption to our clients revenue - and ours. And our clients are looking to us as a billing service to have all the answers.

As with NPI, we can expect that everybody will have a different interpretation of what implementing the new ICD 10 codes will require.

What sill it Cost?

What will the cost be to the small medical billing service? What will it cost our providers?

October 1, 2013 seams like a long way off - but we need to be learning, planning, and preparing for this transition now. I don't know if we have all fully grasped how much this will cost in direct and in-direct costs.

What I mean by direct costs are the time and money required for training, mapping ICD-9 to ICD-10, and potential costly software modifications. Indirect costs refer to interruptions to reimbursement for a providers - especially small ones. I have a feeling this is another unfunded mandate resulting from the 1996 HIPAA legislation thats going to cost all parties involved.

Brief Background of ICD 10 Codes

ICD-9 codes are nearly 30 years old and cannot be expanded any further diagnosis. Many of the diagnosis categories are full. ICD 9 codes are 3 to 5 characters. The first can be a number or letter, the 2nd through 5th are numbers with a decimal after the third character.

ICD 10 codes are 3 to 7 characters, the first one is a letter, 2nd through 7th are either a letter or number, with a decimal after 3 characters. These codes are arranged in chapters and sub-chapters with diseases grouped by letter. It allows over 155,000 diagnosis codes compared to a maximum of 17,000 ICD 9 codes.

Supposedly the greater number of codes in the ICD 10 will make it easier to find the right diagnosis code. ICD 10 has an improved structure and is more specific making it easier to use than ICD 9. Most practices use a relatively small number of codes related to the type of specialty.

Part of HIPAA

HIPAA legislation included the requirement for use of ICD 10 with a compliance date of October 1, 2013 to be implemented. The government agency requiring implementation is the Department of Health and Human Services (HHS). HHS has no plans to delay implementing.

Related to the switch to ICD 10 is the transition to the version 5010 standard for electronic transactions effective January 1, 2012. The 5010 changes are necessary to accommodate ICD 10 codes and NPI.

ICD-9 will no longer be maintained after implementation of ICD 10. ICD 10 is currently in use by other countries and is updated annually just like ICD 9.

Concerns

The issues of concern for most providers and those who serve them are the potential economic impacts. Will practice management systems be able to accommodate the greater number of diagnosis codes (up to 155,000) for ICD 10? Software applications from the front end physicians office to the clearinghouse to the payer will have to be able to accommodated ICD 10.

Will payers that don't yet use ICD 10 codes map everything back to ICD 9 for processing?

Estimates for healthcare providers, coders, and billers to become proficient with ICD 10 is 6 months.

From what I've read about ICD 10, it's an improvement to the current ICD 9 diagnosis codes, however the transition has the potential to be very disruptive. It seams like a long way off, but it's important to begin planning and preparing for this transition now.




Gina Wysor has over 10 years experience in the medical billing industry as well as an additional 10 years in the insurance industry. Gina is the owner of a home based medical billing and coding company, Advanced Reimbursement Solutions.

Visit http://www.all-things-medical-billing.com/ for more information on Medical Billing as a business or career. http://www.all-things-medical-billing.com/medical-billing-information.html has additional information on Medical Billing and some of the issues of concern to the Billing Specialist.





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