Medical Billing and Coding Center




Welcome to the Medical Billing and Coding Center!


Are you looking for valuable information about this exciting field?  You have landed on the right website.  It’s not easy to find good and trustworthy information about this area of the healthcare industry on the internet.

Our website strives to supply accurate and up-to-date information for the career-minded individual researching this medical profession.

Our intent is to provide you with all the necessary information and tools needed to secure yourself a position in this rapidly growing segment of the medical industry.  In essence, this website was built to be a “center” or hub of information about billing and coding.  In that regard, we will offer you insights and tips about jobs, salary, training, certification, schools and much more.

Why is this field growing so rapidly? 

Medical billers and coders are a crucial link in the process for doctors, hospitals and other healthcare facilities to be fairly reimbursed for the services they have rendered.

If the reimbursements from Medicare, Medicaid and private insurance companies are not made in a timely manner, the resulting cash flow problems (reduction of staff, shorter hours, etc., etc.) may severely hamper them from providing the necessary treatment for their patients.

As a result,  jobs in this area have been and, will most likely continue to be for the foreseeable future, a high demand career field as well as a highly competitive field.

What’s the difference?

Medical billing entails the process of collecting all the information which must be included on a submitted bill to the respective insurance companies.  This collecting of information will normally involve:   ensuring that all paperwork is signed and completed, all billing information is entered into a computer record, collecting all reimbursements and payments from the insurance companies and the patients, following up on denied claims and appealing if necessary, communicating with patients and or doctors concerning overdue payments or billing errors and in modifying or adjusting medical bills.

Medical coding is the process of assigning a code or number to a medical diagnosis, procedure or service in order to receive proper payment from Medicare, Medicaid or private insurance companies.  A medical coder should be proficient in a basic understanding of medical terminology, anatomy, physiology and diseases.

What training do I need?

Training programs are plentiful, whether found in brick and mortar schools or in online schools.  The key is to find the right program for your educational and work background.

Many prospective students will have little or no medical education or background, but with hard work and the right training they will find success.  Some students will have quite a bit of medical knowledge or experience and will find the training process somewhat easier.

However, make no mistake about it, this intense training will require a “can do” attitude.

Finding the right school for you

One basic element in searching for schools is deciding whether to attend a brick and mortar school or to receive your education from an online schools website.

This is a very important decision and one not to be made lightly.  Some students excel in a regular classroom environment, while other students do much better with online classes, learning at their own pace and fitting coursework into their schedule.

Another crucial factor is finding an accredited school.  A school program accredited by AHIMA, AAPC or CAHIIM will help ensure that your education will meet the requirements needed to pass the certification examinations you will take later.

Do I need to be certified?

Yes, your prospective employer will, more than likely, put great weight upon seeing credentials after your name.  You attain these credentials through a certification examination by a nationally recognized organization like AHIMA or AAPC.

Credentials or certifications assure the prospective employer that you are skilled and dedicated to this field of study, that you are qualified and have the necessary aptitude to precisely and efficiently be a coder or biller.

With the appropriate certification, you should expect to earn more money in an entry-level healthcare job than most other entry-level healthcare positions.

How much money should I expect to earn?

As with any career position, there are many variables that affect the amount of money one should expect to earn in this field.

A salary in this field will fluctuate depending upon your:

  • geographic area – do you live in a large metropolitan city or in a less densely populated area?
  • physical job location – small hospital, large hospital, insurance company, doctor’s office, etc., etc.
  • training - accredited program?
  • job experience - recently certified, have years of hands on experience or specialize in a certain area like nephrology.
  • economy - almost everyone is affected by their local or national economy.

Given all those variables, the overall average salary for a biller or coder will be anywhere from $29,000 per year and $45,000 per year.  Remember, these are just averages and that all the above variables have been thrown in to the equation.  Your actual salary could be higher or lower.

Is this career right for you?

Is this career the right fit for you?  Find out by browsing through our articles.  You will undoubtedly find some helpful information to make an intelligent decision.  Our website is loaded with free information and, who knows, you may make the best decision of  your life.

 

 

 

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Don’t Be A Victim To A Scam



 

Look Before You Leap

 

Using a well-worn phrase like “look before you leap” may seem overly trite, however, in the world of vocational education it’s a phrase well worth heeding.

Woman leaping into the air.

 

A career in this field has bесоmе super popular due to many reasons, but the prime reason is the atrocious economy we are dealing with today. Since this is a vocational career, many so-called “schools” have been setting up shop physically and online, just waiting to take your hard-earned money in the form of tuition and school loans.   Continue reading

System Rife With Errors



 

This article paints a picture of why it’s critical for any person studying medical billing and coding to gain a full understanding of this field.  Your decisions may affect people’s financial lives for years after their medical treatment has ended.  

The Cleveland Plain Dealer’s year-long look at medical billing continues:

 

 

 

 

Medical billing, a world of hurt: Error-prone system is headache for insurers, providers, patients

Published: Sunday, May 06, 2012, 6:00 AM     Updated: Thursday, May 10, 2012, 9:50 AM

 

 

CLEVELAND, Ohio — Early last month, federal health officials made an announcement that brought cheers in hospital boardrooms nationwide and prompted the American Medical Association, the nation’s largest physicians group, to release a rare letter declaring its appreciation for government regulators.

From all the hoopla, you would think that there had been a breakthrough medical discovery.

But the big news from the Centers for Medicare Medicaid Services was that there would be a one-year delay in implementing tens of thousands of new medical billing codes, part of an arcane system that directly affects every patient in America.

Medical billing codes tell the story of a patient’s treatment, dictating how much is paid to medical providers and, ultimately, who pays it — an insurance company, Medicare or Medicaid, or you. They also are at the heart of many, but not all, of the billing issues that drive consumers crazy.

The world of billing problems is as vast as medicine itself. Among the many frequent complaints are: patients being billed for the wrong treatment, receiving double billing for the same treatment, being charged for more than an insurance contract allows or getting a bill for unexpected costs, such as a “facility fee.”

Insurance companies and medical providers share the blame for the problems, which are common, maddening and expensive. The Plain Dealer will< spend the next year examining these issues. We’re hoping you will help by telling us about your problems with medical bills in our online survey.

“It all comes down to human beings being involved in a process that is very complicated,” said Kevin Theiss, a vice president at Summa Health System who oversees an operation that sends out roughly 800,000 bills a year…continue reading at “Medical billing, a world of hurt…”

 

 

 

 

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Your Cheatin’ Heart



 

 

 This article from the New Miami Times reinforces exactly what I preach throughout my website. You must be relentless in researching these for-profit schools/colleges to make sure you are not being ripped off:

 

 

 For-Profit Colleges Cheat Students and Get Away With It

 

 

 

Diana Medina’s prospects seemed bright. She graduated with honors from Pahokee High School in Palm Beach County and earned a graduate degree in health science education from the University of Florida. But then, after she put her career on hold to raise a child, she entered the tricky world of for-profit education.

In November 2009, looking for a leg up in getting hired, she searched Google for a place that could give her advanced training with flexible hours. She found MedVance, a trade school that teaches health-care skills such as x-ray technology and medical billing. And that’s where her education hit the skids.

Critics say the school, which is based in Baltimore and has Florida campuses from Port St. Lucie to Miami, deceptively lured students into expensive educational programs that ultimately proved worthless.

An admissions rep, who turned out to be little more than a pushy salesperson, steered Medina toward the Medical Office Administration program even though she said she wanted to study pharmacy. It cost around $12,000. The rep told her she’d be able to get a starting salary of $50,000 or more after graduating.

“I was duped,” Medina says. “The program was not worth $12,000. The teachers were not really teaching. It’s like the students were running the classroom. It wasn’t a learning environment

 

…Read the rest of the article at For-Profit Colleges Cheat Students and Get Away With It – Miami New Times

 

 

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Codes Gone Wild



 

 

 

The Cleveland Plain Dealer’s year long look at medical billing continues with this article on how a man fought the system and won.  The critical component of this mess begins with the wrong code:

 

 

Brook Park man has $24,000-plus medical billing error resolved in his favor

Published: Sunday, July 22, 2012, 5:50 AM

By Dave Davis, The Plain Dealer

 

CLEVELAND, Ohio — Nearly two years after paramedics rushed Richard Kestranek to Fairview Hospital, the Brook Park resident is finally able to breathe easy.

The retired East Ohio Gas lineman, who suffers from chronic obstructive pulmonary disease, or COPD, after a battle with lung cancer in the mid-1990s left him without part of a lung, was recently notified by hospital officials that they had resolved in his favor a billing dispute that had cast a cloud over more than $24,000 in bills accumulated during his hospital stay.

Officials at the Cleveland Clinic, which owns Fairview Hospital, said the action came in response to a June 24 Plain Dealer story about Kestranek, now 68.

Unable to breathe in the early hours of Oct. 17, 2010, Kestranek received emergency treatment for several hours before being admitted to the hospital as an “observation” patient, a status that usually designates someone is not sick enough to be an “inpatient,” and one that usually shifts a greater portion of the cost for care from the insurance company to the hospital and patient. He remained in the hospital for four days….More at Brook Park man has $24000-plus medical billing error resolved in his favor – Plain Dealer

 

 

 

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Preparation for ICD-10



 

 

 

An article from Diagnostic Imaging gives an overview into what certain specialties, in this case radiologists, should do to get ready for the ICD-10 implementation:

Prepping Your Radiology Practice for ICD-10

By Sara Michael | July 26, 2012 
Diagnostic Review

 

Physicians historically lag behind hospitals in terms of technology and this just makes it worse. Except for physician practices that are affiliated with or part of an academic center or a larger health care system, the vast majority of practices haven’t done anything of significance to get ready. They have many other pressing issues they are dealing with — quality measures, electronic medical records. But they are just waiting to see what the date is going to be….More at Prepping Your Radiology Practice for ICD-10 – Diagnostic Imaging


 

 

 

 

More Reading

 

Frustration Station



 

 

More from the Cleveland Plain Dealer’s series on medical billing. This time, one word adds more dollars to a patient’s bill:

 

 

 

Confusion over coding adds up to frustration

Published: Sunday, June 24, 2012, 5:59 AM

 

When Denny Linville started experiencing dizzy spells that he thought were related to his blood pressure, the 70-year-old Walton Hills council president called his doctor’s office.

They said they could work him in for an appointment, adding that it could be his annual exam because he had not yet had one.

Before the appointment in March 2011, Linville checked the national “Medicare & You” manual for coverage and found what he wanted on page 53….More at Confusion over coding adds up to frustration – Plain Dealer

 

 

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A Headache of a Bill



 

 

A couple of minutes with her doctor, a cortisone shot and a bill for $1,481 does not add up for this patient. More from the Cleveland Plain Dealer’s series on Medical Billing:

 

 

 

A shot of cortisone, a headache of a bill

Published: Sunday, June 24, 2012, 5:59 AM

 

 

A quick shot of cortisone brought Holly Burgess relief from a painful flare-up of plantar fasciitis, or “policeman’s heel,” a common ailment that makes it difficult to walk.

While the treatment was effective, the 65-year-old retired teacher left the South Pointe Hospital medical offices Janusary 19 with a new medical issue, one she wouldn’t discover for more than a month.

It was the bill: $1,481 for what Burgess describes as two minutes with a doctor and a shot that was so easy to give that she didn’t even have to move to a full-fledged exam room….More at A shot of cortisone, a headache of a bill – Plain Dealer

 

 

 

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The Key to a Bill



 

 

More from the Cleveland Plain Dealer’s series on medical coding…timely and informative articles:

 

 

 

 

Medical coding: the key to a bill

Published: Sunday, June 24, 2012, 5:59 AM
By Sarah Jane Tribble, The Plain Dealer

 

Coders play a significant role in the creation of a medical bill. Understanding what they do could help you interpret your bill.

What do coders do?

Coders review the documentation of a patient’s care and interpret it into billable codes that insurance companies can process. The health care industry uses sets of codes, including the CPT, or current procedural terminology; and ICD, or international classification of diseases. Coding is a difficult job. The ICD-9 code book, for example, is over 100 pages.

What kind of training do coders receive?

University Hospitals hires coders who have at least two years of college education, which generally includes classes in pharmacy, anatomy and physiology, disease processes, pathology and diagnostic studies….More at Medical coding: the key to a bill – Plain Dealer (blog)

 

 

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Medical Billing Errors



 

 

 

The Cleveland Plain Dealer is running a series of articles – for a whole year- concerning medical billing.  So far, these articles are fantastic for the average person, but even more so for the person considering a career in medical billing and coding.  

I’ll be posting as many of these articles as possible for your benefit:

Medical Billing Errors: What can go wrong? What can you do?

Published: Sunday, June 24, 2012, 6:00 AM     Updated: Sunday, June 24, 2012, 8:22 AM

 

CLEVELAND, Ohio — There are lots of places where something can go wrong with your hospital bill. By our count, 289 of them.

That’s how many people who can play a part in creating a bill before, during and after a hospital stay.

There are the intake workers who take information, doctors and nurses who record treatment on a chart, coders who use those notations to assign billing codes, and many others along the way.

Each person who enters information in a medical chart must make sure the notations are mistake-free, complete and tell a story. Any missing, or excessive, detail can affect charges on a final bill and determine how much is covered by insurance.

Then there are people at insurance companies who decide if your treatment is covered, hospital billing employees who review charges and, in many cases, collections workers whose job is to make sure you pay.

The opportunities for mistakes are astronomical, and a mistake early on can compound exponentially. Mistakes can be as simple as human error or as complex as interpretation; some seem inexplicable.

…More at Medical Billing Errors: What can go wrong? What can you do? – Plain Dealer

 

 

More Reading

ICD-10 Preparation Critical





Why preparing now for ICD-10 compliance could save money later (via redOrbit)

CHICAGO, July 9, 2012 /PRNewswire/ — In order to receive reimbursement for patient claims, U.S. healthcare providers must begin using a revised global system for classifying medical diagnoses and inpatient procedures by Oct. 1, 2014. While more than two years sounds like plenty of time to implement…

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