Everyday the American public is overwhelmed with sound bites, headlines and newscasts about the health care industry, yet, for the most part, we understand very little about the intricacies of that same market. One of the most widespread misunderstandings lies in the system of medical billing and coding. Allow me to decode this tricky process for you.
Medical billing and coding takes place in what is called the billing cycle. In its simplest terms, a health care provider (i.e. a hospital, clinic, etc.) completes the appropriate paperwork to summarize an interaction with a patient. This includes the nature of the visit (emergency, checkup, etc.) and any changes to the patient’s records (address, provider, etc.). The health care provider then completes this paperwork which includes any diagnoses given and the amount of service provided to the patient. The information is then encoded to ensure privacy and sent to the insurance company, who processes the information and determines the amount of reimbursement. For claims that deal with higher amounts of money, an insurance company will often have a board of directors review the billing.
We know what you might be thinking: Sure, that sounds important, but why do I have to know this? The answer might surprise you. Medical Billing and Coding is one of the few fields in America that is in dire need of prospective employees to meet the demand of their expanding work force. So how can you take advantage of this incredible opportunity? We’ll tell you.
Because medical billing and coding is such a specialized process and as a result has a rather small pool of potential applicants. This means that you have a high risk of being hired should you attend a school that offers certification in medical billing and coding. Additionally, HIPPA has mandated that providers create electronic transactions for all medical billing and coding. This opens up an opportunity for you to be certified in a growing area with an even smaller applicant pool.
While medical billing and coding may be a relatively unknown process, because of the high reward for those involved, it is one that is definitely worth immersing yourself in.
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