The Art of Medical The Art of Medical Billing and Coding—Billing and Coding—

AA Doctor’s Key to getting paid!Doctor’s Key to getting paid!

By Maria ColellaBy Maria Colella

New Utrecht High New Utrecht High SchoolSchool

What is Medical Billing What is Medical Billing and Coding?and Coding?

Medical billing and coding is the Medical billing and coding is the

practice of helping physicians practice of helping physicians

and health care centers get and health care centers get

reimbursed for services given to their patients.reimbursed for services given to their patients. A billing service can be home-based A billing service can be home-based

and started gradually. It’s ideal forand started gradually. It’s ideal for

people who want to be people who want to be self-employed self-employed

and become and become entrepreneurs.entrepreneurs.

Occupational OutlookOccupational Outlook

Insurance companies and Insurance companies and the government are the government are spending more time and spending more time and money researching for ways money researching for ways to control claims’ fraud, to control claims’ fraud, abuse and “medical abuse and “medical necessity” issues. necessity” issues.

This need has increased the This need has increased the demand for expert billers demand for expert billers and coders.and coders.

Medical Billers and Coders Medical Billers and Coders Career Tracks Career Tracks

Billing specialistBilling specialist Patient Account Patient Account

RepresentativeRepresentative Electronic Claims ProcessorElectronic Claims Processor Billing CoordinatorBilling Coordinator Coding SpecialistCoding Specialist Claims AnalystClaims Analyst Reimbursement SpecialistReimbursement Specialist Medical CollectorMedical Collector Claims ProcessorClaims Processor Claims ReviewerClaims Reviewer Private ConsultantPrivate Consultant

Medical Billing and Medical Billing and CodingCodingCareer LadderCareer Ladder

The Medical Biller and The Medical Biller and Coder’s Work DescriptionCoder’s Work Description

Explains insurance benefits to patients and clientsExplains insurance benefits to patients and clients Accurately completes claim formsAccurately completes claim forms Handles day-to-day medical billing proceduresHandles day-to-day medical billing procedures Adheres to each insurance carrier’s policies and proceduresAdheres to each insurance carrier’s policies and procedures Prompts billing to insurance companiesPrompts billing to insurance companies Documents all activities using correct medical terminologyDocuments all activities using correct medical terminology Schedules appointmentsSchedules appointments

COMPENSATION COMPENSATION Pay levels depend on experience, credential and Pay levels depend on experience, credential and educationeducation

Annual Salary RangesAnnual Salary Ranges Entry-Level: Entry-Level:

$20,000-$30,000$20,000-$30,000 Certified Coders: Certified Coders:

$25,000-$60,000$25,000-$60,000

Coder Consultants: Coder Consultants: $100,000 - $120,000$100,000 - $120,000

Tips on getting H I R E Tips on getting H I R E D!!D!!

Medical TerminologyMedical Terminology Anatomy and PhysiologyAnatomy and Physiology Basic math skillsBasic math skills

Excellent verbal/written Excellent verbal/written communication skillscommunication skills

Strong sense of ethicsStrong sense of ethics

Computer proficientComputer proficient Attentive to detailsAttentive to details

HAVE

KNOW

BE

National Major PlayersNational Major Players

Love TipsLove Tips

Job SecurityJob Security Personal SatisfactionPersonal Satisfaction ChallengeChallenge Rewarding Rewarding

ExperienceExperience Enjoy learning-by-Enjoy learning-by-

doingdoing See potential See potential to start to start

own businessown business

Specific courses in High Specific courses in High SchoolSchool

Medical TerminologyMedical Terminology Human Anatomy and PhysiologyHuman Anatomy and Physiology Computer ApplicationComputer Application BiologyBiology Business MathBusiness Math Health EducationHealth Education

TrainingTraining

Training can be Training can be obtained from any obtained from any of the following:of the following:

2-year college 2-year college (Associate Degree)(Associate Degree)

Technical school Technical school (Diploma)(Diploma)

Certificates from Certificates from correspondence coursescorrespondence courses

Home-study program Home-study program (Certificate)(Certificate)

National Certification must

be obtained at the end of

this training

2-Year College2-Year College

A.S. in Office Administration and TechnologyA.S. in Office Administration and Technology Certification in Medical Billing and CodingCertification in Medical Billing and Coding CTF 25 Introduction, Terminology and Coding (T)CTF 25 Introduction, Terminology and Coding (T)

CTF 26 Procedures and Coding CTF 26 Procedures and Coding (CPT-4 and ICD-9-CM) (T) (CPT-4 and ICD-9-CM) (T) CTF 27 Electronic Billing and Clinical PracticeCTF 27 Electronic Billing and Clinical Practice (T) (T)

http://www.kbcc.cuny.edu/aboutKCC/navlight.html

Technical SchoolTechnical School

On line trainingOn line traininghttp://www.alliedschools.com/Learning/info_onedu.asphttp://www.alliedschools.com/Learning/info_onedu.asp

http://www.chubbinstitute.com

CERTIFICATIONCERTIFICATION

The The Certified Billing and Coding Certified Billing and Coding Specialist Certification (CBCS)Specialist Certification (CBCS)

is given by the is given by the

The National Healthcareer Association The National Healthcareer Association (NHA) (NHA)

upon completion of training upon completion of training

and/or degree.and/or degree.

Employers who’ll hire Employers who’ll hire you!you!

Employers who would Employers who would hire college graduateshire college graduates

Medical/Dental Private Practices

Employers who would Employers who would hire H.S. Studentshire H.S. Students

Hospitals Hospitals Nursing HomesNursing Homes Medical Group Practices Medical Group Practices

Home Health Agencies Home Health Agencies

ClinicsClinics

Facilities in the Community

Need more information…Need more information…

http://www.medicalbillingandcoding.nethttp://www.medicalbillingandcoding.net

http://www.bls.gov/oco/ocos103.htmhttp://www.bls.gov/oco/ocos103.htm

http://www.ahima.org/http://www.ahima.org/