Guide on Medical Billing and Coding Training

For better career in Medical billing and coding proper medical training from accredited school or other programs of this field is required. Almost all medical billing programs are completed in one year or in less than one year, and along with this you can continue your full time job with training if your will get good job.

For enrollment in Medical billing training program it requires either diploma or GED i.e. General education development for admission. Some other schools may be different entrance test depending on school. For more information you can directly contact to school authority for further clearance.

Here I am going to give details of common subjects in which you will get training if you want to work in Medical Insurance Billing and coding Training.

Paper Claims Processing

Sometime it may be challenging to understand medical insurance policies and the administration of medical insurance like HMO and PPO.

Fast processing of medical insurance claims ensures doctors to get their fee quickly and efficiently. For this Medical insurance Billers and Coders plays a vital role in helping doctor to get their refunds on time.

While on training or job students must learn how to analyze and perceive the medical insurance papers and invoice.  An excellent training program will help you a lot in building reports, billing service providers, processing data and many more.

HMO

HMO stands for health maintenance organization(HMO). HMO is kind of medical insurance group bestows health services for a fixed annual fee in United States. It provides health care services for health insurance, self-funded health care benefit plans, individuals in United States.

PPO

PPO stands for preferred provider organization. It is an organization consists of Doctors, Hospitals and other health care providers who do agreement with third party administrator or insurer to provide health care services at affordable price to the insurers or administrators clients.

Health Insurance Policies

While on Medical training programs students should get deep instructions in the field of different health care policies and available programs.

A special class should be provided to students on Medical care, Medical aid, injury claims, health insurance group coverage and workers’ compensation.

CMS 1500 Claim Form

CMS 1500 form is issued by Medicare centers and Medicaid services and further used by all health care professionals to payoff services provided to patients. We can say that CMS 1500 is generally a claim form.

Students should get lot of instructions on CMS 1500 claim form while on training. During training school should give proper advice to student on how to fill the form correct and complete. One more thing while on training students should get training on identifing errors and fix these errors.

Understanding Codes

The most important part of Medical job is to know how to describe and use medical codes. In your course one class should be delivered on CPT and ICD codes. Understanding the code is must for this field if you are looking to make your carrier in Medical Billing and Coding.

CPT

CPT stands for Current Procedural Terminology and is a medical code set preserve by American Medical Association via CPT editorial panel. The CPT codes tell us about medical, surgical, and diagnostic service

These are specially designed to convey consistent information about medical services and procedure among patients, doctors, physicians.

On every October new edition are released. These codes identifies the services provided not about the diagnosis on claim

ICD

ICD stands for international classification of disease coding. The ICD is maintained by WHO and this is diagnostic tool for health management, epidemiology and health management. The main purpose of designing ICD is to classify diseases via diagnostic codes.

These codes are 6 character longs. We can say that these codes are designed to classify health problems and provides assistance on how to diagnostic over these problems.

Medical Billing Software

Students should get training on how to use Medical Billing Software. Training includes how to add information about new patient into your medical database correctly and completely, how to create financial transactions, and how to create common reports using these Medical Billing softwares.

There are various Medical Billing Softwares available online. You can check out these softwares to know more about these.

Workers’ Compensation

This is the most important topic that deals with how to identify fraud and abuse. So students should get training on how to deal with claims for compensation. This area covers study on medical claims in deep, CMS1500 federal worker completion form, judgment, appeal and compensation of claim filled by insurer.

Insurance Claims

Training in the field of Insurance claims help students in collecting and submission of insurance claims easily. It should also include the complete understanding of deductibles, receiving and transferring of payment and how to complete papers of insurance claims.

Here is the complete discussion on various subjects that must be taught to students . These subjects helps student to become more successful in field of Medical Billing and Coding. For more assistance on this please write us directly.

 

Earn a Medical Billing and Coding Certification

Do you know certified in medical billing and coding can take you where you can’t imagine?

Lot of places, depending on skills, work ethics, demand of job in your local area, and your own skills and efforts helps you in finding job. A certification can bring your employment possibilities to a new level. It ensures that you are efficient, professional, and qualified to perform the entire task that are required for medical billing and coding specialist.

What is the meaning of certification?

With certification medical billers and coders can take benefits mentioned below.

  • Higher professional norms
  • Higher professional dealings
  • Ability to direct regard and faith
  • Capable to earn more

The actual work profile of Medical insurance billers and coders is to maintain accurate records for insurance billing service and they are also health care professionals.

The health care providers will not receive actual payments they are demanding without accurate data and along with this patients will not receive correct treatment and medications because of inaccurate data.

How to Become a Certified Medical Insurance Biller and Coder

To start this first of all enroll yourself in good college that offers medical insurance billing and coding program and be graduate in this field. The second and most important task is to qualify in exam given by the American Academy of Professional Coders (AAPC) and by the American Health Information Management Association (AHIMA).  These organizations make you certified in medical billing and coding and ensure your skills in this field as professionals.

CMRS Exam

CMRS stands for Certified Medical Reimbursement specialist (CMRS) that was established specially for medical billing professionals. The AMBA i.e. American Medical Billing Association has been providing certification to this field from last ten years. The purpose of this exam is to enhance their professional status.

This exam consists of 16 sections i.e. Medical Terminology, Anatomy & Physiology, Information Technology, Web & Information Technology, ICD-9-CM Coding, CPT-4 Coding, Clearinghouses, CMS 1500, Insurance, Insurance Carriers, Acronyms, Compliance, Fraud & Abuse, Managed Care, General and Case Study.

In most of cases exam registration will be admitted on same day the exam is purchased. Students who enrolled for exam can complete the exam in 45 days. There is requirement of 85% or higher to pass the exam.

Three books i.e. HCPCS, CPT-4, and ICD-9 books are sufficient for this exam. One more book offered by AMBA i.e. CMRS case study 80% of the exam is taken from this book.

RHIA Exam

RHIA stands for Registered Health Information Administrator and was previously known as Registered Record Administrator. RHIA is completely managed by American Health Information Management Association (AHIMA). Certified person results will get license in health information management.

The certification in RHIA helps in making carrier in health information and medical records management, including management of the processes and systems that capture and report on health care-related data. The RHIA professional’s design and control health information systems to maintain all medical standards.

The main job profile of RHIA professional is to check patient medical report whether it is complete or not, ensures to keep all data confidential and not associated with medical care of any patient and maintains distance.

For certification in RHIA one must have bachelor degree in health information management program authorized by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) or graduate from a foreign association that has a agreement with AHIMA.

Certified Professional Coder Certificate (CPC)

Certification in certified Professional coder is the most recognized certification in medical healthcare industry. In last few years demand for certified professional coder is increasing day by day. According to U.S. Bureau of Labor Statistics jobs in field of CPC will increase by 22% in next 6 to 7 years.

To become CPC certified candidate must have job experience of at least two years in field of medical biller and coder. The candidate must have knowledge in CPT, ICD-9-CM, HCPCS, HCPCS coding manuals, pharmacology, human anatomy and medical terminologies.

The CPC exam consists of 150 multiple questions and covers 18 different fields. The CPC is divided in to two categories i.e.

  • Certified Professional Coder Hospital (CPC-H)
  • Certified Professional Coder Payer (CPC-P)

Certified Professional Coder Apprentice (CPC-A)

There is no requirement of two or more year job experience for CPC-A certification. Candidate can easily get CPC status when you have an experience of two or more years.

That is all about Certification in Medical Billing and Coding. I tried to put all the data that is important for this post. For more updated please tune with us.

What Does A Medical Biller Do?

Medical billing salaries rise as hospitals get busier and busier.

A medical biller is someone who handles the submission of claims with health insurance companies so that payment for services can be given by a healthcare provider.  This is actually different from a medical coder, though they are often considered the same thing.

Medical billers are very important to the business success of the healthcare industry and they must be extremely careful while submitting claims to insurance companies. This keeps the business running smoothly and leads to success of the physicians, hospitals and even the federal and state governments because it ensures that the inner workings of the hospital is going according to plan. (read: Everyone is getting paid properly!)

Though becoming a medical biller doesn’t require long years of schooling, especially with modern day advances in medical billing software available to consumers, it is an essential job within the healthcare industry and they really do contribute a lot within hospitals and other health care facilities and insurance companies.

Medical Biller Job Description

They will review hospital and patient records, figure out charges, submit claims to insurance companies and answer any questions about these claims. They navigate Medicare, Medicaid, and the Health Insurance Portability and Accountability Act. This act, known as HIPAA, is all about patients’ privacy and discusses how their personal health information can be shared. A medical biller will know the ins and outs of HIPAA so they deal with patients and insurance companies properly.

What is the work environment like?

A certified medical biller can work in any health work place including a hospital, nursing home, rehabilitation facility, as well as consulting companies and insurance companies. Medical billers are employed at high numbers as they are needed in all aspects of this industry. Most work full time and some even work from home by developing their own businesses.

Anyone with a high school diploma is able to become a medical biller, however it is a challenging career field. Medical billing courses are normally stand alone and separate from other programs at local colleges. They can also be completed online.

How Much Does A Medical Biller Make?

According to various statistics, medical billing salaries hover around the national average. However, it really depends on the state you are working from, and they can sometimes make more.  Asking for a raise is a possibility if you’d like to earn a little more!

Medical Billing Salary in Texas (TX)

Medical Health Information Technician Salary:

Median $$$ in Texas is $33,730

which is lower than the national median medical billing coding salary in the United States.

 

In the table below we have provided the median and mean salary of coders in TX, as well as in the U.S. so you can compare for yourself:

Hourly Mean $$$
Annual Mean $$$
Hourly Median $$$ Annual Median $$$
MB&C $$$ Texas (TX)
$17.80
$37,020
$16.22
$33,730
Texas State $$$
$21.35
$44,400
$15.81
$32,880
MB&C $$$ US
$18.13
$37,710
$16.81
$34,970

 

Median and mean hourly rates and yearly earnings of the metro and non-metro areas in the state, along with the employment number:

Area Name
Employment
Hourly Mean $$$
Annual Mean $$$
Hourly Median $$$
Annual Median $$$
Abilene TX
110
$14.52
$30,200
$12.76
$26,550
Amarillo TX
260
$16.15
$33,590
$15.30
$31,830
Austin-Round Rock-San Marcos TX
1080
$17.77
$36,950
$16.20
$33,690
Beaumont-Port Arthur TX
210
$17.51
$36,420
$15.28
$31,790
Brownsville-Harlingen TX
130
$14.75
$30,680
$12.74
$26,500
College Station-Bryan TX
100
$13.23
$27,520
$12.72
$26,460
Corpus Christi TX
220
$13.58
$28,240
$12.58
$26,170
Dallas-Fort Worth-Arlington TX
4220
$18.78
$39,050
$17.15
$35,660
Dallas-Plano-Irving TX Metropolitan Division
2860
$18.67
$38,840
$17.17
$35,710
El Paso TX
490
$14.96
$31,120
$13.58
$28,240
Fort Worth-Arlington TX Metropolitan Division
1360
$18.99
$39,490
$17.09
$35,550
Houston-Sugar Land-Baytown TX
4540
$19.62
$40,810
$18.08
$37,610
Killeen-Temple-Fort Hood TX
280
$18.95
$39,410
$18.91
$39,320
Laredo TX
120
$13.80
$28,710
$12.71
$26,430
Longview TX
210
$17.45
$36,300
$14.69
$30,550
Lubbock TX
230
$16.23
$33,750
$14.52
$30,190
McAllen-Edinburg-Mission TX
380
$13.63
$28,360
$11.60
$24,120
Midland TX
50
$16.20
$33,690
$14.53
$30,220
Odessa TX
80
$15.56
$32,360
$14.11
$29,350
San Angelo TX
100
$16.01
$33,290
$14.30
$29,750
San Antonio-New Braunfels TX
1760
$17.92
$37,270
$16.19
$33,680
Sherman-Denison TX
50
$15.22
$31,660
$15.41
$32,060
Tyler TX
240
$14.93
$31,050
$13.63
$28,340
Victoria TX
80
$15.91
$33,090
$13.47
$28,010
Waco TX
130
$15.52
$32,290
$13.87
$28,850
Wichita Falls TX
120
$17.08
$35,530
$14.52
$30,190
Northwestern Texas nonmetropolitan area
360
$14.98
$31,160
$13.95
$29,010
North Central Texas nonmetropolitan area
80
$15.47
$32,170
$13.53
$28,140
Eastern Texas nonmetropolitan area
370
$14.38
$29,910
$12.86
$26,740
Central Texas nonmetropolitan area
220
$14.88
$30,960
$14.27
$29,680
Southern Texas nonmetropolitan area
120
$12.80
$26,630
$11.54
$24,000
Gulf Coast Texas nonmetropolitan area
200
$14.67
$30,520
$12.43
$25,850

 

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