Medical billing and coding professionals ensure that the healthcare industry has accurate and timely medical data. Medical billers and coders translate a health provider’s descriptions of diseases, injuries, and procedures into numeric and alphanumeric codes. Medical codes are used for many reasons, such as mortality data, procedural data, and access to medical records by diagnoses and procedures in clinical care, research, and education. Medical coders have experienced a surge in career opportunities since the federal government’s mandate to electronically maintain all patient health records.
If you’re looking for a secure career in a fast-growing field, then Medical Billing and Coding could be your answer.
Characteristics that contribute to the success of a medical billing and coding specialist include:
According to the U.S. Bureau of Labor Statistics, employment of Medical Records and Health Information Specialists will grow 9 percent from 2020 to 2030, as fast as the average for all occupations.
Medical records and health information specialists will be needed to organize and manage the older generations’ health information data. This development will mean more claims for reimbursement from insurance companies.
What is the difference between Billing and Coding?
The job of a Medical Billing and Coding Specialist is to read your chart, match up what was wrong with you with its corresponding numerical code from the most current ICD-10 book, and then assigns the proper diagnosis code with its numerical code from the CPT 4 book. Those two codes and any modifier codes that may need to be used to better describe your problem and its treatment are then placed onto a patient encounter form or superbill.
This patient encounter form or superbill is then given to a Medical Biller or Medical Billing Specialist, as they are known in the industry, The Medical Biller or Medical Billing Specialist then inputs the information provided by the Medical Coder into whatever software package is used by the practice exactly as it is written. That information is recorded onto either a CMS 1500, UB-04 or ADA form. The information is then electronically submitted directly to the patient’s insurance carrier or sent directly to an electronic clearinghouse. When neither of those options is available, the form is printed out and mailed to the appropriate insurance carrier. If there is no software program available, the claim will be handwritten onto a CMS 1500, UB 04, or ADA form and mailed to the appropriate insurance company for processing.
However, a medical billing specialist’s responsibility does not end there. Once the information is submitted, the medical billing specialist then must follow up on every claim to make sure that it is paid. Sometimes that can be a burden because they must spend a lot of time on the phone with insurance carriers trying to get information about specific claims that come back rejected or denied. They must deal with patients who have concerns about their bills throughout the day. They must deal with the accounts receivable process where the insurance company sends back the physician’s payment and explanation of benefits (EOBs) for posting into their software. They must verify the status of the patient’s insurance coverage. The biller must create patient invoices for any money you may owe the practice for co-pays, co-insurance, and any non-covered services. A medical billing specialist must deal with denied claims and adjustments to a claim by filing appeals to the correct insurance carrier by getting the necessary paperwork to get the claim paid and resubmitting them to the proper carrier. They must run reports for their employers, explain any of the discrepancies that are found, and have a plan in place to correct the problems in a timely manner.
The Medical Billing and Coding program will prepare students for entry-level positions as outpatient medical billing and coding specialists for various health care settings. In October 2015, the U.S. healthcare system transitioned from the ICD-9 coding classification system to ICD-10. In doing so, the number of codes available to today’s coding professionals increased from 17,000 to 167,000. Today’s medical coders are required to have a firm understanding of medical terminology and Anatomy & Physiology. There are two training options available to each student.
Our comprehensive Medical Billing and Coding Program with Medical Terminology and Anatomy & Physiology is best for students who are new to healthcare. For students who have previously completed formal training in Medical Terminology and Anatomy & Physiology, we are happy to enroll you directly in the Medical Billing and Coding training program.
- Introduction to Med Terminology
- Organization of the Body
- Med Specialists and Case Reports
- Body Systems 1
- Body Systems 2
- Diagnostics and Abbreviations
Anatomy & Physiology
- A&P – Learning the Language
- Cells, Tissues, and Systems
- Skeletal and Muscle Systems
- Integumentary System
- Nervous Systems
- Special Senses and Endocrine System
- Cardiovascular System; Respiratory System
- Lymphatic and Immune Systems
- Gastrointestinal System
- Urinary System
- Reproductive System
Medical Billing & Coding
- An overview of healthcare and the insurance industry
- The organization and use of the ICD-10-CM/PCS, ICD-9, CPT, and HCPCS manuals to identify correct codes
- Detailed review and practice using the alphabetic index and tabular list of the ICD-10-CM/PCS and ICD-9
- Detailed review and practice coding examples from all sections within the CPT
- Basic claims processes for medical insurance and third-party reimbursements
- Completing common insurance forms, tracing delinquent claims, and appealing denied claims
Students completing this program can sit for the Certified Billing & Coding Specialist (CBCS) exam administered by the National Healthcareer Association (NHA).
- Program Fee3,595*Medical Billing & Coding
* For students new to healthcare, we recommend our Medical Billing & Coding with Medical Terminology and Anatomy & Physiology Combination Program.
The all-inclusive program fee covers everything a student needs to successfully complete this program, including:
This program qualifies for the MyCAA Tuition Assistance Program sponsored by the Department of Defense—a program designed for military spouses.