What is medical billing and coding? There are important processes that keep the organization of a healthcare setup intact. Medical billing is the preparation of invoices for services rendered. These invoices are given to medical authorities and Insurance companies. Medical coding is the translation of medical reports and records into codes. For in depth details one can also go through medical school near me.

In this article, we are going to present a deep picture of medical billing and coding. We will discuss various questions related to this field such as what is medical billing and coding salary? What type of education is needed for medical billing and coding? and many more.

What is medical billing and coding
What is medical billing and coding

What is Medical Billing and Coding?

Medical billing

Medical billing is the preparation of invoices and receipts for services provided. These invoices are sent to medical providers and Insurance companies. They function as a tie-up between patients, service providers, and payers. Without them, the process of reimbursement cannot be executed. They are the backbones of the medical system.

Medical Coding

Medical coding refers to the encryption of medical reports and records into codes. This helps in summarising the complex medical reports into different codes. Knowledge of three main code sets such as CPT, ICD, and HCPC is necessary for understanding these codes. 

These coding systems help the coders in documenting the complex and cumbersome medical records. The codes also help in understanding the medical procedure that is to be performed to treat the patient. Now lets discuss the questions regarding what is medical billing and coding education.

What type of education is needed for Medical billing and coding?

It is not legally binding for a person to get medical coding and billing education and certification in this field. But for those who lack experience and have no prior knowledge of allied healthcare, certification is highly recommended. We are going to present a detailed breakdown on what is the Certification courses.

Medical billing and coding certification
Medical billing and coding certification

Medical billing and coding certification – Courses

Here we will discuss see what is the certification requirements. We have divided the courses into two. so, let us look on the medical billing and coding certification courses. These are- 

  • AMBA– AMBA is a professional organization that is committed to the medical billing area. The AMBA has the authority to validate medical billing professionals through the Certified Medical Reimbursement Specialist (CMRS) exam. 

CMRS exam is a highly competitive exam that examines the aspirants on different parameters. This test is highly rated for producing outstanding professionals in the medical billing field. Students must have a membership of AMBA to take the exam. Membership of AMBA costs $99 per year. So having an idea of accredited medical billing and coding schools online with financial aid can help you out financially.

The examination comprises  16 subjects. The subjects covered are:

  1. Medical Terminology
  2. Anatomy and Physiology
  3. Web and Information technology
  4. Computers
  5. ICD-10-CM Coding
  6. CPT coding
  7. EDI Transactions and Clearinghouses
  8. CMS 1500 Claim Form
  9. Insurance
  10. Insurance Carriers
  11. Terms in Healthcare
  12. Compliance and HIPPA
  13. Fraud and Abuse
  14. Managed Care
  15. General
  16. Case studies 

There are more than 800 questions in this exam and to pass this exam, students must score a minimum of 85%. Students can give this exam online. They have 45 days between sign-up and the exam. Scores are known immediately after completion.

Two retakes of this exam are allowed. But these two retakes must not have more than 60 days between them.

After clearing the exam, you will need to sustain your certification. To do this, you must complete 15 credits of continuing education each year. You will have to attend classes available through AMBA, AMA, and several accredited organizations as well. 

  • AAPC– The American Association of Professional Coders provides certifications for both Medical Coding and Medical Billing. The medical billing certification by the AAPC is awarded upon the completion of the Certified Professional Biller (CPB) exam. The exam is rigorous. 

The CPB exam includes 200 questions. The duration of the exam is more than 5 hours. The subjects in the syllabus of the exam are- 

  1. Types of Insurance
  2. Billing regulations
  3. HIPAA and compliance
  4. Reimbursements and collections
  5. Billing
  6. Coding
  7. Case Studies 

Students are required to score a minimum of 65% or higher to pass the exam. Students are allowed to use their codebooks in the exam; the codebook has a list of ICD-10-CM, CPT, and HCPCS codes. Like the CMRS exam, students are required to pay for a membership in the AAPC. They must finish a certain amount of courses to maintain their certification.

Completing 36 units of education is a prerequisite for maintaining certification. 

On the other hand, the AAPC and AHIMA are the top two organizations that grant medical coding certification. The various medical coding certifications are-

  1. Certified Professional Coder (CPC)
  2. Certified Outpatient Coding (COC)
  3. Certified Inpatient Coder (CIC)
  4. Certified Risk Adjustment Coder (CRC)
  5. Certified Professional Coder-Payer (CRC-P)
  6. Certified Coding Assistant (CCA)
  7. Certified Coding Specialist (CCS)
  8. Certified Coding Specialist-Physician-based (CCS-P)

AAPC 

It is the biggest organization of coders. It provides basic and specialized medical coding courses. For a beginner, searching out for what is medical billing and coding should start with the general certification. The most popular coding certification exam is the Certified Professional Coder (CPC) exam. It is recommended for all the aspirants to at least have an associate degree by the AAPC.

This general certificate covers different dimensions of the coding profession. These dimensions are based on different subjects such as diagnostic codes, procedure codes, coding guidelines, medical terminology, and more.

When talking about what is medical billing and coding certification one should know that there are other core certification programs that are offered by the AAPC. These are Certified Outpatient Coding (COC), Certified Inpatient Coder (CIC), Certified Risk Adjustment Coder (CRC) and Certified Professional Coder-Payer (CPC-P)

For those who are already certified professional coders and want to earn more qualifications, there are more advanced courses available. The AAPC offers specialized certifications in Ambulatory Surgery Centre coding, Cardiology, Family Practice, and many other disciplines. 

Along with clearing assumptions on what is medical billing and coding certification requirements one should know that with completing one of the AAPC Examinations, certified individuals are required to complete 36 hours of continuing education every two years. This makes sure that the individual is up-to-date with his skills. Seminars, Online training courses, Chapter meetings, Workshops are components of continuing education programs. 

Individuals can gain promotion and become full-time coders from apprentice ones, by demonstrating two letters of recommendation that signify two years of experience in working with CPT, ICD, and HCPCS codes. The proof of completion can also be provided by showing the record of 80 hours of education in coding. 

AHIMA

The American Health Information Management Association is a large organization that offers certification to medical coders. The programs offered by AHIMA are Certified Coding Assistant (CCA), Certified Coding Specialist (CCS), and Certified Coding Specialist-Physician-based (CCS-P).

The major distinction between AAPC and AHIMA is that in AAPC the aspirant must have membership; such compulsion is not there for AHIMA. However, AHIMA expects certified professionals to complete 20 continuing education units every two years to sustain their medical coding certification.

The education units include seminars, AHIMA meetings, webinars, online training courses, formal education programs, etc. AHIMA offers certification for administrative posts as well. One can also look out for free online medical billing and coding certification programs.

After discussing on what is medical billing and coding education you should know that these certifications are affordable and they are not heavier for your pockets. The facility of online training is available which is excellent. This will be convenient for those who move around very frequently.

What is Medical billing and coding salary
What is Medical billing and coding salary

What is Medical billing and coding salary?

Most of the American healthcare centers are modernizing themselves. This means more and more opportunities for medical coders and billers. Demand for healthcare professionals is rising day by day. According to the Bureau of Labour and Statistics, the medical billing and coding field is expected to grow by 20% between now and 2026. 

There will be a lot of opportunities in Hospitals, clinics, nursing homes, healthcare centers, etc. Medical billers and coders are in high demand in Insurance Companies and Government agencies as well. The average salary for coders and billers is $50000.

Here are the various types of posts available for students asking on what is medical billing and coding salary.

  • Medical Billing Specialist– He reviews and validates medical bills and invoices. He has to ensure accuracy in record keeping. He follows insurance claims procedures. The average annual salary of a medical billing specialist is $41,500. Click here to know more about medical billing specialist.
  • Medical billing clerk– He is responsible for reviewing, researching, and generating third party billing for medical centers. He is tasked with completing ICD -10 coding. He maintains all records in the payment book and other daily services. The average annual salary of a medical billing clerk is $38,750.
  • Medical Records Coding Manager– He is tasked with supervising and providing coding training to the staff so that the reimbursement is correct and complies with guidelines. He has to ensure the accuracy of the coding processes.
    Besides this, he also has to look after the day to day management. He ensures that all the targets are met within the approved budget.
  • Medical Records Coding Technician– He extracts information from medical records and assigns ICD 10 codes to patient records. He inputs and maintains data on procedures required for state reporting. The average annual salary of a coding technician is $53,810.
  • Billing Manager– He looks after the proper execution of procedures that ensure accurate billing. He ensures that billing practices comply with regulations and guidelines. He oversees the investigation and resolves billing errors. The average annual salary of a billing manager is $94000. 
  • Billing Analyst– He designs and executes billing processes and ensures its timely delivery. He advises changes to the procedure, keeps an eye on customer accounts for timely payments, and provides reports about those accounts to the management. His work is collaborative in nature as he has to frequently contact supervisors.

    The average annual salary of a billing analyst varies according to the seniority status. It begins at $47000 and can reach $67000.
  • Billing Clerk– He performs clerical functions in the medical department. This involves data-entry, information validation, and bill generation. In case of errors, he reports the management. He responds to customer inquiries pertaining to bills. The average annual salary of a billing clerk is $39000. Hope the above discussion on what is medical billing and coding salary was useful to you.

What is Medical coding and billing – Skills

The medical coder should be fully focused on assessing the codes. One coding mistake can result in a terrible situation. This can result in a patient getting the wrong treatment and many more problems. Lets have a look on the what is medical coding and billing skills that they should possess.

  • Computer skills– Excellent computer skills are not only required in medical coding but also in medical billing. A medical biller must know about using medical billing software effectively. Many hospitals are upgrading towards the Electronic Health record systems that are why proficiency in computers is a must.
  • Communication skills- Many people who ask about what is medical billing and coding also think that medical billing and coding is just a typical; desk-job and communication skills hardly matter here. But this is a big myth. In this field, you must possess good writing skills and presentation skills so that you can give the information properly.

    They also have to take instructions and work as a team with other departments. This field requires a lot of interaction with the doctors and the patients.

  • Knowledge of the human body– Medical billers and coders should have proper medical information about the patient for Insurance purposes. This also involves a basic understanding of how the human body works. They must know about complex terms related to anatomy and physiology. 
  • Detailed approach– A medical biller and coder must have an eye for detail. They should be very delicate in their approach. Medical billers require a higher attention span so that they can find mistakes in bills and correct them. 

As we know, understanding the difference between what is medical billing and coding is necessary likewise understanding the human body is essential for reading, understanding, and processing medical paperwork. This knowledge helps medical coders to assign codes to different patients and their treatment.

Medical Billing and Coding Jobs
Medical Billing and Coding Jobs

Medical Billing and Coding Jobs – Workload

Now that we have touched upon salaries being offered, it makes sense to talk about the workload that you will have to take to make it in the field. As a newcomer, the starting phase is likely to be quite challenging. However, as you gain more experience in this job and learn about the complexities of the job, the stress levels will automatically start to go down. 

The initial issues are likely to arise due to the adjustment period and comprehending the new codes etc. As you learn them, the time needed to draw up reports, etc. will go down drastically. Your typing and record entering speed will also increase with more and more practice.

Time also plays an important when asked about what is medical billing and coding question, an average medical biller and coder work around 40 hours a week.

To get a proper idea of medical billing and coding jobs, we would advise all potential professionals to do some volunteer work before committing to this field. This will give them a proper idea of what goes on and what to expect. 

We have covered everything and discussed on what is medical billing and coding profession and its respective types in detail. It is a great career and the future is very bright for the allied healthcare aspirants. The pay is reasonable and there is a lot of scope for upward mobility in this field. So, look out for top accredited online medical billing and coding schools as this career rewards hard work and consistency. Contributing to the health sector in any way is an act of social service. There is a great sense of satisfaction in working in the medical profession.

So now we have cleared what is medical billing and coding? What are the opportunities in this field? If you have any queries, reach out to us. Find us at online schools near me for further information.