subject: Medical Insurance Billing And Coding 101 [print this page] Medicine has three functions namely art, science and business. Medical professionals learn the art of healing and theories of scientific explanation of the human body in the medical school. But, the act of getting paid and business management as part of their practice requires a completely different set of skill that most doctors do not really have time or interest to learn at least not in their lifetime of medical practice.
Only a few of medical practitioners have time to deal with the administrative and management aspects of the modern-day medical establishment and this is where the medical insurance billing and coding come about. Specialists in medical billing and coding work in doctors practice offices, establishments and other medical facilities with a primary job of submitting claims to insurance companies.
Their job is to ensure that both doctors and support staff are properly reimbursed for their services. Specialists for medical billing and coding tend to handle private insurance companies and government agencies with regards to claims filed on them. In your practice, the medical billing department is important also in terms of collecting payments and deductions from patients accounts.
For processing claims, medical insurance billing and coding professionals have to look into the patients medical record that contains all the progress notes including the services that were performed to ensure that the health of the patient is preserved. The medical billing professional will then translate all of the services done into a five-digit code based on the American Medical Associations CPT guide (Current Procedural Terminology) and the actual diagnosis is based on the ICD coding. It is important that both ICD and CPT matches up otherwise the insurance claim will be rejected.
Medical insurance billing in the past was done mostly on paper, which will require time and effort on the medical billing professional as well as in the insurance companies processing the claims. However, with the advent of technology, hundreds and thousands of claims are mostly done and filed electronically although the paper type has not disappeared completely.
If you want to become a medical insurance billing and coding professional, you should take a specialized training that focuses on this field from an accredited school where you will be completing the program normally within a year. Certification in the industry will then be required from the American Medical Billing Association, which is one of the recognized certification associations.
by: jamesguertin
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