Medical billing is essentially exactly what it sounds like; medical billers take the information from the medical coder and they use it to calculate the bill. It may sound like a pretty daunting field and to be honest, there are some hurdles to overcome, especially when it comes to certification. Before we jump into the certification portion, however, let’s talk a bit about what it is and what you should expect to be doing it.
Understanding Medical Coding
To start, medical coding is basically translation. As the coder, you will be tasked with taking a diagnosis and translating it into an alphanumeric code. For every diagnosis, from a slight headache to cerebral palsy, there is a corresponding code and as the coder, you will either need to know it, or you will need to be able to look it up. There are literally thousands of different codes that can be used, from medical procedures to outpatient procedures, diagnosis, and much more.
In medical coding, there are various subsets of code that a medical billing and coding expert should be well versed in, and there are two that are going to immediately come to mind:
International Classification of Disease (ICD) – Corresponds to patient injury or sickness
Current Procedure Terminology (CPT) – Refers to functional services that are being performed on the patient.
As part of medical billing and coding education, you will learn these codes which act as a universal language between medical facilities, insurance companies, government agencies, and much more. Each code that is put into use will have its own subset of rules and be used for a very specific purpose. Learn it and love it!
Understanding Medical Billing
Medical billing is essentially exactly what it sounds like; medical billers take the information from the medical coder and they use it to calculate the bill. In this way, the two professions go hand in hand. Of course, it’s not nearly as simple as it might sound as you will need to take into account their insurance, their co-pay, and dozens of other calculations that could seem extremely complicated. This isn’t a simple job but it is a very rewarding one. A biller has many different jobs, but the primary one is ensuring that the healthcare provider is properly reimbursed whether it is through the individual or through their insurance carrier.
There are several types of certification to obtain once you learn medical billing and coding but today we’re going to look at just two of them:
This is the most basic medical billing and coding certification that you can obtain and it stands for Certified Coding Associate. To sit for this exam you will need to have either a high school diploma or a GED, so make sure that you are prepared for that. Also keep in mind that AHIMA does not require specialized training, but you should have a basic understanding of medical terminology, coding, anatomy/physiology, and perhaps some on-the-job coding experience.
With the AAPC you have a number of ways to achieve certification from bundling courses or going module by module. It can be a bit more expensive and in-depth, but it is also more comprehensive and overall a great thing to have on your resume.
There is nothing simple about medical billing and coding but it can be an extremely rewarding experience. That said, you would do well to start looking at career opportunities and checking into financial aid options. It’s about time you jumped into a career that will last and will allow you to make a difference. Medical billing and coding will do exactly that.
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