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Medical Billing and Coding/Receptionist

Health Care Science Job Fair project

Kimberly Parada

on 24 September 2012

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Transcript of Medical Billing and Coding/Receptionist

Medical Billing and Coding http://www.medicalbillingandcoding.org/medical-billing-and-coding/what-is-medical-coding/ History Associate degree in medical billing and coding. Educational Requirements Personality/Strengths Cost of Education Job Titles Duties and Responsibilities In this activity, you will be able to take a moment to analyze some scenarios and to decide which is the specific code for it! Let's practice!!!! Repair intermediate, wound face 1. A 49 year old female sustained injuries to the forehead, 1.5 cm. And a 1 cm wound to the eyebrow when she hit her steering wheel with her head. The closure was layered. Code the service only.
a 12001
b 12011
c 13131
d 12051 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet section. Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes section. Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet) section. Steve presents with a deep, old hematoma on his shoulder. After examination of the shoulder area, the doctor decides that the hematoma needs to be incised and drained.
a 10160
b 23030
c 10140
d 10060 Incision and Drainage Procedures on the Skin, Subcutaneous and Accessory Structures section. Incision and drainage, shoulder area section. Incision and Drainage Procedures on the Skin, Subcutaneous and Accessory Structures section. Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia) section. The history of medical coding, or diagnostic coding, dates back to seventeenth-century Great Britain with the London Bills of Mortality. Medical coding can be defined as the process of assigning numeric or a combination of numeric and alpha values to all types of medical services. The services include diagnoses, medical procedures, surgery, drugs and other treatments. The practice of medical coding is a continually evolving process, which has led to greater effectiveness and efficiency in the delivery of health care services. From Paper to Computer Medical billing and coding was initially processed on paper, which was inefficient and costly. With the introduction of computers and medical billing software there are benefits such as saved time and money, eco-friendly practices by using less paper, more productivity and ease of use. Medical software companies offer ongoing support and automatic updates. File transfer of billing information is fast and secure making editing and updating efficient. Information can be retrieved, electronically filed and printed using a few keystrokes. Most of the medical coding in the United States is centered on ICD-9-CM and HCPCS. Hospitals, doctors, nursing homes, home health providers and other health care practitioners used the ICD-9-CM diagnostic codes. The ICD-9-CM is the uniformed system for gathering information regarding inpatient procedures in hospitals.

The HCPCS is the coding system that is used for outpatient procedures and doctor services. The HCPCS has two levels of coding. Level I is based on the AMA's CPT system. Level II HCPCS codes are used by medical suppliers, ambulance services or medical equipment vendors. Medical coding has its roots set in the early 1900s and is an integral part of a medical practice. Standardized codes are associated with diseases, procedures, treatments and diagnoses of patients. Accurate documentation of data (assigned numeric and alphanumeric codes) assures timely payment for services rendered. According to the BLS, many employers favor candidates who have certification from the American Health Information Management Association (AHIMA) as a registered health information technician. There’s also significant financial incentive to earn a credential: a 2010 survey by the AAPC shows that certified medical coders earn an average of $45,404, which is $8,000 more than those who are uncertified. Coding Systems Roots What Qualities Do Medical Coding and Billing Professionals Need to Have? As with most administrative jobs, medical coding and billing professionals need to have excellent attention to detail, as one wrong code or inaccurate statement can have an extremely negative impact on a health care facility. A good head for numbers is also an obvious requirement since the majority of the job involves working with codes and numbers. Customer service is another vital skill in this industry because it is a common occurrence for medical billers and coders to communicate with patients and insurance companies to answer questions, clarify information, and request payments. Some of the more hands-on skills required by medical coders and billers include a working knowledge of computers, and the ability to work with general business software applications as well as industry-specific software. Strong accounting skills are also a must-have since medical billers are partially responsible for the financial aspects of a health care facility. A few of the personal traits that can lend well to a career in medical coding and billing include:

Patience. Dealing with medical bills can be stressful on patients and their families, and it can be upsetting to hear that insurance doesn't cover certain procedures, medications, etc.
Compassion. You will often have to interact with patients and families who are dealing with serious illnesses or injuries, and a little compassion and understanding can go a long way to ensuring a more positive experience for everyone involved.
The ability to manage stress. A high rate of burnout is attributed to professionals in the health care industry due to high work demand, long hours, and stress. Being able to manage stress effectively and knowing when and how to say "no" to an unreasonable work demand can help prevent burnout, minimize stress, and allow for career longevity. http://www.trade-schools.net/career-counselor/medical-billing-coding-information.asp ESSENTIAL DUTIES AND RESPONSIBILITIES :

Includes the following;

1. Processes billings to patients and third party reimbursement claims; maintains supporting
documentation files and current patient addresses.
2. Processes patient statements, keys data, posts transactions, and verifies accuracy of input to
reports generated.
3. Researches and responds by telephone and in writing to patient inquiries regarding billing
issues and problems.
4. Follows up on submitted claims; monitors unpaid claims, initiates tracers; resubmits claims as
5. May receive and receipt cash items and third party reimbursements; posts and reconciles
payments to patient ledgers.
6. Balances daily batches and reports; prepares income reports and statistics; distributes reports.
7. Maintains patient demographic information and data collection systems.
8. Participates in development of organization procedures and update of forms and manuals.
9. Performs a variety of general clerical duties, including telephone reception, mail distribution, and
other routine functions.
10. May assist in preparing documentation and responses for legal inquiries, litigation, and court
11. Ensures strict confidentiality of financial records.
12. Computer literate, able to use Microsoft Office Word, Excel, Outlook, PowerPoint, Publisher,
and Accounting.
13. Performs miscellaneous job-related duties as assigned. http://www.troyerurgentcare.com/docs/MedicalBillingJobDescription.pdf There are many different jobs related to the field of medical billing and coding. Although most of the responsibilities remain consistent across all positions, the actual job titles can vary greatly. Some of the most common jobs for medical billing and coding graduates include:

Medical coding and billing specialist
Medical billing clerk
Billing coordinator
Medical claims analyst
Electronic claims processor
Reimbursement specialist
Claims assistant professional
Patient account representative http://www.trade-schools.net/career-counselor/medical-billing-coding-information.asp What is the Medical Billing and Coding Training Cost?

The cost of medical billing and coding programs can vary depending on the type and length of the program.

The tuition for medical billing and coding associate degree programs averages around $32,000. The cost of tuition for certificate and diploma medical billing and coding programs is generally much lower—usually between $12,000-18,000. Some programs include books and supplies in the tuition, while others do not. Typically, books and supplies total around the $800 mark.

Programs that are accredited by the Commission on Dental Accreditation (CODA) are typically designed to take about nine to 11 months to complete. http://www.trade-schools.net/career-counselor/medical-billing-coding-information.asp Job Fields Job opportunities for new medical billing and coding specialists are generally abundant across the health services industry, especially in large hospitals and public health clinics. The U.S. Bureau of Labor Statistics (BLS) reports that the employment of receptionists in the health care and social assistance industry is expected to increase more than 16% in the period from 2008-2018. Due to technological advancements in coming years, medical receptionists will need to possess a diverse array of technical and clerical skills that are not easy to automate. Moreover, preference may be given to job candidates with a lot of experience in the field (www.bls.gov). Job Outlook Where Do Medical Billers and Coders Work?

Medical coding and billing professionals can find employment within a wide range of health care settings. While larger facilities may separate coding and billing into two separate jobs, smaller health care environments often combine the separate duties into one position. Some of the places that employ medical billing and coding professionals include:

Physicians' offices
Health clinics
Long-term care facilities
Dental offices
Home health agencies
Nursing homes
Health insurance companies
Ambulatory services http://www.trade-schools.net/career-counselor/medical-billing-coding-information.asp Salary Marcy after having an abnormal shoulder x-ray in the clinic yesterday is admitted. The physician decides to do a diagnostic arthroscopy. What is the Average for Medical Billing/Coding Salaries?

In an online survey** of more than 10,000 medical billing and coding professionals in 2010, it was discovered that certified employees saw a salary increase of 1.5 percent from the previous year, bringing the average salary to $45,404. Non-certified employees also saw a rise of 1.2 percent, though at $37,746, the average salary was slightly lower than that of certified medical billing and coding professionals.

Medical billing/coding salaries are also directly impacted by experience. The more years of experience, the higher the salary tends to be. Here is a breakdown of the average annual salary of certified medical coding and billing professionals by years of experience:

1 Year—$34,551
5 Years—$40,638
10 Years—$45,683
15 Years—$50,307
20 Years—$51,563
25+ Years—$53,669

The highest average salary was found to be that of experienced medical billing and coding instructors, who may also work as consultants outside of teaching. The average annual salary for these professionals was $69,207. http://www.trade-schools.net/career-counselor/medical-billing-coding-information.asp Credible Websites Excision Procedures on the Shoulder section. http://www.bls.gov/

http://www.trade-schools.net/career-counselor/medical-billing-coding-information.asp Arthroscopy, shoulder, surgical section. Biopsy, soft tissue of shoulder area section. Arthroscopy, shoulder diagnostic a 23100
b 29805
c 29806
d 23066 http://www.medicalbillingandcoding.org/medical-billing-and-coding/what-is-medical-coding/
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