Author: Patricia Walling
According to the U.S. Bureau of Labor Statistics, the health care industry makes up several of the top ten sectors of the American economy that are growing. This is consistent with findings of both past government studies and those conducted by private economists. No one who reads the want ads needs official confirmation of something that is easily observable -- the health care field needs workers and it needs them as soon as possible.
Not all people employed in health care need advanced degrees, but they do need specialized training. However health care services are not limited to direct patient care providers. After every patient receives care, there are back office operations that need to be performed to ensure medical services are reimbursed appropriately and legally. Medical billing and coding may not be the most glamorous job in health care, but it is an essential component of the industry that keeps it profitable and guarantees that patients can continue to receive the care they need.
Medical billers and coders are trained in translating available documentation provided by licensed health care professionals, rendering written notes into universally accepted, industry-standard coding systems for reporting purposes. Medical billers and coders share many of the same disciplines, but the two professions are not identical. Medical billers deal directly with private insurance companies and with government agencies that provide direct reimbursement for medical services. Medical coders deal with issues of accurate coding and compliance within established industry standards and legislative protocols that dictate how codes should be employed. However both professions require the thorough understanding that is ideally gained from structured, accredited study.
Many community colleges and private technical schools provide accredited training in coding. This is the foundation from which medical billers and coders practice their trade. There are no minimum, legally mandated qualifications for entering the field of medical administration, billing and coding in particular, but having certified training will help people who wish to enter this vital sector. Some schools offer certificate programs in medical billing and coding, while others may grant two-year degrees.
Likewise, informal classes offered by certified professionals can substitute for passing a certification exam. Online tutorials and schools are another option for people whose schedules don’t fit with those found at a traditional university. For instance, the Center for Medicare and Medicaid Services (CMS) offers free online training for billing and coding issues that affect dealings with government programs.
Private insurers also offer ongoing seminars and resources for those who are contracted to submit medical claims to them, but these tools are tailored to the specific needs and requirements of contractors. The basic groundwork of obtaining certification in the field can be found by researching the Web sites maintained by the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA). Both of these are professional organizations that establish standards of what can reasonably be expected from medical coders and billers. Similarly, both organizations offer examinations and grant credentials to those who prove they have the knowledge and experience to succeed and deliver reliable results in this specialized field of study.
The basic credential offered by the AAPC is that of a certified professional coder (CPC). On the other hand, the AHIMA offers certification as coding specialist (CCS), as well as other credentials, such as registered health information technician (RHIT). Each of these certifications requires knowledge of anatomy and physiology, medical terminology, medical abbreviations, documentation standards, relevant government regulations and the standards established by the coding systems’ governing bodies.
Ultimately, being able to navigate the coding systems used to describe medical services is a paramount for those in medical billing and coding. While this proficiency can be obtained by self-study and on-the-job training, these opportunities are shrinking as the profession becomes more demanding. The need for additional training is becoming a benchmark that many entering the field need to establish before they enter this valued and lucrative career.
For instance, it is necessary for many RHIT’s to obtain four-degrees to gain the knowledge they need to get certified in the field. On the other hand, CPCs and CCSs can pass their tests after anywhere between eight weeks or two years of classes. The fact of the matter is that no one can be too well prepared to get their credentials in order to enter the field of medical billing and coding. Structured, accredited training offered by proven professionals will offer students real life examples of the theoretical experience they are expected to master. No matter what specialty a medical biller or coder finds him or herself in, they have a solid education in the basics of the systems and issues with which they will deal every workday.
About the author:
Patricia Walling is a web content designer for several health care related sites, including Medical Billing and Coding. She self-identifies as a perpetual student of medicine, and can be found most of the time researching anything related to the field.