ANSWERS: 1
  • After a patient receives medical care, his health insurance company is usually asked to remit payment for what is covered under the patient's policy. Medical billing and coding is the process used to determine what is owed by the insurance company for the care a patient receives.

    Function

    Medical billers and coders translate the services provided and the diagnosis given by a physician and other health care professional into a code or group of numbers or letters that insurance companies interpret to provide payment.

    Features

    Once the insurance company remits payment for a service, medical billers credit the patient's account with the amount of the payment and then bills any secondary or supplementary health insurance companies that the patient has available. If there is no secondary insurance, billers mail a request for payment to the patient.

    Types

    Some medical billers and coders work for a hospital, outpatient clinic or a physician's private practice. Others work for companies that perform billing and coding services for many different companies.

    Requirements

    Medical billing and coding must be done quickly in order to keep up with the large volume of services being provided by physicians and other professionals and to ensure prompt payment from the insurance company. The process also requires accuracy as even small mistakes may result in a claim being denied or a patient being improperly charged for a service.

    Warning

    The Federal Trade Commission (FTC) has issued a warning to consumers about fraudulent medical billing and coding training programs or work-from-home opportunities. The FTC urges those interested in pursuing a career in medical billing and coding to receive education from established schools and to consult their state's attorney general's office about job offers, especially those that are unsolicited and offered through a letter in the mail or an email.

    Source:

    American Health Information Management Association: About Medical Coding

    FTC: Medical Billing Opportunities

    U.S. Bureau of Labor Statistics: Medical Records and Health Information Specialists

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