Medical insurance

Medicine is a form of an art, a science and as well as a form of business. Doctors try to learn all the artistic and scientific aspects of their profession from their medical school. But the kind business aspect of the practice – getting paid – requires completely different set of skills – and those are the skills which most of the doctors have neither time nor interest to acquire. Even if they do so, few doctors will have to handle all the complex administrative aspects of a modern medical office. Enter the Medical Insurance Billing and Coding.
Medical Insurance Billing and coding specialists are seen doing work in doctors' offices, clinics and other medical facilities. Their main job is to submit claims to various insurance companies to make sure that the doctors and support staffs are properly reimbursed for all the services they render. Medical Billing and Coding professionals deal mostly with these private insurance companies and the agencies of the state and federal governments who pay the medical claims, e.g. Medicare. The Medical Billing department is also responsible for collecting all the co-payments or deductible amounts from the patients directly.
Processing a Claim
To process all the claims, the Medical Insurance Billing and Coding specialist first needs to deal with the patient's medical record, which will contain the entire physician's notes on what services, were being performed. The specialist then needs to translate all this information into a five-digit numerical code which is drawn from the American Medical Association's Current Procedural Terminology (CPT) guide. The actual diagnosis can also be coded based on the government guide called the International Statistical Classification of Disease and its Related Health Problems (ICD). It is very important to note that the CPT and ICD codes match up, or the claim will likely be rejected.
According to the Healthcare Billing and Management Association, up to one and half medical claims are initially rejected by the insurance carriers. Medical Insurance Billing and Coding specialists should therefore learn how to skilfully adjust and resubmit the claims in such a way that the insurance companies are more likely to accept those.
Paper vs. E-Claims
Earlier days, all the medical billing and coding were done on paper, which was slow, inefficient and an expensive one. Today, there are more and more claims which are being filed electronically, although the paper-based billing is still very common. In the upcoming years, computer skills might increase the importance to the Medical Insurance Billing and Coding professionals.
Training & Certification
If you want to become a Medical Insurance Billing and Coding professional, then you need take a specialized training program in that particular field from a recognized and accredited college or university. These programs can normally be completed in a year. After completing that, the industry certification is also a recommended one. The Certified Medical Reimbursement Specialist (CMRS) accreditation given by the American Medical Billing Association is considered as one of the most recognized of the specialized certification in this particular field.