Tag Archives: Education

Medical Billing and Coding Professions, Which one is best for you?

By: Karen Mooney, MBA, BS, CPC, CPC-I, CMSCS, CHI

There is a large misconception from those that are just entering into the medical administration field.  Many people believe that billers and coders are one in the same.  In reality, there is a big difference on the focus between these two categories.  A medical biller is focused on data entry of claims, claims processing, claims follow up, accounts receivable, patient billing, and collections.  Billers also make very strong registration specialists and front desk staff.  A medical biller is a strong strength when it comes to collecting funds due by the patient at the time of appointments as they know what to look for.  Billers are also great enforcers of referrals and authorizations that may be necessary for payment of services.  One other avenue that could work for a biller would be working in the health information department as billers are trained on HIPAA requirements and the need for completed medical records.

When a person is considering a coding profession, there is much more challenge in this aspect due to the level of knowledge that is necessary to perform the duties of a coder.  A coder must understand the working knowledge of the ICD-9-CM as well as the CPT coding reference. Coders are responsible for making sure that when coding services and procedures that the diagnosis that has been provided supports the medical necessity for the service before these are forwarded for processing.  Medical Coders hold a very large responsibility in their hands when performing their daily duties and are completely responsible for what they code.  Coders can find work in physician offices, clinics, hospitals with the right background of training.  From there, coders become quality reviewers, advanced educators, auditors, and consultants.

When individuals are researching new careers, the medical profession is a great choice as there is a long line of stability in the medical profession.  With that said, locating the best focused training is very important to a person’s success.  History has proven that the most direct route into medical administration is through the billing side of the profession.  This provides a great passageway into the field and allows many opportunities to a new comer to the medical field. Practices and physicians are more likely to hire individuals that are right out of school for a billing position versus a coding position.  The reason for this is that the coders hold a large responsibility of a physician’s revenue in their day to day process. Physicians are completely aware of this fact and are less apt to hire a person, right out of school without any live experience in the coding realm.

When researching your career path, and you are looking to learn to become a Medical Biller, then you want to focus on a program that will be sure to provide you with the background knowledge of the types of insurances, patient’s responsibilities, what can and cannot be processed from a billing side of the process and still covering an introduction of ICD-9 and CPT coding.  An introduction to ICD-9 and CPT does not make a biller qualified to work as a coder.  If you are looking to become a coder, be sure that the program offers you an entire review of the CPT coding reference. This process should be a minimum of 3 months to accomplish the course you are looking at.  If you decide that a medical biller and coder is the program that you are interested in, the program should be a minimum of 9 months to ensure that you have learned the skills necessary for both specialties. The most direct process is to become a biller and introduce yourself to the profession in the billing community, build experience, continue to code, then work your way into a coding position within the profession.  Ultimately the final decision is yours.  You need to make the best decision for reaching your final goal. Just remember that anything worthwhile is worth working towards.

Clinical Medical Assistant, is it for you?

Certified Clinical Medical Assistant

Maybe it is time to give your career that much needed BOOST, but how?  Think about becoming a Clinical Medical Assistant. The clinical medical assistant is an important healthcare expert who performs tasks related to basic patient care. They are a crucial component to any doctor’s office, clinic, or hospital.  Starting here can open the door to many opportunities for you.

So what are some of the duties of a Clinical Medical Assistant?

Some of the common duties of clinical medical assistants include taking vital signs of patients, conducting in-office screening tests, collecting and preparing specimens to send to diagnostic laboratories, and recording medical histories. Below is a list of some of the other duties a Clinical Medical Assistant may do.

  • Welcoming patients.
  • Answering patient phone calls.
  • Prepare patients for the visit by taking them to the exam room
  • Helping during examinations.
  • Preparing laboratory specimens/basic lab tests.
  • Telephoning prescriptions to pharmacies.
  • Drawing blood.
  • Preparing patients for x-rays.
  • Removing sutures and changing dressings.
  • Explain/Educated patients on treatment procedures, medications, diets, or physicians’ instructions.
  • Applying bandages.
  • Administering medications.
  • Keeping supplies ready and in stock for the office/clinic.
  • Cleaning and sterilizing instruments.
  • Disposing of contaminated material.
  • Maintaining confidential patient information.

So now that we know some of the duties of a Clinical Medical Assistant, what are some of the qualities I should have before deciding on this particular field?

The first thing that comes to mind is compassion and concern for others well being. This job requires you to be understanding to others in their time of need. The ability to listen and give each patient your undivided attention is critical.  You will have to accurately chart patient details and convey that information to the doctor.  Speaking clearly is also an important ability so others can easily understand you. Reading and writing comprehension along with critical thinking skills are preferred in this profession. Clinical Medical Assistants need to have several skills because their general duty is to ensure the office/clinic is running smoothly.

As you can see, a Clinical Medical Assistant is crucial component to any hospital, clinic or doctors office. You can get trained to become a Clinical Medical Assistant is less than a year and the job opportunities are limitless. This is a profession you can be proud of. To learn more about becoming a Clinical Medical Assistant, please visit our Program Overview- Clinical Medical Assistant


Speech Recognition Editing – Do You Have the Skills?

Speech recognition is the process by which specialized software, often called a “speech engine,” transforms the spoken word into written text.  Speech recognition is being used more and more in the healthcare documentation industry as a complement to what we think of as “traditional” medical transcription.

Speech recognition technology (SRT) does not eliminate the need for the human element – not by a long shot.  Although SRT can reduce overall turnaround times, making a patient’s documentation available more quickly, the technology is not capable of the critical thinking skills required of accurate documentation and possessed by the MT.

Enter the speech recognition editor.  While “traditional” transcription is still very much in use, speech recognition is being used in a percentage of our work.  Healthcare documentation specialists are often called on to switch hats from transcriptionist to editor in the course of the day when encountering providers who use SRT for their dictations.

The editor role is NO LESS IMPORTANT and NO LESS CHALLENGING than the transcriptionist role we are accustomed to.  Editing requires additional skills that must be honed in order to catch errors made by a “hand” other than our own, examine the context of the report, and correct any errors made by the speech engine.  Whether a report is transcribed or edited, critical thinking skills are of upmost importance.

While with time speech engines can “learn” dictators and produce somewhat more accurate initial results, there will always be a need for that human element that the technology doesn’t possess.  Errors will range from small errors in wording or punctuation to more…interesting translations of the dictated word.

As healthcare documentation specialists, we possess skills and experience that are in high demand.  No matter what hat we wear in a given day, our skills are absolutely essential in order to ensure accurate documentation for patients.  As SRT use has increased in the industry, so has the demand for speech editors.  If you have not already experienced speech recognition editing, now is the time to expand your education and learn techniques to complement your skills.

Enroll now in the Speech Recognition Editing course offered by AHDPG.  This independent-study, online course was created in conjunction with AHDI and is the first of its kind, offering hands-on editing experience.  More course information is available at American Healthcare Documentation Professionals Group (AHDPG) .

Medical Billing and Coding…..Is it Billing? Is it Coding? How do I choose?

Almost everywhere you turn today you see the combination of Medical Billing and Coding or Medical Coding and Billing tied together in some way shape or form so many people, if they are not familiar with the medical profession may believe that they are one in the same process.  In reality, they are really quite different.  This is a good thing because there are often times that people come into this specialty thinking “I want to be a coder” until they start seeing what exactly the job entails and they quickly realize that this responsibility is not for them so they automatically begin to think “Great, I chose the wrong profession”.  That is not the case.  Not everyone is meant to be a coder and that is perfectly fine to discover.  It takes a special mind set to be able to wrap your brain around all of the concepts and processes that need to take placed to be an effective coder and not everyone fits that bill.

So, if not a coder, what then is there for me to do?  There is the billing aspect of this profession to consider.  Here the responsibilities are just as important as on the coding side of the process because it is the billers that ensure that the claims are properly filled out, correctly submitted to the insurance companies for processing, follow up on outstanding claims that have not been processed by the insurance company, The Medical Biller is responsible for knowing and understanding the parts of the different insurances  in their geographical area, may handle the accounts receivable in a working environment,  work on submission of secondary insurance claims, responsible for correcting and reprocessing rejected claims and the list goes on and on.

There is a whole other world that exists in the medical profession outside of being a coder and that is the Medical Biller.  Now often times, Billers and Coders work closely together to help ensure that claim information is correct to expedite the processing of the claim for proper reimbursement which is a great way for the system to work but to be honest, the system needs both of these parts for the whole process to work as one.  Without one side or the other, you will find that there will be delays, errors, hold ups, mistakes, and all around major problems.

So, have you wondered what Medical billing and coding really is?  Have you ever asked yourself if it was one or two positions?  As you can see from above, there are many more than just two positions that exist in this realm which is great because it provides many different pathways for those that are looking for something different.  If you do not want to be a coder, do not think that this will prevent you from working on this side of the administrative process of the medical profession.  There is more to this profession than just coding.  Research this
and see what the pathways may be.  Billing can provide many different veins for you to take advantage of and the choices are yours to make.

If you are considering a change in career, Billing and Coding may be a great pathway based on the opportunities outlined above.  Now all you have to do is decide where and how you are going to obtain that education you are going to need to move forward on this career decision.  Hopefully you will find that this will help with making your decision in moving forward. What do you have to lose? Not sure coding is for you? Then take that billing course first as it should introduce you to the use of the coding references used in the profession and once through your introduction of the coding material if you find you really liked the coding aspect then look to expand your education  pathway to pick up some coding classes after your billing course is completed. After all, some of the best coders today were billers before they became coders.  Feel free to leave your thought. May you have a Happy New Year and may you make this a New Year’s resolution that you follow through on.