Discover the Best Doctor Billing Format for Businesses

Doctor billing format for businesses

medical billing and coding jobs are in high demand they pay well and you can work from home but how do you know if this is the right choice for you well stick around because i'm going to tell you everything you need to know about the medical billing and coding industry hey everyone i'm victoria i'm a medical coder auditor educator and content creator i've been in this industry for over 10 years and i love making videos to tell people about the medical billing and coding industry so that they can make the right choice for themselves if this is something they want to pursue as a career so let's start out by talking about medical billing and coding usually when you go into a training program they kind of lump them all together it's medical billing and coding but billing and coding are kind of two different sides to the same coin so medical coding which i do more of is the process of reviewing all of these different medical records and documents and pulling out all of the diagnoses all the procedures equipment any kind of reportable information and then translating it into various alphanumeric code sets so for example a patient that has type 2 diabetes is assigned icd-10-cm code which is the diagnosis code e11.9 but if they have type 2 diabetes and end-stage renal disease it's assigned 11.22 and an 18.6 and z 99.2 so it's not always as simple as a one-to-one match there's lots of different guidelines and things that can change the codes that we use the medical codes are used for a lot of analytics a lot of data a lot of even things like financial planning but the big thing that we think about using them for is bills right we take all those diagnoses and procedures and put them on a claim form to generate a bill that usually goes to insurance or sometimes the patient so the billing component really is more so monitoring all of those claims making sure that all the charges get in making sure that things were built correctly a monitor for denials maybe appeal those denials maybe they were denied because you know someone fat fingered a code maybe they were denied because that patient's insurance doesn't cover that procedure and then following up and making sure that everything goes through and is finalized as far as the billing payments go now there's also different types of medical coding and different types of credentials for medical coders the two main certifying bodies are aapc or ahima those are the ones that are the most valued in the industry the most sought after you can't really go wrong with either typically though most people that want to go into inpatient coding go with ahima people that want to go into any other type of coding professional fee or risk adjustment or even outpatient oftentimes will go with aapc i personally am only certified through the aapc i find aapc to have a wider variety of credentials it's easier to get continuing education units and personally i just kind of find them a little bit less stuffy but i always tell people that if you're looking into medical coding and you want to get a credential you cannot go wrong with the cpc certified professional coder credential with the aapc that is one of the ones that is looked for the most so if you're like i really just don't know i can't pick go with the cpc now there are lots of different code sets the main ones that you will use in medical billing and coding first is icd-10-cm this is your diagnosis coding system and this cm is the clinical modification so it's the version that's used in the united states there are different versions that are used across the world so icd-10-ca is what they use in canada for example so you'll find different variations based off of icd-10-cm but generally they look for the most part the same there's also icd-10-pcs pcs is the procedural coding system it's primarily used for inpatient stays at the hospital not every coder knows every single code set i only know a little bit of icd-10-pcs like enough to be dangerous but i am certainly not an expert one day one day we'll do it and then there is cpt current procedural terminology all kinds of procedures and services your doctor's visits your surgeries your x-rays everything in here and then hic pics is a lot of things like durable medical equipment drug codes there's some insurance specific codes like capital blue cross has their own code for an annual gyn exam and these codes change every single year the icd-10 changes on october 1st and january 1 cpt and hitpix changes so generally you have to buy new books every year there's also cdt for current dental terminology and then the dsm 5 is for mental health conditions so where do medical biller encoders work well obviously a lot of them work from home some of them work in offices in an office setting but what kind of companies are they working for provider offices hospitals insurance companies consulting firms providers specialty groups so working maybe for the medical specialty societies i know some people that work in legal practices they own their own consulting firm they work as educators so there's a lot of different opportunities even in like compliance and things once you have your foot in the door in medical coding but as far as work environment you could be commuting to an office or a hospital or clinic or you could be working from home in a home office and by home office i mean home office because of things like hipaa and patient privacy and the sensitivity of the medical information that you're going to have access to a lot of employers have much stricter security protocols than some other industries might so for example you can't go out to starbucks and have your laptop open with people's charts displayed because that would be a violation of patient privacy and some companies do have different policies as far as how stringent they want to be you know some will make you sign off a waiver and that's might be the end of it others might um have to you take photos of your homework space others might do pop-ins where they just say hey can you turn your camera on for a minute or two just to make sure that you are like in your home office that you're not also trying to take care of young children or elderly parents or that you're you know not doing your laundry while you're working but we actually have a lot more opportunities now coming up in the industry i work with code health for example and code health is great because they're more of a gig work platform so you would just sign on and work on your own kind of schedule like you would for an or for uber or a lyft but it does pay 10.99 so there are some considerations with that now as far as salary is concerned the median median salary for a certified professional coder again the most popular credential is about fifty eight thousand dollars a year but it can actually go extremely high depending on your years of experience and some specialties actually pay more than other specialties now keep in mind that 58 000 is median that's the total average of a lot of different coders meaning that if you're starting entry level it will likely be less than the 58 000. and of course there's also things like geographic areas to consider so if you're interested in salaries in your region my best suggestion for you is to check out the aapc's salary calculator i will link it in the description below so that you can check out kind of salary information pertaining to what you might be considering for credentials and your location now what training is needed to become a medical coder and this is one of the things i love about the medical coding industry is that you do not need to go and get a two-year or four-year degree if you want to absolutely go ahead and do that but it's really not needed for a general medical coding position what's really needed is preparation for that certification so for the cpc credential to the aapc or through the ccs credential through ahima so whatever will prepare you so that you can be ready to pass that certification exam and also be efficient when you find a job there are self training options i have gone over that and you can check it out in this video it doesn't mean free because you still have to pay for things like books there are licenses on some of the code sets so you cannot get them some of them cpt for free you also have to pay of course for like workbooks and things so there is a way to do it but oftentimes you don't wind up saving a ton of money so the sweet spot is kind of like getting the training that will prepare you for the certification and also your job but it isn't so much that you're investing a ton into a two or four year degree so kind of somewhere in the middle i actually work with a program called preppy if you go to my link in the description medicalcodingmasterclass.com you can find out lots of great things about the industry in general like all of the things you want to check off in your training programs and then the program that checks off all that boxes it just makes it really simple like it gives you that step-by-step road map of what you need to do to go from hey i'm kind of interested in medical billing and coding too hey now i'm job ready as a medical coder in as little as six months definitely definitely check out the master class it is linked in the description below now another big thing i get asked about medical billing and coding is the demand and the future need automation is becoming a big part of a lot of industries and medical coding has had automation in it for years but what you have to understand is the volume of medical services that are being needed the complexity of medical services that is needed is always always going to warrant intervention in medical coding so while there are some simple look up tools there's some automation that we've had for well over a decade there's new stuff coming in you know it's not going to replace that hands-on physical problem-solving need for medical coders medical coding is a lot more complex than just looking up things in a book like you would a dictionary there's a lot of moving parts in anything related to healthcare a good way to think of it is have you ever done your online banking and it kind of automatically categorizes things for you for like your books and your financing and your budget so like you'll go out to walmart and buy a tv but it'll file it in your online banking under groceries because that's just kind of where it generally puts them so imagine having like your online banking just automatically categorize everything and then take all of that and file it to the irs to do your taxes well it's not going to be as accurate and you're not going to have as good of an output as actually having someone look through all of that categorize it appropriately and then have an accountant look at it and file your taxes so even though there's that automation you still want that human intervention and you still want a tax professional to be filing on your behalf you can't defend what you did in the irs by just kind of shrugging your shoulders and going oh well you know the online banking told me wrong same concept in medical coding if a provider goes in because they're being claimed that they were billing fraudulently they can't just go the electronic medical system coded them wrong and even if we were to go to a system where we would get like a medicare for all where we would have government-funded insurance i really honestly think we would still have commercial insurance i think you would be able to get them as a replacement just like you can for traditional medicare and second we would still need to track everything for data purposes and for financial planning that doesn't mean just because the government pays for it that it's a free-for-all there would still be abuse there would still be a fraud and we would still have to monitor for that and have guidelines and have regulations now one thing a lot of people forget to touch on is the cost there is a cost associated with being a medical coder you have to get things like books every year if your employer doesn't pay for your books or for a look up tool and online look up tool which we call an encoder you would need to be responsible for some of these expenses for your books you also have to pay membership dues for the aapc i believe it's up to 190 a year just to be a member to maintain your credentials with the aapc you don't pay your membership dues you lose your credentials there's also continuing education costs although the great thing is i have lots of videos about where you can get those continuing education units that you have to submit every year for free so things like the aapc will ship you healthcare business monthly magazine and you can earn a ceu by doing a quiz based off of the content in healthcare business monthly and while it's not required there's always extra credentials there's conferences there's training sessions that are going on again not saying you have to invest in those things but sometimes that fomo kind of gets the best of you now we talked a little bit about work locations but what about the work environment honestly it varies like every other office job you're going to have a lot of them that are good you're going to have some of them that are a little bit toxic you're going to have some that are really amazing honestly things like management could play a big part in that you know how they're structured if they have a lot of backlog they want you to work overtime and you don't want to work overtime you know how much you invest in yourself how much they invest in code a lot of different things play a factor in that the good thing though is once you've got like a year or two of experience it's really easy to switch jobs if you find out that you're bored at your job or there's a manager you don't like or you just think the environment isn't suited to you and again we're starting to see a lot more things emerging like code health where you can kind of be your own boss in medical coding so what do you think is medical coding for you it's very high in demand for experienced coders and it doesn't have that expensive traditional cost of training like your traditional degree programs although the cost of books and memberships and upkeep can be kind of daunting but really honestly don't let that stop you the benefits far far outweigh the cost and if you want to know more about this industry go to medical coding masterclass it's a really affordable training option and they will teach you everything you need to know to help you be successful in a career in medical billing and coding so with that i will see you guys in the next video and until then just keep on coding on