Careers in Medical Coding: Physician Office Billing

The medical profession evolves rapidly, changing as discoveries and technologies bring new treatment methods and approaches. No matter how much the field of medicine shifts, however, one thing remains the same: doctors need to bill their patients. Whether a physician provides services in their own office, in an inpatient hospital setting or an outpatient facility, a separate bill is generated for that physician’s services. That’s why a career in medical coding is a good move; physician’s office billing is something that will never become obsolete.

Is there a difference between medical billing and coding? Medical coders use current procedural terminology (CPT) to assign codes to the procedures a patient has received. They also refer to the International Classification of Diseases (ICD to choose diagnosis codes to label the patient’s condition. These codes are important because they’re going to be used by the insurance company to process the patient’s claims. Coders often have to coordinate with medical staff to ensure the accuracy of their information.

Medical billers are responsible for entering codes into software and processing insurance claims. Making use of billing software, they input codes assigned by coders along with other important insurance information. Billers have to understand the claims process. They often get insurance information directly from the patients, explain benefits to patients and answer questions about insurance. Once the claims have been submitted, billers are responsible for making sure medical bills are paid. This can involve explaining to patients their coverage and responsibilities as well as talking with the insurer to determine any issues with timely payment. If an insurance claim is rejected or denied, it’s the responsibility of the medical biller to talk to the insurance company and determine the cause as well as inform patients about the status of their claims.

Often, a physician’s office will employ one person to fulfill both the billing and coding roles. That’s why well-informed certified medical biller/coders are extremely valuable, not just because they understand codes and procedures, but because they can be a small medical practice’s first line of defense against legal charges of fraud and abuse in the healthcare reimbursement system. Physicians are focused on treating patients, and they rely on professional medical billers and certified medical coders to provide valuable, informed advice and keep abreast of relevant issues.

Because medical billers and coders are so important to physicians, anyone seeking a career in this field should look for a reputable medical billing and coding program for their training. Students will leave a good program with knowledge of:

  • Insurance guidelines, the claims submission process and procedures
  • Complex insurance claim forms and how to properly file them
  • Analyzing Explanation of Benefits (EOB) forms to ensure insurance companies have paid for charges
  • How to generate accounts receivable reports, clients
  • Following up with insurance companies and patients to ensure bills are paid

The first step in getting a medical coding job is finding the right school for your training. ABC Training Center is a medical assistant school NYC students trust, and our nationally certified program prepares you to work in any medical setting. Continue browsing to learn more about our medical coding and billing training in New York or call us at 718-618-5589.