Though many consider medical billing to be analogous to medical coding, expertise in medical billing is equally important, has nationally recognized certification, and continues to be in high demand from the healthcare industry.
As the healthcare industry looks towards more efficient ways to manage their accounts receivable reports (AR) and minimize billing errors, the demand for skilled medical billers will enjoy continued growth. According to the Bureau of Labor Statistics (BLS), the economy will need a projected 566,000 medical billers by 2016, with a median annual wage of $44,560 compared to $30,950 in May 2008.
If medical billing is the direction in which you are heading, there are a few basics that encompass the core of the profession. They are as follows:
Thorough knowledge of managed care laws in your state
Laws on fair debt collection practices for balances owed by patients
Knowledge of how to properly reconcile an accounts receivable (AR) reports in your practice
Knowledge of proper electronic submissions process
Knowledge of claim forms so that information is properly completed for timely and error-less submissions
Good communication skills – written and oral for both payers and patients
Classes can be either online or in a traditional classroom setting and instructors are experienced medical billers and coders. Students will be required to obtain a certified medical billing certification (CMBS) through the Certified Medical Billing Specialist® exam. Prior to course enrollment, potential students can review a programs syllabus, which should include the following key components:
A comprehensive introduction on the process of medical billing
Overview on data gathering
Differentiation between paper claims processing and electronic claims processing
Breakdown of payer types and plan coverage
The life of a claim
How to appeal a denied claim
Course curriculum will include an array of practical exercises for students in order to apply their knowledge of of billing to practical situations. Courses will introduce students to software programs–and since there’s a learning curve, students should work outside of class to become comfortable with them.
Students will also learn the importance of rules and regulations like HIPAA and PHI to maintain a patient’s privacy. They will learn how to obtain all necessary patient information such as Social Security number, a driver’s license number, demographics, and insurer. While these may seem mundane, the basic patient information is crucial to a successful reimbursement.
Part of the curriculum will also discuss how to read an explanation of benefits (EOB) form, received from an insurer to determine what payment was made, was it correct and what–if any–balance is due from the patient.
Additionally, medical billing schools should teach students how to handle the various reports from electronic billing and how to interpret and apply a carrier’s policies and procedures. Schools should also instruct on the process of archiving correspondence with payers and patients for future reference.
It is important for students to sit for certification in order to be recognized as a professional in the industry and attain the salary and benefits that come with certification. Once the course is completed, students will sit for the Certified Medical Billing Specialist® (CMBS) certification exam.
For more information on medical billing courses and curriculum: American Medical Billing Association — AMBA is a part of the Better Business Bureau and offers courses. The course itself runs about $600.00 with annual dues for individuals of $99.00. Additionally, the AMBA has a free medical billing micro-course you can try out.
Happy Coding!
Holly, Follow me on Twitter @hollycassano