Although medical billing and medical coding are considered separate disciplines, they are taught together because they are so closely related. To bill correctly takes a close understanding of coding and to code correctly requires an intimate knowledge of billing.
In simplest terms, a medical biller is trained to collect the necessary information from the patient and medical staff to correctly bill the patient and the insurance company. The medical coder, on the other hand, is trained to translate the patient’s medical records into the proper codes and place those codes on the proper forms for the medical biller. In addition, medical billers and medical coders may have other administrative duties in the workplace to help things run smoothly and efficiently. Formal training in medical billing teaches all of these skills and more.
For those considering taking medical billing courses straight out of high school, it is recommended that the student take courses in advanced math, health, biology, bookkeeping and keyboarding and have experience with word processing, spreadsheets and databases before graduating. Those without these skills and those who haven’t used them recently will want to take remedial or refresher courses to have solid preparation for the coursework ahead.
Students can begin their careers with a diploma or certificate in medical billing, an associate’s degree in medical billing and coding or a bachelor’s degree in health information or health care administration. Many factors come into play as a student decides on the best program but, generally speaking, if a student wants a long-term career in health care, getting as much education as one can afford and has time for is probably the best course.
Regardless of whether the student is in a diploma program or seeking an associate’s or bachelor’s degree, the medical billing courses are the same, only the number of academic courses differs. Many medical billing programs are divided into three parts: administrative duties, medical knowledge and medical billing and coding.
Administrative courses include business software and equipment, patient relations and record keeping, skills that are needed in any office setting. Basic medical courses include information every health care professional from medical assistant to neurosurgeon needs to know, such as first aid and CPR, anatomy, physiology, medical terminology, pharmacology, prevention and treatment of disease and infection, medical law and ethics.
Medical billing and coding courses include medical documents and record keeping, patient and supplier billing, insurance claims, government programs, personal injury claims and workers’ compensation. Especially important in this training is mastering the International Classification of Diseases (ICD-9) and the American Medical Association’s Common Procedural Terminology (CPT) upon which medical billing and coding is based.
When researching medical billing training, it’s recommended that the prospective program include an externship and coursework toward obtaining professional certification. An externship is typically unpaid hands-on training in a doctor’s office or clinic that provides the student with real-world experience under the wing of a practicing medical biller and/or medical coder. This training is important for the student’s growth as a health care professional and as a reference for potential employers. Certification serves the same purpose. Although not required or absolutely necessary, certification from one of the recognized professional associations proves the student has a working knowledge of medical billing and provides a credential that a potential employer can rely upon.
Continuing education is also an important component of medical billing training. As health care becomes increasing complex and as changes occur more frequently in insurance plans, government programs and medical record keeping technology, the need to take additional coursework to keep abreast of these changes is essential. Further education is a constant for the health care professional.
Medical billing can be a fascinating and rewarding career for the right person. Helping patients get the treatment they need and helping doctors and hospitals receive the funds necessary to pay for that treatment make medical billers an important player in the future of health care.