The health care industry is always on the lookout for well-trained administrators who have attended medical billing schools. People who are formally trained to provide professional medical billing services are especially prized by hospitals, clinics and private practices; and practically anyone can learn this specialized skill.
Physicians, patients, hospital administrators, and insurance companies all rely on billing specialists to keep accurate records of medical procedures and charges. So, what does it take to learn medical billing? Of course, it can be helpful to have a background in office administration, accounting, health care, or other related field; but there are no firm prerequisites to learning to be a medical billing specialist. If you are a high school graduate, you already have one foot in the door.
You might choose to take a short course to become certified in a matter of weeks. You will learn about various medical terminology and procedures, and how to interpret the specific numeric codes assigned to everything that occurs during the patient's visit. You will develop skills in communication to help discuss claims with HMOs and insurance companies, as well as to understand patient and physician requests for your assistance.
Although billing and coding are focused on just one area of medical office administration, you can definitely expect to broaden your employment horizon with a certificate in the field. However, if you really want to open the doors to a better future, you might want to delve further into the field by seeking a degree in medical office administration. Not only will you learn about medical billing and coding, you can become a valuable part of a health care team by learning to run an efficient practice and how to take the administrative burden off busy doctors, nurses, technicians and surgeons.
With the call for extended medical care increasing each day, there is also a growing need for experts in office administration, and you can quickly get in on the trend. Learning medical billing might be the beginning of a whole new career for you! Why not find a good class and start today?
DISCLAIMER: Above is a GENERAL OVERVIEW and may or may not reflect specific practices, courses and/or services associated with ANY ONE particular school(s) that is or is not advertised on SchoolsGalore.com.
Copyright 2008 - All rights reserved by Media Positive Communications, Inc.
Notice: Publishers are free to use this article on an ezine or website, provided the article is reprinted in its entirety, including copyright and disclaimer, and ALL links remain intact and active.
We invite you to visit SchoolsGalore.com where you can find good medical billing schools in your area today.
Article Source: http://EzineArticles.com/?expert=Michael_Bustamante
Friday, November 7, 2008
Details Needed For Medical Billing
Who handles the medical billing process in any health care environment? Well, it may be handled either directly by the doctor or by his staff or by a third party professional medical billing company if it is for a bigger clinic or hospital. Medical billing is a specialized profession today and billing could be a team work process that can involve the following people.
* Office manager
* Nurse
* Receptionist
* Medical assistant
* Insurance clerk
* Medical coders
The medical claim process begins with proper identification and medical coding as all medical procedures and diagnoses have been assigned with codes. The Current Procedural Terminology (CPT) was developed in the year 1966 by (AMA) American Medical Association and it lists medical procedures and corresponding codes. Each medical procedure has a unique code that is listed in a CPT manual. What are the types of details that are required during the medical billing process? They include,
* Name, address, telephone number, and ID number of provider
* Name of insurance company / group
* ID number of insurance holder
* Patient's name, date of birth/address/phone no
* Insured person's name, date of birth/address/phone
* Relationship between patient and insured person
* Details of provider name, address, telephone number, and ID number
* Details of other health insurances
* Patient's medical history /condition
* Details whether the medical condition is related to accident etc
A document called the explanation of benefits (EOB) often may accompany the payment that is received from the insurance or managed care company. This document describes all the details of services covered and not covered. It also mentions all the bills that have been sent to the service provider and the patient. One can also know if the patient has missed out on his annual payments/deductibles to the insurance company making him ineligible for total claim.
Article Source: http://EzineArticles.com/?expert=Ricci_Mathew
* Office manager
* Nurse
* Receptionist
* Medical assistant
* Insurance clerk
* Medical coders
The medical claim process begins with proper identification and medical coding as all medical procedures and diagnoses have been assigned with codes. The Current Procedural Terminology (CPT) was developed in the year 1966 by (AMA) American Medical Association and it lists medical procedures and corresponding codes. Each medical procedure has a unique code that is listed in a CPT manual. What are the types of details that are required during the medical billing process? They include,
* Name, address, telephone number, and ID number of provider
* Name of insurance company / group
* ID number of insurance holder
* Patient's name, date of birth/address/phone no
* Insured person's name, date of birth/address/phone
* Relationship between patient and insured person
* Details of provider name, address, telephone number, and ID number
* Details of other health insurances
* Patient's medical history /condition
* Details whether the medical condition is related to accident etc
A document called the explanation of benefits (EOB) often may accompany the payment that is received from the insurance or managed care company. This document describes all the details of services covered and not covered. It also mentions all the bills that have been sent to the service provider and the patient. One can also know if the patient has missed out on his annual payments/deductibles to the insurance company making him ineligible for total claim.
Article Source: http://EzineArticles.com/?expert=Ricci_Mathew
Tuesday, November 4, 2008
Medical Billing Rules
What is the main purpose of medical billing? Well it is just to make sure that the service provider receives a fair payment for services provided and also so that the payment is received in time. The medical billing procedures are governed by certain laws. What are the main laws that govern medical billing? They include the following 3 laws;
# Fair debt Collection Act
# The Health Insurance Portability and Accountability Act
# The Privacy Rule
The Fair debt collection Act is a federal law that dictates how and when a debt is to be collected.
This act is for the protection of all the patients and other consumers from unlawful threats.
The Health Insurance Portability and Accountability Act of 1996, better known as the HIPAA, was enacted by the U.S. Congress in 1996. It has two titles.
Title I of HIPAA regulates the availability, breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act. This act also prohibits any group health plan from creating eligibility rules or deciding of insurance premiums for individuals in the plan based on health status, medical history, genetic information, or disability. Thus Title I also protects health insurance of workers and their families if they have to change jobs.
The second title of HIPAA contains a portion that increases the efficiency of data exchange for healthcare financial transactions and protects the privacy of electronic data transmission and the confidentiality of patient records. All medical providers are asked to send their claims electronically in compliance with the act to receive their payment. This includes electronic transmission of major financial and administrative dealings, including billing, electronic claims processing and reimbursement advice. Various offenses relating to health care are set and criminal penalties imposed. Besides creating several programs to control fraud and abuse within the health care system it imposes penalties when rules are violated.
The privacy rule regulates the use and disclosure of Protected Health Information (PHI). PHI is any information about health status, provision of health care, or payment for health care that can be linked to an individual. Any person who believes that the Privacy Rule is not being upheld can file a complaint with the Department of Health and Human Services Office for Civil Rights.
Article Source: http://EzineArticles.com/?expert=Ricci_Mathew
# Fair debt Collection Act
# The Health Insurance Portability and Accountability Act
# The Privacy Rule
The Fair debt collection Act is a federal law that dictates how and when a debt is to be collected.
This act is for the protection of all the patients and other consumers from unlawful threats.
The Health Insurance Portability and Accountability Act of 1996, better known as the HIPAA, was enacted by the U.S. Congress in 1996. It has two titles.
Title I of HIPAA regulates the availability, breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act. This act also prohibits any group health plan from creating eligibility rules or deciding of insurance premiums for individuals in the plan based on health status, medical history, genetic information, or disability. Thus Title I also protects health insurance of workers and their families if they have to change jobs.
The second title of HIPAA contains a portion that increases the efficiency of data exchange for healthcare financial transactions and protects the privacy of electronic data transmission and the confidentiality of patient records. All medical providers are asked to send their claims electronically in compliance with the act to receive their payment. This includes electronic transmission of major financial and administrative dealings, including billing, electronic claims processing and reimbursement advice. Various offenses relating to health care are set and criminal penalties imposed. Besides creating several programs to control fraud and abuse within the health care system it imposes penalties when rules are violated.
The privacy rule regulates the use and disclosure of Protected Health Information (PHI). PHI is any information about health status, provision of health care, or payment for health care that can be linked to an individual. Any person who believes that the Privacy Rule is not being upheld can file a complaint with the Department of Health and Human Services Office for Civil Rights.
Article Source: http://EzineArticles.com/?expert=Ricci_Mathew
Medical Billing And The PPO Plan
Medical billing is the process of collecting fees for medical services. A medical bill is also called as a claim that has to be collected from the insurance company. There are different types of insurance plans. What is the PPO plan? PPO is a term used in health insurance that stands for Preferred Provider Organizations. It is a managed care organization of medical doctors, hospitals, and other health care providers who are associated with an insurer agent/administrator's clients to provide health care at reduced rates. It is today one of the most preferred kind of health care plan in the country. A preferred provider organization is sometimes also referred to as a participating provider organization.
More than 50% of the insured population in the US have chosen to go for the PPO plan. Its popularity is mainly because of the fact that in this system, doctors / hospitals have made an agreement with the insurance companies to offer discounted fees to the company's members.
The primary advantages of going for the PPO insurance plan are,
# Its not mandatory to maintain a primary care physician
# Can directly see a specialist without referral
# Freedom to choose own doctor / hospital
The main advantage of going for a PPO plan is that one can choose a health service provider from outside the provider list Another less popular system is called an (EPO) exclusive provider organization (EPO), wherein if you seek care from a non-preferred provider there is no coverage at all. One must remember that with freedom to choose will always mean more expensive medical bills.
There are many types of PPO plans and the actual benefits depend on different factors like,
# Monthly premium amount
# The amount of coinsurance obliged to pay,
# Whether treatment from the network/ outside
# Annual deductible amount
What are the other features of a preferred provider organization? They generally include services of review of the patient records by the company representatives to ensure that there is no foul play. In the case of non-emergency admissions, an approval is taken from the insurer in advance.
Article Source: http://EzineArticles.com/?expert=Ricci_Mathew
More than 50% of the insured population in the US have chosen to go for the PPO plan. Its popularity is mainly because of the fact that in this system, doctors / hospitals have made an agreement with the insurance companies to offer discounted fees to the company's members.
The primary advantages of going for the PPO insurance plan are,
# Its not mandatory to maintain a primary care physician
# Can directly see a specialist without referral
# Freedom to choose own doctor / hospital
The main advantage of going for a PPO plan is that one can choose a health service provider from outside the provider list Another less popular system is called an (EPO) exclusive provider organization (EPO), wherein if you seek care from a non-preferred provider there is no coverage at all. One must remember that with freedom to choose will always mean more expensive medical bills.
There are many types of PPO plans and the actual benefits depend on different factors like,
# Monthly premium amount
# The amount of coinsurance obliged to pay,
# Whether treatment from the network/ outside
# Annual deductible amount
What are the other features of a preferred provider organization? They generally include services of review of the patient records by the company representatives to ensure that there is no foul play. In the case of non-emergency admissions, an approval is taken from the insurer in advance.
Article Source: http://EzineArticles.com/?expert=Ricci_Mathew
Friday, October 31, 2008
Texas Medical Billing - Use The Clean Claim Law
Texas has one of the most helpful and powerful clean claim laws in the United States. The penalties for a clean claim violation can go all the way up to the payer being required to pay billed charges; that's right billed charges. The basic idea of the law is that a payer has to respond to a clean claim within 30 days (45 days if it is not submitted electronically). In order to utilize the clean claim law effectively you must have a tracking system built into your medical billing process that flags:
1. Which payers are subject to the clean a claim law (not all are),
2. When a claim was submitted,
3. When a request fro information was received from the payer (if you receive one then it stops the 30 day clock until you respond),
4. When your office responded to the information request (this starts the 30 day clock again), and
5. When you received a payment or denial.
The design and implementation of the system and reporting can challenging, but it will pay huge dividends in terms of the penalties from payers and in the way in which you will make payers take notice of your claims next time. At ClaimCare Medical Billing Services we have used our clean claim tracking system extensively and have seen significant rewards for our clients. We have actually received calls from managers at some of our payers that have assured us they would process our claims quickly and asked if we would please stop submitting complaints.
A quick way to get started with using the clean claim law is to pick a specific payer that you believe habitually delays claims beyond 30 days. Find a handful of claims that have gone past 30 days and then test the water with those claims. This will allow you to learn the basics of using the on-line tool provided for submitting complaints and see the impact of your initial complaints.
Article Directory: http://www.articledashboard.com
1. Which payers are subject to the clean a claim law (not all are),
2. When a claim was submitted,
3. When a request fro information was received from the payer (if you receive one then it stops the 30 day clock until you respond),
4. When your office responded to the information request (this starts the 30 day clock again), and
5. When you received a payment or denial.
The design and implementation of the system and reporting can challenging, but it will pay huge dividends in terms of the penalties from payers and in the way in which you will make payers take notice of your claims next time. At ClaimCare Medical Billing Services we have used our clean claim tracking system extensively and have seen significant rewards for our clients. We have actually received calls from managers at some of our payers that have assured us they would process our claims quickly and asked if we would please stop submitting complaints.
A quick way to get started with using the clean claim law is to pick a specific payer that you believe habitually delays claims beyond 30 days. Find a handful of claims that have gone past 30 days and then test the water with those claims. This will allow you to learn the basics of using the on-line tool provided for submitting complaints and see the impact of your initial complaints.
Article Directory: http://www.articledashboard.com
3 Benefits Of Web-based Electronic Medical Billing Software
When you decide to opt for Web-based medical billing software you will find many great benefits. These include but are not limited to, reduced install and maintenance costs, security from natural disasters, anytime access.
Anytime Access
A major benefit of a Web-based medical billing solution is that you can access the information anytime. Whether you are at home, or in the office, you only need an Internet connection and you will be able to access all the information you need. Late at night or early in the morning or during the day you will be able to access the information for your practice.
Reduced Install and Maintenance costs
Another benefit of the software being Web-based is that there are much lower installation costs. You will see this benefit right up front as it will be the first step that you go through. Another benefit is the reduced maintenance cost. Many server based technologies need to be upgraded and constantly monitored. This can sometimes lead to unexpected costs to help maintain your current system. With Web-based technologies these maintenance costs are much, much, much lower.
Accidents unfortunately happen
As much as we like to think that accidents never happen to us, there is a chance that they just may. Many people use insurance to cover them incase of these major accidents. But many people do not think about what is going to happen to their information in an accident. With Web-based electronic medical billing software there is greater satisfaction in knowing that if an accident where to go through a horrific accident, you would be not lose all of your records. If there were a fire, earthquake, flood and your servers were hit, you would lose all of your client information. But if you had a Web-based software solution, even though your office may be damaged, your records wouldn’t be. You would be able to be up and running in almost no time.
So when deciding between Web-based and server side software remember these major benefits of Web-based medical billing software.
Article Directory: http://www.articledashboard.com
Anytime Access
A major benefit of a Web-based medical billing solution is that you can access the information anytime. Whether you are at home, or in the office, you only need an Internet connection and you will be able to access all the information you need. Late at night or early in the morning or during the day you will be able to access the information for your practice.
Reduced Install and Maintenance costs
Another benefit of the software being Web-based is that there are much lower installation costs. You will see this benefit right up front as it will be the first step that you go through. Another benefit is the reduced maintenance cost. Many server based technologies need to be upgraded and constantly monitored. This can sometimes lead to unexpected costs to help maintain your current system. With Web-based technologies these maintenance costs are much, much, much lower.
Accidents unfortunately happen
As much as we like to think that accidents never happen to us, there is a chance that they just may. Many people use insurance to cover them incase of these major accidents. But many people do not think about what is going to happen to their information in an accident. With Web-based electronic medical billing software there is greater satisfaction in knowing that if an accident where to go through a horrific accident, you would be not lose all of your records. If there were a fire, earthquake, flood and your servers were hit, you would lose all of your client information. But if you had a Web-based software solution, even though your office may be damaged, your records wouldn’t be. You would be able to be up and running in almost no time.
So when deciding between Web-based and server side software remember these major benefits of Web-based medical billing software.
Article Directory: http://www.articledashboard.com
Medical Billing And Coding Online Schools
Online Medical Billing and Coding Specialist Schools teach courses that focus on the administration of Medical Billing and Coding for purposes of proper categorization of medical procedures and accurate billing processes. Students of Medical Billing and Coding will be prepared with those skills essential for Medical Billing and Coding processes and for Certified Medical Coding and Billing Specialist examinations for certification.
Online Medical Billing and Coding Specialist Schools train students specifically in the universal language that was developed for the purpose of streamlining medical insurance claims that ensure correct reimbursement from insurance companies for services rendered. Every symptom, diagnosis, procedure, and treatment has been assigned a numeric code that informs the insurance company which services were administered in a hospital, a doctor's office, a clinic, or other medical facility. This numeric language is used by Medical Billing and Coding Specialists to establish the exact services provided. The Medical Billing and Coding Specialist determines these codes and makes a selection based on information provided by the care provider, then processes the claim.
Online Medical Billing and Coding students can expect to study medical terminology, anatomy and physiology, reimbursement methods, law and ethics that apply to medicine, information management, and practices of various office environments.
Additionally, courses in Medical Billing and Coding will prepare students with professional skills that will allow for management of records, preparation of insurance forms, correct filing of claims, and for billing insurance companies for services rendered.
Responsibilities of a Medical Billing and Coding Specialist involve the accurate completion of billing and medical claim forms, appropriate billing, and good understanding of individual insurance company policies and procedures. Medical Billing and Coding Specialists can expect to work for hospitals, medical practitioners, medical clinics, and physical therapists, where efficient and well-prepared Medical Billing and Coding Specialists will manage billing and coding processes.
If you are interested in learning more about Online Medical Billing and Coding Schools please search our site for more in-depth information and resources.
DISCLAIMER: Above is a GENERAL OVERVIEW and may or may not reflect specific practices, courses and/or services associated with ANY ONE particular school(s) that is or is not advertised on our website.
Copyright 2007 - All Rights Reserved in association with Media Positive Communications, Inc.
Article Directory: http://www.articledashboard.com
Online Medical Billing and Coding Specialist Schools train students specifically in the universal language that was developed for the purpose of streamlining medical insurance claims that ensure correct reimbursement from insurance companies for services rendered. Every symptom, diagnosis, procedure, and treatment has been assigned a numeric code that informs the insurance company which services were administered in a hospital, a doctor's office, a clinic, or other medical facility. This numeric language is used by Medical Billing and Coding Specialists to establish the exact services provided. The Medical Billing and Coding Specialist determines these codes and makes a selection based on information provided by the care provider, then processes the claim.
Online Medical Billing and Coding students can expect to study medical terminology, anatomy and physiology, reimbursement methods, law and ethics that apply to medicine, information management, and practices of various office environments.
Additionally, courses in Medical Billing and Coding will prepare students with professional skills that will allow for management of records, preparation of insurance forms, correct filing of claims, and for billing insurance companies for services rendered.
Responsibilities of a Medical Billing and Coding Specialist involve the accurate completion of billing and medical claim forms, appropriate billing, and good understanding of individual insurance company policies and procedures. Medical Billing and Coding Specialists can expect to work for hospitals, medical practitioners, medical clinics, and physical therapists, where efficient and well-prepared Medical Billing and Coding Specialists will manage billing and coding processes.
If you are interested in learning more about Online Medical Billing and Coding Schools please search our site for more in-depth information and resources.
DISCLAIMER: Above is a GENERAL OVERVIEW and may or may not reflect specific practices, courses and/or services associated with ANY ONE particular school(s) that is or is not advertised on our website.
Copyright 2007 - All Rights Reserved in association with Media Positive Communications, Inc.
Article Directory: http://www.articledashboard.com
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