Medical coding is the heart of the healthcare industry. It keeps doctors and nurses on track and organized, and shows in clear terms a patient’s medical history. One slip-up with an improper code could be big trouble for a patient. You wouldn’t want to mistakenly code a lymphoma (cancer) for lipoma (benign fatty tumor) because you didn’t know the difference. This is just one example of why it is essential for a person with a medical coding job to have a sound understanding of medical terminology, anatomy, physiology and pharmacology.

When you study in MTI College’s Medical Billing and Coding certification program, you learn the important skills you need to work as a healthcare professional – including the basics of anatomy and physiology. A requirement for a medical coding job is receiving an ICD-10-CM/PCS certification. Here’s why you need to have a basic medical background.

ICD-10 universally classifies and codes all diagnoses, symptoms and medical procedures. The International Classification of Diseases, Tenth Revision (ICD-10), is an organized way of telling the entire story of a patient’s care and encounter with a doctor and/or hospital. According to the World Health Organization, which created the ICD in 1948, it is the gold standard for reporting diseases and health conditions. The universally accepted codes that you, as a medical coder, use make it easy to share and compare patient medical information among various hospitals, regions and providers. They also ensure that the procedure that is billed makes sense with the diagnosis. For example, if you code a bee sting diagnosis as a justification for an x-ray, it’s likely the claim would be rejected. You don’t want a clerical error on your part to result in patient harm. If you indicate that a patient with a known allergy to penicillin received that drug for an infection rather than Bactrim, it could prove disastrous.

Various codes correspond to various bodily systems and procedural locations. You need to understand anatomy, physiology and pharmacology so that you can accurately enter the codes that apply to specific procedures, diagnoses and treatments. These codes are so highly detailed that they even indicate on which side of the body the procedure is being done. In addition, your understanding of basic anatomy and physiology will help you categorize the different bodily systems (e.g., respiratory, muscular, skeletal, circulatory, etc.) involved.

Medical coding is extremely specific. In addition to learning ICD-10 codes, you must know CPT® codes as well. The five-character Current Procedural Terminology codes are the U.S. standard for the way medical professionals document and report medical, surgical, laboratory, radiology, anesthesiology and E/M (evaluation and management) services. Some procedures are straightforward, but others can be confusing. Take a lipoma, for example. A lipoma’s depth into the tissues varies, but its coding depends on exactly where it is located. Coders need to not only know what a lipoma is, but also what the difference is between subcutaneous and intramuscular tissue, as well as the size of the excision to remove it.

Deciphering a doctor’s scribble is important.  When a doctor is writing patient notes, the coder needs to understand it. He or she is likely to be in a hurry and writes down a diagnosis, a treatment plan, a prescribed medicine and maybe a follow-up procedure. For someone doing medical coding, that needs to be transcribed into standard code to record the patient’s medical history and to submit it all to insurance for billing. If you misinterpret the notes or just don’t understand, it could cause confusion and delays in paying insurance claims, or even result in a denial of coverage.

Your medical coding expertise is essential to patient care. We live in a data-driven world, and that’s critically important in health care. Listing symptoms, diagnoses and procedures, and sending reports to an insurance company to request reimbursement, is not enough. Every time a person visits a doctor for an illness, for example, there are symptoms. They are recorded, along with the procedures performed and medicines prescribed. Maybe it’s a fever and sore throat. The doctor might order a strep test. If strep throat is the diagnosis, an antibiotic is generally prescribed. That’s rather straightforward. What if the patient sees the doctor because she is pregnant? She needs regular testing, ultrasounds, blood work, abdominal measurements, special vitamins, etc. Then what happens if there is a complication? More documentation is required. It gets very complicated, and your responsibility increases for accurately recording data that you first need to understand. You don’t want to mistake gestational diabetes for Type 2 diabetes, or preeclampsia for edema.

As a medical coder, you do not make diagnoses or treat patients, but you do need a basic understanding of anatomy, physiology and pharmacology to ensure that health information is documented accurately. Medical coders are in demand, and jobs are expected to rise much faster than average. MTI College offers the training you need to enter this high-growth field..

Partially because of a rapidly aging U.S. population, healthcare jobs are in demand, because as people age, they usually need more medical care. Medical billers are needed to handle insurance and patient claims.  MTI College offers a Medical Billing and Coding Professional Diploma Program that can prepare you to enter this in-demand field. You could be working alongside doctors and nurses in a hospital, doctor’s office, clinic, nursing home or other medical facility using your skills to provide much-needed assistance.

According to the Bureau of Labor Statistics, the employment rate for medical records and health information technicians (billers and coders) is growing much faster than the average rate for other occupations. Because more people have access to health insurance these days, claims on behalf of patients are going to increase. If you have a medical billing job, you will be the one to submit the bills for insurance reimbursement.

Does this sound like a job you would enjoy? Find out what a medical biller is responsible for on a day-to-day basis and learn whether it is a good career choice for you.

What is the job of a medical biller?

The medical biller plays a vital role in the relationship among medical providers, patients and insurance companies. Although the medical biller is not responsible for patient care, he or she should have a good understanding of medical terminology to be able to discuss medical bills with both insurance carriers and patients. These are a few duties of a medical biller:

  • Audit and submit claims to insurance companies for patient procedures and treatments.
  • Obtain insurance referrals and pre-authorizations for patient procedures.
  • Verify insurance eligibility and benefits.
  • Understand insurance guidelines, including those for HMO/PPO, Medicare and Medicaid.
  • Review patient bills for accuracy and fill in any missing information.
  • Check payments for accuracy.
  • Research and appeal denied claims.
  • Talk with insurance companies about payment discrepancies.
  • Set up payment plans for patients.
  • Collect delinquent accounts.
  • Answer phone inquiries from patients and insurance companies.
  • Use medical billing software to perform job duties.
  • Update software with rate changes.
  • Know Fair Debt Collection Practices.

As a medical biller, you may not perform each of these duties every day, but they are all considered responsibilities of the job.

Is a medical biller the same as a medical coder?

When you train at MTI College, you train for both positions. If you work in a small office, you may also perform the duties of a medical coder, a person who applies industry-standard codes that relate to specific medical diagnoses, treatments and procedures to patient health records. The medical biller then takes the coded information and submits the bill. However, if your job is for a larger organization, you may just do medical billing.

What personal skills are helpful to have if you want to be a medical biller?

A medical biller’s job is very important to the financial cycle of a provider, and you need to always strive for accuracy.

These are some other skills you should possess if you want to be a medical biller:

  • Attention to detail. You’ll always need to check bills for accuracy and identify discrepancies.
  • Excellent communication ability. Much of your job will involve phone conversations with patients and insurance companies.
  • Good customer service. Remember that the bottom line is a person’s healthcare management, and it can be an emotional topic for some people. You need to speak diplomatically, compassionately and accurately to answer questions.
  • Computer knowledge. Since you will be using medical billing software, you should know how to use a computer and the Internet.
  • Accounting and bookkeeping. An understanding of the basics can be very helpful since you will be sending out billing statements and will need to reconcile them as payments come in.
  • Medical terminology. Your MTI training will cover this, but you need to keep up to date to be able to converse with patients, providers and insurance companies.
  • Problem solving. Sometimes there will be discrepancies or inconsistencies, and knowing how to go about solving the problem is necessary.
  • Being comfortable with teamwork. Since you will interact with other medical staff members, you should enjoy working as part of a team.

MTI College’s Medical Billing and Coding Training Program gives you the background you need to enter the exciting, busy world of healthcare. Contact MTI College Sacramento today to jump-start your medical billing career.

Healthcare is a rapidly growing field with an excellent job outlook over the coming years. With a modicum of training, you could begin a stable, fulfilling career in any one of a number of healthcare technician or assistant positions – and you could do it in a relatively short amount of time.

But most jobs in healthcare require certification, and to get certification, you usually need to get some education or training under your belt first. You might be wondering what certification training for healthcare positions costs. Well, truth be told, there’s no easy, definitive answer to the question.

The cost of healthcare certification training varies, depending on the field of specialization you want to get into, the area in which you are seeking your education and eventual certification, and the individual institution that you are hoping to attend for your training.

Not All Healthcare Certification Training Programs Are Created Equal

These days, you can find online, remote instruction for just about any specialty or field that you are interested in going into, and of course, there are good online training courses and bad ones. But even the best online training courses cannot offer you the level of individual attention that a classroom setting can.

Also, depending on the specific requirements in your area, an online training course provided by an out of state or online-only institution may not count toward certification or licensure. Make sure to check the state and local licensing and certification requirements for the specialty of your choice in your area before inadvertently selecting a program that may not get you what you need.

It is also very important to make sure that the institution in which you are seeking certification training for the healthcare specialty of your choice meets the accreditation requirements set forth by the licensing body for your particular area. There are a great many schools, and some so-called diploma mills, both online and with physical locations that provide training, but do not meet accreditation requirements for licensure.

Healthcare Certification Training at MTI

If you’re hoping to pursue a career as a medical assistant, certified phlebotomist, or medical billing and coding professional, then consider beginning your career with an education from MTI College. We offer students the opportunity to become certified in all three of these specialties in our Diploma Program, so you can get started in the healthcare profession of your choice.

Link to homepage: www.mticollege.edu

Looking to start a career in the healthcare industry often begins with seeking some type of professional certification. There are many courses offered that prepare prospective healthcare workers for exams that lead to certification in a wide variety of specialties. And certification is offered by a variety of certifying bodies in a variety of specialties, including medical assisting, clinical or administrative assisting, phlebotomy, billing and coding, and many others.

Regardless of the specific field in which you may be interested pursuing a career in, you may have some questions about medical certification itself. While certifying bodies and the laws that govern them do vary a bit from state to state, there are some general answers that can be applied to several of the most frequently asked questions about healthcare certification.

How Do I Become Certified?

The road to certification can be different for each healthcare specialty in each state, depending on the certifying body and a variety of other possible factors. Typically, there are a few simple steps toward certification, including enrolling in and completing a course of instruction at an accredited school, and preparing for, taking, and passing a certification exam with the certifying body in your particular geographic area. 

What Does Healthcare Certification Cost?

The cost of certification can vary widely, depending on the specialization involved, the state in which certification is pursued, and the certifying body. Costs for different kinds of specialization range greatly, as does the cost of certification from state to state. Also, other local governing bodies, including counties and municipalities, may have certification requirements beyond those of your individual state, with attendant differences in cost.

Consult your local or state government licensing body to ask about the licensure requirements and costs for your specialization in your particular area.

How Long Does Healthcare Certification Last?

Again, this is somewhat dependent on your specialization and your location. Federal regulation stipulates that a certified nursing assistant work at least eight hours, for pay, as a CNA without a break of more than two years to remain licensed indefinitely. Your state or local government may have ongoing education and certification requirements specific to your area of healthcare specialization beyond the federal regulation.

Thinking About a Career as a Certified Healthcare Worker?

If you’re looking to pursue a career as a certified healthcare worker, then be sure to consider starting your journey with MTI College. We offer students the opportunity to become certified in a several specialties in our Diploma Program including:

Phlebotomy
Medial Assisting
Medical Billing and Coding

Fill out our simple online application and begin the process to a rewarding career helping others!

What is a Medical Billing and Coding Professional?

Whenever a healthcare provider sees a patient, a medical biller and coder is called on to submit claims to the patient’s insurer in a specific manner, with services, procedures, and diagnosis identified by a medical billing code.

Medical billing and coding professionals work with health care providers and insurance companies to insure that procedures are correctly billed and paid for. In some contexts, the two jobs (billing and coding), are performed by separate individuals or departments. In others, the jobs are combined into one position.

Where the jobs are performed separately, medical billers are typically focused on ensuring that patients and insurance providers are billed correctly, while coders are specifically focused on the accurate coding of all data associated with a patient’s care.

What Medical Billers and Coders Do

Professionals in medical billing and coding are very important to making sure that the money due to a healthcare provider is received, allowing the healthcare provider to stay in business and to provide further care to patients in need. Medical billers and coders are essential to the ongoing function of clinics, hospitals, and private practitioners.

Medical insurance billers and coders primarily work in an office setting, whether in a care giver’s facility or in a separate contractor’s office, utilizing computers and telephones to handle the majority of their work. If working in a clinic or hospital setting; the relative size of the healthcare provider will typically determine the level of specialization afforded to the billing and coding professionals employed.

The work can be challenging in some ways, depending on the level of direct interaction required with insurers and patients. Successful medical billers and coders generally possess a good eye for detail, work well on their own and in small groups, and are able to work with a computer.

Training and Certification Necessary to Work in Medical Billing and Coding

Nearly all medical billing and coding positions in the United States require training and certification prior to employment. Training can be secured through a variety of accredited institutions, such as MTI College, and certification as a Certified Medical Reimbursement Specialist (CMRS) or a Certified Coding Associate (CCA) is available through the AMBA and the AHIMA.

A typical course of study toward certification generally includes classes in medical billing software, medical administration, medical ethics, documentation evaluation, terminology, human anatomy and physiology, and government programs.

Preparing for a Career as a Medical Billing and Coding Professional

These days, there is a wide variety of training and certification programs being advertised on television and the Internet. Make sure that whichever program you select to prepare for your career as a medical billing and coding professional, you are receiving proper training and recognized certification.

If you’re hoping to pursue a career in medical billing and coding, start your journey with MTI College, where we offer students the opportunity to become a certified Medical Billing and Coding Professional in our Diploma Program. Contact an admissions advisor today, and take the first step towards your new career!

For employment opportunities and job security, few industries can compare with healthcare. Some people might be initially deterred from seeking work in this field because they believe a long, arduous educational process is involved. However, working as a medical assistant or a medical billing and coding professional does not require a lengthy training process. In fact, many people can obtain employment in these positions with less than a year of training.

What Is a Medical Assistant?

In many doctor’s offices, it is the medical assistant who has greatest amount of one-on-one contact with the patient. A medical assistant may check in patients upon their arrival or answer the phone at the front desk. They may also do some routine document filing. However, these administrative tasks are just half of the medical assistant’s job. When a patient is in an examining room, it may be the medical assistant who takes and records vital signs. They might also sterilize the equipment, draw blood and prepare samples for testing at the lab.

How to Become a Medical Assistant

Medical assistant programs at technical schools and community colleges are available, and can typically be completed in less than a year. Many medical assistants receive some on-the-job training to adjust to their work site’s particular system. However, competitive job candidates will have to come in with some background in medical terminology, procedures, and applied skills. Learn more about MTI’s Medical Assistant program.

What Is a Medical Billing and Coding Professional?

While a medical assistant has plenty of face-to-face contact with patients, the situation is quite different for the medical biller and coder. This is a much more behind-the-scenes role, but it is no less valuable to the healthcare field. People who are adept at using computers and have excellent attention to detail are likely to succeed in this career. Essentially, medical billers and coders organize patient data using the complex system of coding that has been devised for every condition, diagnosis and treatment used in the medical field. It is this coded data that is subsequently submitted to insurance companies as an invoice for payment. Without the medical billing and coding professional, it would be impossible for healthcare professionals to be paid for their services.

How to Become a Medical Billing and Coding Professional

Formalized training is a necessary component of entering this field. In places like Sacramento medical billing and coding training provides students with the knowledge they need to efficiently and correctly utilize the codes and guidelines that are indispensable to the profession. Most programs require less than a year to complete and should prepare students to complete professional certification by or after graduation. Learn more about MTI’s Medical Billing and Coding Professional program.

Choosing a Goal for a Healthcare Career

Whether choosing Sacramento medical billing and coding training or a program that leads to a medical assistant position, potential employees in the healthcare field can feel confident that their choice will provide them with the training to pursue a meaningful career with excellent employment stability.

As the graduation rate of doctors continues to be an issue in the United States, the shortage of physicians is expected to become an even bigger problem. Currently, less than 25% of newly graduated doctors choose to go into primary care, and of that group less than 5% locate their practices in rural areas. In addition to a shortage of primary care physicians, there is also a critical shortage in other specialties such as general surgery. As a result, hospitals and other medical facilities are feeling the strain of having fewer personnel to handle a variety of necessary tasks such as medical coding and billing. To ease the strain on these facilities, many are turning to those people who have received medical billing and coding training to handle the workload.

Medical Billing and Coding Training

For medical facilities that need help handling their vast amounts of paperwork, the trend is to outsource the work to those skilled in medical billing and coding. Most training programs in this field can be completed within six months to one year, and provide graduates with knowledge on numerous topics. Students in medical billing and coding training programs learn the many different coding techniques necessary to ensure medical records and insurance forms display the correct procedures and conditions for each patient, in addition to learning how to bill patients and insurance companies. Upon completing the program, a graduate can choose to take various certification exams from the American Academy of Professional Coders, leading to certification as a Certified Coding Professional. While many medical billing and coding professionals work in hospitals or medical offices, others choose to be self-employed and work from home.

Medical Assistant Certification

Another position helping to ease the strain on the health care system is that of medical assistants. People interested in completing a medical assistant diploma program have numerous options from which to choose, including online studies or in person at community colleges or technical schools. A medical assistant diploma program can be completed within one year, providing a student with knowledge of various medical duties. A medical assistant is not only skilled in handling various office procedures such as scheduling appointments, calling in prescriptions and speaking with insurance companies, but is also able to perform medical procedures. These can include checking a patient’s blood pressure, height and weight and pulse. They can also become certified to perform more complex tasks such as administering EKG’s to patients and performing phlebotomy duties.

As hospitals and medical offices continue to struggle with a lack of doctors, the role of medical assistants and billing and coding professionals will grow in importance. For those seeking a medical career with fast-track training, these two careers are good options.

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