Introduction to Medical Billing

Want to know more about medical billing? Need training? Medical biller job description? Or start your own medical billing business?

Medical billing as a career is gaining ever increasing interest among new job seekers either shortly after graduating from high school to begin their career path or more advanced people who desire a meaningful career change or job rehab to reenter the workforce. The medical billing career has a pull on those who wish to work in the healthcare industry without providing direct patient care, such as nursing staff or medical assistants normally do. Their strength lies on the administrative and business aspects of the industry.

To fully understand the definition of medical billing and the role of a medical biller you must understand the intricacies and complexity of the medical billing and coding process.

• what is medical billing?
• what is medical coding?
• are medical billers also medical coders?
• why won't doctors do their own billing?
• what is the purpose of medical coding?
• can I learn medical billing on my own?

Medical Billers

Embarking on the medical billing career path builds a solid foundation for those who wish to pursue a meaningful career or plan to eventually become their own boss, freelancer, or independent medical practice advisor from their own medical billing business from home.

Our voluntary Medical Billing Community forum moderator, Steve Verno, an experienced medical biller, mentor, author and independent medical billing business consultant has provided an interesting metaphor for us to understand what medical billing is all about. He said...

"Metaphorically speaking, medical billing is much like a river. It has deep parts and shallow parts. It can go straight or curve around bends. Its current can be slow and lazy or it can rush by so fast you have no control. It can be navigated, but carefully and cautiously. If you take a wrong turn, you can end up in deep water and up the creek without a paddle. If you don't heed the dangers, it can destroy you. The journey can be wondrous or boring. As the journey ends you can feel happy that you accomplished your goal, or you can arrive wet and miserable."

Medical billers, as well as their medical coding colleagues, are an invaluable asset to a doctor's office, hospitals, ambulatory care clinics and many, many other facilities from coast to coast that provide medical and health care services to the public. Most of their days are spent at a computer desk in the claims processing office, the administrative billing and accounting department, or a private office, depending on the type and set up of the medical billing company or consultant firm. The size of the facility, or company directly affects their weekly work load, but in general, most salaried medical billers work 40 hours per week.

The best advice often comes from medical billing experts who have already worked in this field and can define medical billing experiences based on true events, medical billing software they have actually used, and medical billing and medical coding situations they have actually handled. Only this way can you truly realize how medical billing plays an extremely important role in the success of the healthcare industry as a whole, and how the art of medical billing relates to medical coding when applied.

Can I Teach Myself To Do Medical Billing Or Is Formal Training Essential?

Medical billing is versatile and rewarding, however, self-training may only confuse you. Formal career training provides you the knowledge you need to handle a demanding medical billing job. Medical billing staff must understand both, medical billing procedures AND the medical coding process. Formal medical billing training can be extensive (note, we said extensive, not expensive) where you learn about:

• Medical terminology
• Insurance terminology
• Basic anatomy
• Claim forms and claims process
• EOBs
• Aging reports
• AR recovery
• Coding basics
• Data entry and software
• Basic medical office management and admin

Not only will this training teach you fundamental medical billing basics but also introduce you to the latest technologies and processes that enables you to select codes that best represent the services furnished during a medical office visit or hospital stay.

When Am I Done Learning?

Education does not end upon graduation from a formal training program, even for the best medical billers and coders! The rules and regulations, billing procedures, coding system, Medicare rules, technology, research and laws in health care constantly change, and so, serious professionals in the medical billing and coding discipline will always have to continue learning, solidifying, refining, refreshing, revisiting and enhancing their skills. The best way to continue learning is through seminars, workshops, online webinars, continuing education programs, magazines and courses offered from various groups and medical office and billing software vendors. Some of the workshops and webinars are free, others are quite expensive, but in either case, they are important and well worth the money and time spent.

Certificate medical billing training programs typically require the following courses followed by a practicum:

1. Medical Terminology
2. Human Anatomy and Physiology
3. Pathology and Disease Processes
4. Keyboarding
5. Health Information Management
6. CPT Coding
7. ICD-9-CM Coding
8. Healthcare Laws and Ethics

Employers carefully screen their applicants and prefer those medical billers who have the specific experience, training and credentials that best meets their need.

Can I Make More Money If I Have More Training and Credentials?

As with any job, wages are commensurate with experience and can be higher or lower in different areas of the country. American Association of Professional Coders (AAPC) states the average starting salary for Certified Medical Coders is approximately $35,000 per year, but that's average. Experienced professionals may eventually set up their own medical billing and coding consulting business and earn additional income for seminars, coding review analyses for providers and freelance consulting to payers. An independent consultant will try to make as much money as possible by investing their time and skills accordingly.