We’ve all been to a doctor’s office, clinic, or hospital at least once in our life, but many people are not familiar with how a medical office operates. In many cases, we receive the needed medical care and we are on our way! People may be familiar with receiving communication from healthcare providers or health insurance companies by mail, email, or even by phone. Have you wondered what happens between the moment a patient leaves a provider’s office to the point when they receive follow-up communication about their medical bill? This is where professionals trained in medical billing and coding come into play. Continue reading below as we discuss the two types of medical billing and the processes involved!
About Medical Coding and Billing Jobs: Common Responsibilities
Those who work in billing and coding jobs in the medical field are responsible for correctly coding and processing medical bills. This is to ensure all parties have what they need to document the services rendered by healthcare providers and issue billing for those services. That includes providing the correct data to patients, providers, healthcare facilities, and insurance companies. If you are interested in medical billing and coding jobs, it is first important to have the necessary training. In order to pursue a medical billing and coding career path, one should be trained in several areas, some of which may include1:
- Medical billers and coders should know or have access to information for each insurance company in order to submit medical claims efficiently.
- Those who handle medical billing have access to private patient information on a regular basis. As a result, they must be informed on proper procedures and handling of such information in order to avoid violating HIPAA privacy and security rules.
- Medical billers and coders should also be familiar with the type of billing software being used in the practice, as it can save time and minimize errors.
- In order to prevent delays in receiving payment, medical billers should be able to understand how to bill claims in the correct order.
Although billing and coding specialists do not provide direct patient care, they do regularly work alongside doctors, nurses, and other healthcare professionals. Medical billers and coders are an important part of any healthcare facility! Pursuing a career as a billing specialist in the medical field can be a great way to become an important part of the healthcare team!
The Two Types of Medical Billing and Coding
If you’re interested in how to start a medical billing and coding career path, you should know more about the two types of billing in the healthcare field, which are professional billing and institutional billing.
Professional billing is the type of medical billing that is used in individual physicians’ practices. Specialists who focus on professional billing are often required to know both billing and about the coding system.
Here are some more details on professional billing1:
- Professional billing is completed on the CMS-1500 Forms.
- Medicare, Medicaid, and some other companies will accept electronic claims as the primary form of filing, but some claims may still be made via paper. Filing paper claims is another important aspect of professional billing.
- If an electronic claim is filed, a medical biller uses the 837-P, which is the electronic version of the CMS 1500 form.
Institutional billing is the type of medical billing that is used to handle the billing for hospitals, clinics, rehab facilities, nursing homes, etc. This may also cover outpatient and inpatient services such as equipment, lab services, radiology services, and more.
Here are some more details on institutional billing1:
- The standard claim form for Institutional billing is the UB-04.
- Electronic claims filed in institutional billing use the 837-I form.
- While job duties may vary from one employer to another, those who work in institutional billing, will likely only focus on billing and/or collections. Medical Coding is handled by designated medical coders in these settings. This is because medical coding for institutional services is often more complex than what is seen in a professional billing setting, and it often necessitates the attention of a dedicated coder.
Pursuing A Medical Billing and Coding Career Path
Are you thinking about pursuing a medical billing and coding career path? If so, those with billing and coding training are needed to help organize and manage health information data. This also means that there could be a rise in claims that need to be filed for reimbursement from insurance companies. Additional records, coupled with the widespread use of electronic health records (EHRs) by various providers, could also lead to a potential increase in need for skilled medical billers to organize and manage this information in all areas of the healthcare industry.
Are you ready to take your place as a member of a healthcare team? Do you want to become a billing and coding professional but you are wondering “how to start a career in medical billing and coding”? If so, training in the Medical Administration and Billing program at Dorsey Schools could help you get on your way. Students enrolled in this program can benefit from instruction covering a variety of topics to assist in their transition from the classroom to an administrative position within a healthcare setting.
The Medical Administration and Billing program at Dorsey Schools includes training on the following topics:
- Computer Applications for Allied Health Professionals
- Interpersonal Skills
- Medical Terminology
- Anatomy & Physiology
- Medical Office Procedures
- Electronic Health Records
- Medical Billing and Coding
- Hospital and Institutional Billing and Coding
- Medical Insurance Software Applications
- ..and more!
In just one year, you could be on your way to beginning a new career in the healthcare field as a Medical Administration and Billing professional!
The Dorsey Schools Medical Administration and Billing program is offered at the following campus locations:
- Dearborn, MI (A branch campus of Madison Heights)
- Madison Heights, MI (Main Campus)
- Roseville, MI (A branch campus of Madison Heights)
- Saginaw, MI (A branch campus of Madison Heights)
- Wayne, MI (A branch campus of Madison Heights)
- Woodhaven, MI (A branch campus of Madison Heights)
We understand that it takes time and effort to transition to a new career path. For those who want to reskill or retrain towards a potential new career field, Dorsey Schools can help you get started. We are committed to the success of our students and we strive to help them each step of the way as they pursue their new career. Take the next steps towards pursuing your new career. Contact us today to learn how you can begin training for your new career in Medical Administration and Billing!