Whether patients go to a private practice, a hospital, or a clinic, they deserve the best care available. While doctors, practical nurses, medical assistants, and other healthcare professionals have significant encounters with patients, they aren’t the only ones who have an impact on the process. Those who have chosen medical coding and billing career paths are relied upon to help facilities manage patient visits and procedures. Here, Prism Career Institute explains the value of this often-overlooked position and how our programs can prepare you for a new career.
Understanding Medical Coding
The medical field is a complex one. Unlike retail stores where customers can simply walk in, find the items they want, and pay for them, healthcare visits require more intricacies when it comes to paying for services and procedures. That’s where medical coding comes in.
Medical coding is a process that begins when a patient visits any medical facility. The provider will create a detailed account of the visit in the patient’s medical record, offering insight into why each service was performed. Those who work in medical coding will then take this information and connect these services to medical billing codes. There are specific code sets, including:
- ICD-10-CM: This code set stands for the International Classification of Diseases, 10th Revision, Clinical Modification, and is for reporting diagnoses in all healthcare settings.
- ICD-10-PCS: The Procedure Coding System code set is designed specifically for inpatient services at hospitals.
- CPT: This HIPAA code set stands for Current Procedure Technology and helps coders denote services and procedures performed by physicians, including anesthesia, surgery, radiology, pathology, and more.
- HCPCS: Also known as the Healthcare Common Procedure Coding System, the HCPCS code set is for the use of prescription drugs, medical equipment, ambulances, and other non-physician services.
HCPCS code sets are the standard code sets for hospital care, chemotherapy, Medicaid, and Medicare and come in different levels to make them easier to identify. Charge capture codes are another type of code that may include things like descriptions of procedures, billable items and supplies, and time reference codes. There are also professional codes, which capture physician and other clinical services delivered and connect these services with a billing code, and facility codes, which help healthcare environments account for the basic cost and overhead of providing their services.
What Is Medical Billing?
Medical billing is how healthcare facilities submit claims to payers and send bills to patients. This process is more complicated than other billing procedures because of the involvement of insurance companies. The billing process begins with front-end billing, which helps gather important patient information before the patient sees any medical staff. This helps ensure their health plan will cover the services that are requested. Front-end billing is also where a copayment can be collected after the appointment.
Back-end billing occurs after patient care and once the biller has received the proper codes from the medical coder regarding the services provided. They will create a detailed invoice based on these codes that will be sent to the patient’s insurance provider. This may require reaching out to the insurer to work out any issues. Once the insurance portion is covered, the biller will also need to send an invoice to the patient themselves to help cover any remaining balance. They will be in charge of following up with patients to help ensure that the balance is taken care of, and, once everything is paid, will need to collect the necessary data for financial reports.
Why Are Medical Coding and Billing So Important?
All roles within a healthcare facility make a profound impact on patient care and the facility’s ability to run as it should. Those who work in medical billing and coding help these workplaces get the funding they need to keep providing high-quality services to those in their communities. Running a hospital, for instance, isn’t cheap. Between the medical equipment, medications, supplies, professionals, and overhead costs of the facility itself, receiving payments for patient visits is necessary to keep the lights on.
Medical coding and billing are 2 separate sectors of the healthcare team, but they work together to turn practices into billable documentation for insurance companies and patients. They also help ensure there are no inaccuracies related to the billing process, which could slow things down.
Why Should Students Look to These Positions?
Choosing a career that involves medical coding or billing is a smart choice for anyone looking to make a difference. Some of the advantages of these positions are:
Job Security
Given the number of patients who seek medical attention these days, the positions are in high demand, which makes them even more exciting for those looking for a stable and rewarding career. Because all healthcare facilities need these professionals, you’ll have an easier time finding a job.
Competitive Pay
The average annual salary for medical coding jobs is above the national average for all occupations, which makes this career especially enticing for young learners or those who want a career change later in life. You can even obtain certifications that will further increase your earning potential.
Flexibility
Because these positions deal with files and data, some of the work can be done remotely. This means that you can find positions that allow you to work from home, offering a level of convenience that many positions in the medical field don’t.
How We Can Help
At Prism Career Institute, our medical assistant program provides some training to help students gaining an understanding of how medical billing and coding works. Because, as a medical assistant, you may be asked to assist coders and billers from time to time, having this extra knowledge will make you a team member they can count on. It will also help make you more intriguing to employers looking to fill open positions.
Prism Career Institute is committed to providing the best education we can offer to each of our students. Whether you’re interested in becoming a medical assistant or a practical nurse, we have an extensive program for you. Our instructors are dedicated to giving you the knowledge and training you’ll need to find success in a wide variety of different work settings, and our curriculum includes a mix of classroom lectures and practical training in our laboratories. We even offer externships for our medical assistant program, giving students real-life experience at medical facilities.
Start Your Education Today
You can learn medical coding and billing skills from Prism Career Institute, allowing you to approach each day on the job with confidence. Our programs in Philadelphia, Pennsylvania, and Cherry Hill and West Atlantic City, New Jersey, give you a leg up on the competition. Our career services department offers helpful services like resume writing assistance, training on interview techniques, and finding suitable employment opportunities. If you qualify, we even feature a financial aid department that can help you find Federal Pell Grants, subsidized and unsubsidized loans, and more. Contact us today if you’re interested in learning more or are ready to enroll.