One of the most common places medical billing and coding professionals are employed is in a doctor’s office. From the small clinic of a single physician to a partnership between a dozen doctors, often the first employee one of these practices will hire is a billing and coding professional. The reason for this is simple: without a billing and coding professional there would be no incoming revenue to keep the practice afloat.
A good billing and coding professional is one of a physician’s best assets. This will mean codes are accurately entered and bills are properly generated for the correct amount. Incoming revenue will be consistent and there will be minimal danger of being investigated for insurance fraud. Billing and coding mistakes are red flags for insurance companies, which are always on the lookout for fraudulent claims. However medical services are more likely to be under-coded than over-coded, a statistic that is still costly to physicians. Besides mistakes, a lack of professionalism and confidentiality on the part of a billing and coding professional can also incur millions of dollars in fines through HIPAA violations.
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Medical Billing and Coding – What to Expect
The type of physician practice greatly determines the type of work a billing and coding professional will be doing. There are two predominant groups of physician practices, which can each range from a single doctor to a medium-sized partnership:
General Practitioners – These physicians perform a wide range of general services for their clients, ranging from physical examinations to vaccinations. Billing and coding professionals who work with general practitioners should be knowledgeable in an equally wide range of medical codes to ensure the most accurate statement is created when a healthcare service performed.
Specialists – The current trend in the field of physicians is to focus on a particular specialization. This includes familiar practices such as ophthalmologists, pediatricians, cardiologists, and a long list of other titles which derive their names from Greek and Latin. Currently specialist physicians are some of the highest paid professionals of their kind in the healthcare industry. One of the main factors of this high rate of compensation is billing and coding professionals. Working as such for a specialist practice requires the billing and coding professional to be aware of a patient’s entire medical history and the codes which are specific to the physician’s area of specialization. This allows for coding which accurately designates specialized medical procedures, especially those that have been for multiple or reoccurring treatments.
Preparing for a Billing and Coding Career in a Physician’s Office
Both general practitioners and specialists may deal with many different insurance companies, including healthcare plans organized by the federal government such as Medicare and Medicaid. Billing and coding professionals should be familiar with the different types of coding systems that major insurers use, such as Current Procedural Terminology (CPT) and the International Classification of Diseases (ICD).
Landing a billing and coding job with a small doctor’s office can often depend on personal charisma backed up by relevant education and experience. In many instances a doctor’s practice is comprised of a billing and coding professional and a single physician. Many billing and coding professionals begin their careers in this kind of intimate setting.