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The Importance of Medical Necessity in Medical Coding/Billing
Procedures and the reasons for performing them are at the heart of medical necessity and it’s the medical coder and biller’s job to properly explain them in a claim by selecting the correct codes. Put [more…]
How to Collect Payments from Patients as a Medical Coding and Billing Associate
As a medical biller and coder you may be called upon to contact patients to collect payments due the provider. Yes, your most important job is to fully abstract all billable services and supporting medical [more…]
What are Evaluation and Management Medical Billing Codes
Evaluation and management (E&M) codes are the most commonly billed codes and the medical coder/biller will use them a lot. These are the codes for every office visit and encounter a physician has with [more…]
Hospital Level Codes Used in Medical Coding and Billing
Choosing hospital level codes to report hospital visits by a physician can be a challenge for even the most experienced coders. Over-coding these visits can be an invitation for unwanted attention from [more…]
Medical Inpatient, Outpatient and Observation Billing Codes
The medical coder has to define the patient’s relationship to the hospital, (inpatient, outpatient or under observation), while receiving treatment in the hospital to properly code a claim. [more…]
Medical Conditions that Justify Billing for a Consultation
Medical coders and billers often have to justify the inclusion of another doctor’s consultation visit to the payer in a claim. A consultation visit is simply a visit that’s been requested by another physician [more…]
How Medical Coders Can Choose an AHIMA Certification Level
Although AHIMA certification is most desirable for hospital-based medical coders, this certification is also accepted in physician practices or practice management companies. Here are the basic certifications [more…]
How to Work with Payers as a Medical Coding and Billing Associate
As a medical coder and biller, your primary goal when interacting with payers is simple: Make sure payers show your client the money! Ideally, your billing software and clearinghouse will keep you apprised [more…]
How to Provide Positive Feedback to Medical Coding and Billing Colleagues
Part of being a professional medical biller and coder is being able to provide positive feedback to co-workers. Let’s face it: Office politics are often [more…]
How to Maintain Your Integrity and Keep Your Medical Coding and Billing Job
As a medical coder and biller, clients and employers trust you not only with their patients’ personal and private information, but they also trust you to code accurately, fairly, and legally. To be worthy [more…]
What to Document Each Day as a Medical Coding and Billing Associate
As a medical coder and biller, a great way to keep all of your coding activities on the up-and-up is to spend some time each day writing down (or typing up) what you work on each day. You should keep a [more…]
Medical Coding and Billing: Keep Patient Info Private
The moment you sign on for your new medical billing and coding job keeping patient information private becomes vital. Most healthcare providers require employees and vendors to sign confidentiality agreements [more…]
Medical Coding and Billing: Levels of Insurance Coverage
As a medical coding professional, it is important to understand various insurance coverage levels. The more the individual contributes to the cost of medical insurance, the better the coverage. Say, for [more…]
Medical Coding and Billing: Types of Insurance Coverage
In order to properly code and bill for medical procedures, it is important that you understand the various types of insurance policies. An insurance plan seems to exist for just about every situation, [more…]
Medical Billing and Coding: COBRA Health Insurance Extension Benefits
No medical insurance? No problem. Though it’s not that simple when it comes to medical billing, that’s what you’re supposed to think when you hear the word [more…]
Medical Billing: Health Insurance Networks
Some health care payers and providers participate in networks. You will encounter many networks in billing for medical procedures. A network is essentially a middleman that functions as an agent for commercial [more…]
How to Deal with Third-Party Administrators for Medical Billing
Third party administrators (TPAs) are intermediaries within the medical billing system who either operate as a network or access networks to price claims. TPAs often handle claims processing for employers [more…]
Medicare for Medical Coder/Biller
Four types of Medicare exist — Parts A through D — and each serves a particular purpose, which makes it complicated for medical coding and billing. The different types of Medicare and the fact that participation [more…]
Medical Coding and Billing: Medicare Supplement Policies
Medicare supplement policies cover the charges that Medicare doesn’t pay, so it is important to know if a patient has supplemental policies for medical coding purposes. Normally, Medicare pays 80 percent [more…]
How to Code and Process Medicare Claims
It probably comes as no surprise to you that coding and processing medical claims for Medicare billing can get pretty confusing, dealing with a large bureaucracy. [more…]
How to Code and Process Medicaid Claims
As a government program, Medicaid claims must follow specific medical coding processes in order to bill for procedures. Medicaid’s purpose is to assist low-income people pay for part or all of their medical [more…]
How to Code and Process Military Medical Claims
Medical coding for current and former military personnel follows certain fee schedules through two separate programs: Tricare, which funds medical claims for active military and their dependents, and CHAMPUS [more…]
How to Code and Process Workers’ Compensation Medical Claims
With Workers’ Comp claims, not only are you billing and coding for the benefit of the medical provider or payer, but you are also coding something that will affect whether someone receives proper compensation [more…]
How to Choose a Medical Coding Credentialing Organization
The two primary credentialing organizations for medical coding and billing professionals are the AAPC (formerly the American Academy of Professional Coders) and the American Health Information Management [more…]
How to Figure Return on Investment for Medical Coding Certification
It really does pay to be a certified medical biller/coder, no matter what designation you choose to pursue. Surveys conducted by the AAPC indicate that coder salaries have continued to increase despite [more…]
