Medical Coding and Billing

What Medical Coders Should be Taught in Class

2013-02-19T12:29:00.001-05:00

Medical medical coding instructors should have a clear understanding of state and local laws that affect medical coders at the work place and understand the medical office workflow and duties. This requires first hand experience and an organized teaching plan that outlines all administrative and managerial skills, as well as legal, ethical and moral considerations.

Employment Rate and Trends in Allied Health Careers

2013-02-11T20:21:00.001-05:00

The greatest demand will be for allied health and diagnostic technicians, among other allied health occupations. “There’s a dramatic shortage of lab techs, not everywhere but in many parts of the country.

Allied Health Careers without a Degree: Anesthesia Technician

2013-02-10T19:49:00.001-05:00

Becoming an anesthesia technician doesn't take long at all. Training is available through vocational training institutions, community, or junior college and usually ends with a certificate/diploma. The median salary for an anesthesia technician is $34,304.

Continued Warnings About Bad Medical Assistant Schools and Diploma Mills

2012-05-13T21:55:00.001-04:00

We have criticized, reported and warned about misleading advertisements and fake schools targeting potential medical assistant students seeking online courses on our website for years. Now, Donald Balasa of the American Association of Medical Assistants (AAMA) legal department is also raising awareness among prospective medical assistant students with a public note of caution.
Mr. Balasa points out that several AAMA members have informed him of misleading advertising fliers from St. Augustine School of Medical Assistants, a self-study online program. the following language is used in their advertisings: "Medical Assistant Program Online. Medical Assistant Home Study Program. Nationally Accredited and Certified Program. 24/7 Convenient Online Classes. St. Augustine School of Medical Assistants now offers a Nationally Accredited and Certified Medical Assistant Program completely online. Yes, Complete This Program in as little as 6-8 weeks." You can read their article titled Misleading Advertisements on their Eye On The Law blog.

Similar warnings about such schools that may not deliver what you expect, including St. Augustine School of Medical Assistants have been on our own websites and medical assistant blogs since 2005. We also filed a rip off report against St. Augustine School of Medical Assistants on the Rip Off Report website for taking content from our Medical Assistant Net website without our permission and publishing it on their own site.

Mr. Balasa states that approximately three years ago the AAMA also reported St. Augustine School of Medical Assistants to the Federal Trade Commission (FTC) and promises that they will continue to report medical assisting diploma mills to the appropriate governmental authorities.

St. Augustine School of Medical Assistants also has also received several negative ratings with the Better Business Bureau (BBB) from students who feel they were misled, or that they did not receive what they paid for. When it comes to vocational training, especially online, awareness is the key to successes! If an online post-secondary training program, non-traditional university, or so-called virtual college attended is not legit students may be in for an unpleasant surprise.

Association of Professional Medical Billers & Administrators

2012-04-17T10:50:00.001-04:00

MyAPMBA Networking to Success
We are pleased to announce that the APMBA has officially opened and we are now accepting memberships. As an appreciation to Michelle Rimmer CHI, all former PMBA members (active as of 12/31/2011) we are offering ½ off the Platinum and Gold memberships until 05/31/2012.

Platinum Membership: $199.00 covers 1 year membership benefits including the CMBA and CMBA-D exam.
Gold Membership: $159.00 covers 1 year membership benefits includes the CMBA exam
Silver Membership: $99.00 membership only does not cover exam (not eligible for ½ off discount)
CMBA-Certified Medical Billing Administrator
CMBA (D) - Certified Medical Billing Administrator (DME)

*While the promotion is going on we will not offer the exam until 06/01/2012*
Membership includes: monthly newsletter, access to the APMBA forum, referral program, discounted billing guides, learning center and much more to come. *All members are listed on the MyAPMBA - Association of Professional Medical Billers & Administrators website with a link to their website if applicable.

MyAPMBA
Association of Professional Medical Billers & Administrators, was created to promote unity and networking among healthcare professionals. The APMBA's goal is to network with Medical Billers, Front Desk Administrators, CMA's, etc who seek to communicate, educate, and grow with others in this industry. We are offering certification (geared to the experienced biller) but working towards eventually having an online program for hands on experience for those who want to learn medical billing.

Please feel free to email or call me with any questions or concerns:
Charlene Hargrove
Myapmba4u@gmail.com
919-482-5940 (Cell)

Choosing the Right Career after High School

2012-03-11T22:40:00.001-04:00

There are many young Americans today just graduating from High School that are looking to go right into the job market, or start new career within two years of graduating.

Let’s face it, with today’s economy and the unemployment at an all time high, college tuition at an all time high, college loans interest payments are at an all time high and immediate employment for college grads are not what it use to be. Both parents and young adults are seriously considering skipping the four year college for now, and encouraging their kids to consider post-secondary schools, vocational training, and private or public two year schools. The good news is that there are many opportunities available for bright young adults who are willing to learn and apply themselves. A few opportunities available are:

Firefighter
Automotive Service Technician
Accounting Clerk
Carpenter
Customer Service Representative
Electrician
Police and Law Enforcement
Web Design and Desktop Publishing
Fitness Trainer and more.

All of these are great careers, however the career field that offers the most opportunity for employment and for advancement is of the healthcare industry.

In particularly the career with the most promise is that of Medical Assisting. A medical assistant performs administrative and clinical tasks in doctor’s offices, ambulatory clinics connected to regional hospitals, emergency and walk-in clinics, and sometimes pharmacies. Some medical assistants can be trained right on the job, but most are opting to complete a one or two year formal training program. Depending on the state you live in, a medical assistant can earn as much as $30,136 a year, or even more.

Another great aspect of becoming a medical assistant is that it offers opportunity for advancement into other healthcare fields like:

Medical Laboratory Technicians or Medical Technologists; performs laboratory work to identify, diagnose, and treat diseases. They use laboratory equipment, computers to perform laboratory procedures. They may collect blood and prepare culture specimens and can earn as much as $40,000.
Medical Library Technicians; collects and organize medical information and help practitioners find the information they need for patient care, education, research, and administration. Most of the information is now stored in electronic databases and information systems. They can earn from $25,000 to $35, 000 per year or up to $55,000 for Librarians.

Medical Records Specialist; obtains, post, and analyze medical, workload, finance, and insurance data. They ensure that this information is properly recorded into medical records so practitioners can plan and evaluate health care provided to patients. They can earn $25,000 to $33,000 (Medical Records Administrator can earn as much as $40,000).

The list of job opportunities for a medical assistant to advance in other fields goes on and on, such as Ultra-Sound Technician, Nuclear Medicine Tech, Patient Representative, Radiation Therapy Technologist, or Medical Appliance Technician, who helps patients learn to use medical devices prescribed by podiatrists or prosthetists, etc to name just a few. We could go on to list at least another 30 different job opportunities in related fields, but the main point we are driving home here is that becoming a medical assistant, especially in a large group practice, or HMO can actually put a young person in the right place at the right time for advancement; where opportunity is always knocking.

Become A Medical Laboratory Assistant (MLA)

2012-02-28T23:06:00.001-05:00

Exciting Opportunities in Medical Laboratory Assisting

A Medical Laboratory Assistant (MLA) is another fast growing and in demand career among allied health and medical professions. Medical laboratory assistants are in demand in hospitals, major medical centers and specialized healthcare offices. Often, people who advance into this very interesting field already have a strong background in medical assisting, or phlebotomy.
MLAs are responsible for assisting phlebotomy technologists and lab technicians in collecting biological samples, operating technical equipment, data input, sterilizing equipment and tools, and maintaining laboratory cleanliness. The exciting thing about assisting in a medical laboratory is that you get involved in a wide variety of different medical laboratory sciences, including bacteriology, virology, parasitology, immunology, and mycology and automated processes with potential advancement to Medical Laboratory Technician (MLT), or with additional education to department supervisor, laboratory manager, or even laboratory medical director.

Medical Laboratory Requirements

The requirement for most hospitals for MLAs is an associate's degree in laboratory sciences, or an equivalent certificate. The major focus of the curriculum typically lies on chemistry, math, and biology. In addition to on-campus classroom instruction there also are many online courses available for Medical Lab Assistant, however, employers are looking for those who have hands on lab training or experience. Many community colleges and secondary schools offer laboratory training.

Medical Laboratory Assistant Pay

The pay for a MLA is usually between $15 and $21 per hour. Of course the pay will vary from state to state and depending on the population and healthcare demand in your area. There are many units, specialties, and sub-specialties in a medical laboratory, ranging from:

microbiology, which receives almost any clinical specimen, including swabs, feces, urine, blood, sputum, cerebrospinal fluid, synovial fluid, as well as possible infected tissue
toxicology, which mainly tests for pharmaceutical and recreational drugs
immunology, which uses the concept of antigen-antibody interaction as a diagnostic tool, genetics, which mainly performs DNA analysis
surgical pathology, which examines organs, limbs, tumors, fetuses, and other tissues biopsied in surgery such as breast mastectomys
hematology, and blood specialty labs where whole blood is analyzed for full blood counts, and blood films as well as many other specialized blood tests

These are just a handful of the many different departments and exciting fields in a medical laboratory. If you are just graduating from high school, or looking for a career that can open doors to bigger and better places in the healthcare industry, then you might want to consider becoming a Medical Laboratory Assistant.

Medical Assistant Students Frustrated About Medical Coding Expectations

2012-02-26T16:58:00.001-05:00

Can Two CPT Codes Be Billed Together?

Medical assistant students enrolled in medical assistant courses often have difficulties understanding the medical billing claim form and have problems understanding evaluation and management codes. We often hear from frustrated students; many wind up venting on one of our active forums.

A medical assistant student recently posted that her instructor wasn't very helpful while teaching the administrative medical assisting module; she felt the instructor apparently wasn't well versed in the medical billing and coding process herself and therefore was unable to explain the process in a manner that made it clear to the class. The students are frustrated and overwhelmed. Another one posted in the forum: I work for a cardiologist. We are trying to get clarification on the following...

QUESTION:

Can these two codes be billed together if both of these services are performed?

CPT 93454 (Catheter place in coronary arterty(s) for coronary angiography, imaging supervision, and interpretation.)
CPT 93458 (with left heart catheterization including intraprocedural injection(s) for left ventriculogy, when performed.

Another question that is often raised in our medical assistant forum (at Medical Assistant NET on the Web) is why medical assistant students should have to learn medical coding and billing in the first place, and why it is such an extensive part of the medical assistant certification exams.

I have received emails from frustrated medical assistants who contacted me right after taking their certification exam, where they state that they were totally stumped on the many medical coding questions in the exam. They encountered questions that were multiple choice and asked about specific numeric codes, or modifiers for a given specific diagnosis, or procedure.

Now, ask any medical assistant to give you a specific code without any reference book/manual and he/she would be hard-pressed to give the right one, since there are so many, not to mention specific modifiers. There are codes for evaluation and management from 99201 - 99499, such as 99201 - 99215 for office and other outpatient services; codes for anesthesia from 00100 - 01999, such as 00100 - 00222 for the head; codes for surgery from 10021 - 69990, such as 10021 - 10022 for general, and 60000 - 60699 for the endocrine system, Category II CPT Code(s) – Performance Measurement (optional), Category III CPT Code(s) – Emerging Technology (Category III codes: 0016T - 0207T, to name just a few.

We also heard from a physical therapy instructor who teaches basic medical coding and billing as it pertains to PT because the majority of his students do their own billing and coding, who is equally frustrated at times, not knowing the exact codes and how to apply them.

Do Medical Assistants Really Need Medical Coding Skills?

I can see where medical assistants need to have an idea of medical practice financial management, such as banking deposits, accounting and bookkeeping, dishonored check processing, payroll - and even that is nowadays often outsourced. Nevertheless, in any profession you should get a picture of how the whole kit and caboodle functions to make it run.

I think, as far as medical assistant students are concerned, it is okay to briefly introduce them to the billing and collections process to give them a general understanding of how things work. The medical assisting instructor should also provide commonly used standard forms, such as laboratory requisition slips, which often already have CPT codes already printed on them, a Superbill, health insurance claim forms, medical history, and HCFA-1500 forms for the students to fill out, and practice. This way, they can better address patient questions and communicate with the medical billing and coding staff efficiently should certain issues arise.

However, as far as spending a great amount of time looking up CPT and ICD-9 codes and drilling billing and coding procedures, and assigning specific codes from memory to procedures, diseases and injuries from memory in final exams, from my perspective as a former working medical assistant and medical assistant program instructor, it seems redundant. In my role as a Certified Medical Assistant (CMA) I was NEVER directly involved in the billing and coding process at the work place, neither were any of my medical assistant colleagues.

In Conclusion (Editorial Commentary):

I believe medical assistant programs who delve too deeply into the medical coding and billing process and expect more than a handful common diagnostic and procedural codes looked up in the CPT-9 manual are using up too much valuable time that could be better spent on practicing telephone manners, appointment scheduling, patient registration, filing procedures, electronic medical record management, calculating adult and pediatric medication dosages, practicing injections, taking vital signs, and drawing blood.

Those who want to embark on a medical coding and billing career, or aim for a medical office management, or hospital administration position can always sign up for an in depth medical coding and billing training program, or in continuing education classes, and workshops to further their medical coding and billing skills to become proficient.

Working in the Healthcare Industry

2012-02-25T20:25:00.001-05:00

Healthcare is the largest industry in the American economy and includes public and private hospitals, nursing and residential care facilities, offices of physicians, dentists and other licensed practitioners, home healthcare services, outpatient care centers and other ambulatory healthcare services and medical and diagnostic laboratories. Occupations within a medical office and healthcare facilities are plenty and varied, and their rate of growth remains rapid and above average.

The list of jobs that are essential to the medical field and healthcare industry is long:

physicians
surgeons
dentists
dental hygienists
nurses (RN, LPN, LVN)
physician’s assistants
social workers
physical therapists
psychiatrists
psychologists
radiologists
audiologists
chiropractors
dieticians
nutritionists
pharmacists
optometrists
podiatrists
medical records
health information technicians
clinical laboratory technologists
diagnostic-related technicians
emergency medical technicians
paramedics
ambulance drivers
nursing aides
home health aides
orderlies and attendants
occupational therapists
speech-language pathologists
medical assistants
personal and home care aides
medical transcriptionists
custodial and food service workers

and those functioning in either management or administrative support roles for clinicians who provide direct services.

Many of these occupations, including nursing and medical assisting, often involve potential exposure to airborne and bloodborne infectious disease, needle stick and sharps injuries, back injuries, latex allergy, stress and other dangers. Some are at risk for occupational exposure to a variety of hazardous chemicals and situations that can be physically demanding and stressful; being aware of the potential hazards in the work environment makes them less vulnerable to injury. Past reports issued by the U.S. Department of Labor’s Bureau of Labor Statistics revealed that musculoskeletal injuries were the most common type of non-fatal injury or illness for nursing, psychiatric and home health aides who represent nearly two-thirds of all healthcare support occupations.

Qualification Standards
To safely and efficiently perform work related duties the healthcare worker must be able to physically and mentally satisfy the requisite skills and be able to perform required job related duties with or without a reasonable accommodation. Essential functions which the healthcare worker must be able to perform are based on factors such as education and job-related work experience, the reason for the position, the number of other employees available to perform the same duties or among whom the function can be shared and the degree of expertise or skill required to perform the duties.

Many healthcare establishments operate around the clock and need staff at all hours. Shift work is common in some of the above mentioned occupations. It is not uncommon for healthcare workers hold more than one part-time job, of which each one comes with unique challenges and health hazards. Healthcare workers, especially nurses, clinical laboratory workers and medical assistants, face unique situations at work of which some may pose safety concerns. Medical office and healthcare facility workplace settings typically involve direct patient care with invasive procedures, exposure to body fluids, handling bio-hazardous materials in a fast-paced setting. Errors and oversights due to the demanding nature of duties may result in health or safety consequences.

Exclusion Due to Disability
If a job requirement excludes a healthcare worker, including a medical assistant working under the direct supervision of a doctor, from a position due to a disability, the requirement must be job-related and consistent with business necessity. Some requirements will obviously meet this standard, such as licenses required by state and/or local governments for doctors and other healthcare professionals. In other instances, however, an employer may need to consider whether the standard that is excluding an individual with a disability from employment accurately predicts the individual’s ability to perform the job’s essential functions.

Many states and localities have disability anti-discrimination laws and agencies responsible for enforcing those laws. EEOC refers to these agencies as “Fair Employment Practices Agencies" (FEPAs). Individuals may file a charge with either the EEOC or a FEPA. If a charge filed with a FEPA is also covered under the ADA, the FEPA will “dual file” the charge with the EEOC but usually will retain the charge for investigation. If an ADA charge filed with the EEOC is also covered by a state or local disability discrimination law, the EEOC will “dual file” the charge with the FEPA but usually will retain the charge for investigation.

Healthcare job applicants or employees who believe that their employment rights have been violated on the basis of disability by a private sector, state government, or local government can file a Charge of Discrimination proceeding with the EEOC. The charge must be filed by mail or in person with a local EEOC office within 180 days from the date of the alleged violation.

Education and Training Programs for Older Adults

2012-01-29T15:57:00.001-05:00

Many jobs are open to citizens ages 50 and older in teaching, nursing, and medical office environments.

Free Education and Training Programs for Senior Adults

What you might find is surprising is that there are many education and training programs available to the older population. Nearly 60 percent of accredited colleges or universities are granting tuition waivers for older adults. For example; there’s a Senior Adults Scholarship Program in Alabama that provides free tuition for mature citizens ages 60 and over, who are admitted into a public two-year college or university. The state of Tennessee offers tuition waivers and discounts for senior citizens. Many schools in Michigan offer tuition waivers for seniors. Bottom line is you have to check or research your particular state.

If you are a military veteran with a service connected disability, you may qualify for the Veterans Vocational Rehabilitation Program. This program allows veterans with a service connected disability of 10% of more to attend college. Tuition, fees and books are fully covered by the US Government. There’s also a monthly subsistence allowance paid; amount varies on number of dependents; however some veteran programs have limitations on taking online courses. See your Vet representative or visit www.va.gov for more information.

There are many public employment and training service programs available like the Senior Community Services Employment Program (SCSEP), website: http://www.doleta.gov/seniors/.
This program enables individuals to participate in temporary training assignments where they gain valuable on-the-job work experience and training needed to gain employment in the private sector. Again this program may vary from state to state.

If you are really looking to get back to work or retrain. Whether you want to work full-time, or part-time, one the best careers fields to enter into is the healthcare industry. Many citizens 50 and older find working as a medical office receptionist, administrative medical assistant, medical billing clerk and/or in the medical coding department of a smaller medical practice, or hospital very a rewarding job that they can keep pace with.

For those who are looking to supplement their social security income, you must check with your SSI office to find out what or if there are any limitations on income you can receive. You might be limited to working 20 hours or less a week.

Medical Billing and Coding - Medical Billing Part 1

2012-01-27T10:07:00.001-05:00

Medical billing is gaining ever increasing interest among new job seekers either shortly after graduating from high school to begin their career path or people who desire a meaningful career change or job rehab to reenter the workforce. The medical billing career has a pull on those who desire to work in the healthcare industry without providing direct patient care, such as nursing staff or medical assistants. You can learn more at MedicalBillingandCoding.net.

Medical Coding's Code-Pendency With Medical Billing

2012-01-17T19:58:00.001-05:00

What is a Medical Coder?

A medical coder is not a medical biller, but medical coders need basic medical billing knowledge to competently and efficiently do their job, since both disciplines are so closely related and code-pendent (pun!)

There are over 819,000 physicians and surgeons; 2.4 million registered nurses, 77,000 occupational therapists, 182,000 physical therapists, 94,000 respiratory therapists and a plethora of other allied health professionals in the USA alone. Naturally they ALL want to get paid for their medical services and supplies provided to the public. This is where the medical coder comes into play! The medical coder gets the ball rolling by initiating the reimbursement process. The process begins by abstracting coded information from the patient's medical record into the financial system for billing.

Correct medical coding is just as crucial as correct medical billing in getting paid for services provided, otherwise, when ever a claim is not properly coded, filed, submitted, and processed it leads to denials, and this means losses for the provider. Naturally a professional business cannot prosper on losses. When medical coding firms or doctors outsource their medical coding and billing it is critical to assure the chosen individual or company is well versed in the latest coding standards and follows AHA, UHDDS, HCFA and HCHS coding guidelines, latest medical billing criteria, and uses clearinghouses to get the job done in an efficient manner.

Medical coders and well as medical billers must have the ability to read and understand handwritten physician notes and documentation and a working knowledge of at least one patient management system, along with familiarity with electronic medical records and ability to discuss and resolve claims issues with clinic staff and patients.

The close relationship between medical coding and billing is undeniable and inescapable! While they are well respected and highly regarded they often face adversities from insurance companies, such as inappropriate denials, poor payments and other obstacles and disservices to the doctors and patients that the must resolve working hand in hand with each other to coordinate their efforts. Their mutual goal is to meet patient and health insurance billing needs of doctors, clinics, hospitals, home health care service agencies, and similar businesses in the health care network. Although regarded as two different disciplines, medical coding and billing professionals work hand-in-hand to assure health care providers get paid for all procedures and materials rendered.

You can learn more at MedicalBillingandCoding.net.

Opportunities For Medical Billers Are Rife for Everybody

2012-01-08T12:02:00.001-05:00

Opportunities for Everybody and All Ages

Opportunities in the medical office exist for everybody, including late bloomers. It is not limited by age, gender, race, religion, or even certain disabilities. There is plenty of room for men and women of all ages.

From the employer's point of view, the young energetic medical biller right after high school is just as valuable as the mature and experienced professional with years of experience under her belt, as long as they have the right attitude and the drive to succeed. Each one brings special talents and skills to the office, and if they qualify medical office managers are ready to hire them.

Medical billers can work in almost any medical facility where they are supervised by the physician who hired them. Doctors and senior medical staff train, supervise and monitor their medical assistant's activities right on the job.

Where can I work as a Medical Biller?

The neat thing about being a medical biller is that the opportunities in healthcare disciplines and medical services are so wide open and varied. There are countless general and special focus areas, such as family medicine, pediatrics, geriatrics, internal, gynecology, urology, dermatology, cardiology... you name it, and you can work in so many places, from small single-provider to large group practices, to ambulatory health clinics and large regional medical centers—it's all out there and available to you in your role as a medical biller to keep the office running smoothly and efficiently.

You can learn more at MedicalBillingandCoding.net.

Subject: Medical Assistant Training Through ROP

2011-12-18T22:58:00.001-05:00

Someone has just posted a new comment in our Medical Assistant NET forum about joining Regional Occupation Program (ROP) for vocational training in California, where high school students are eligible to take appropriate ROP classes, including medical coding, medical billing, HIM and medical assisting.

The discussion thread in our forum is rather extensive with lots of feedback, discussion and advice. The latest message was posted by Kat (from the ip address 66.27.143.33).

Message: Health Care Student

Hi everyone, I appreciate reading the post by "Teach" and providing her insight since I am looking into an ROP MA program (CA) to start medical assistant training in the next six weeks and will help me and my family tremendously. I need to work, have children and I know how to make sure I get the medication labels straight. I understand Lori's concerns in that discussion thread and they are valid yet, RNs are sued, doctors are sued, and MAs need to be competent too. This comes with common sense, an ablility prior to walking into the classroom. I had to pass an exam prior to my registration date. EMT's have less training than MAs. I have an MBA, and taken my RN prerequisites yet, moving to California where the clinicals are at 6:00 AM, I can not do that with children who start school at 8:00 AM. MA is my plan B to actually work in my field, and thanks again Lori for your post, and helping me understand the benefits about the MA ROP program. Affordable, fast, and efficient (for those who work hard and want to pass the exams) :). ~ Kat, SMA

ROP typically offers classes on a trimester basis, with many new courses starting throughout the year for California high school graduates and eligible adults. Job training opportunities offered are phlebotomy courses, clinical and administrative medical assisting, dental assisting, various other medical career programs, citizenship courses, High School diploma and GED courses, and more, depending on available resources and faculty at various institutions across California.

Don't Rely On Medical Billing Forums—Documentation Is The Key

2011-12-09T19:32:00.001-05:00

All too often we receive questions regarding specific medical billing issues and matching medical codes in our forum; but that's not just our Medical Billing Forum alone, that's ANY medical coding and billing forum on the Internet is packed with questions regarding specific (CPT) codes and urgent requests for help. That way, if something goes wrong they have someone else to blame.

Medical Coding Questions Posted in a Forum

Unfortunately, this tells us that there are medical coders (and medical billers) who, quite frankly, have no clue; they are inadeqately trained, or self-trained, and when they hit a wall, they post their question in a forum in hopes to get answers or find someone (anyone!!!) to give them approval of codes they have somehow come up with themselves. This could be a student with a test question, or homework assignment, or a medical coder, or biller already working but that is in over his or her head. One example of such requests posted to our medical billing forum is asking for help with a specific CPT code.

It reads:

"I bill for a rheumatologist. I am familiar with most codes that he uses but last week he gave XYZ-medication (*brand name removed - not relevant for this example) to one of his patients who had a severe drug reaction. There was considerable disruption in the office and the direct observation lasted 2 hours. The doctor wants me to bill for his observation services but I am not sure which code to use. I was thinking may be 99058 will fit the bill, but the doctor insists that the code should be time specific since he spent two hours on the patient's care. Can someone please help?"

Medical coding must never be performed without first looking at the original documentation and the final decisions regarding coding issues rest with the provider. It must be clearly understood that a forum is not an official organization, agency, or anything else that provides a final decision regarding coding or billing issues. A forum is not here to code visits, to train a visitor how to code, or to recommend which codes to select. All a forum, its members and/or guests do is provide limited guidance. Guidance is limited to what is presented by a poster, however, what is presented may, or may not be true, accurate or correct.

The CMS website, specifically at https://www.cms.gov/MLNEdWebGuide/25_EMDOC.asp states:

"Providers are responsible for the correct submission of claims and response to any remittance advice in accordance with current laws, regulations and standards."

The patient's medical record must show detailed entries as to time, who did what, when, for how long, was it the doctor who monitored the patient directly, or was it delegated to a nurse or a medical assistant, what directives were given, was emergency intervention provided, and if so, how much total direct hands on and face-to-face time from the doctor was involved? When it comes to accurate medical coding, any code selected must be:

medically necessary
documented as being rendered
the proper code for the documented services rendered.

Telling a patient to sit in the waiting room for 30 minutes before they can leave after an injection and direct face-to-face attention after an acute reaction can both be described as monitoring, but it doesn't always mean it can be billed it at a higher level.

The Doctor Makes the Final Decision

The provider knows what was done and everything must be coded as it was documented in the patient's records. A medical coder can research a subject, provide suggestions and present supporting documentation from the proper sources to to make a point, however, the final decision rests with the doctor.

Documentation is the key.
You can learn more at MedicalBillingandCoding.net.

Distance Education Online vs. Traditional Classroom Instruction

2011-12-06T20:52:00.001-05:00

Many community colleges now offer medical assistant classes that are strictly web based and hybrid courses where all, or most of the required course work and instruction is done online. Our local community college, for example, offers 3-4 credit online courses in accounting, biology, algebra, medical computer applications, word processing, computer sciences, economics, English composition, pharmacology, medical terminology, anatomy and physiology, certification exam prep for Health Information Technology and many more online.

The only time you see enrolled distance education students show up on campus is when they take their mid-term and final exams on paper (if required, because even that can be done online). Some schools make provisions for their students to come in once a week for an hour, or two, to review certain skills, especially if they require hands on supervision under the guidance of an instructor, such as, for example a credit hour course in phlebotomy technology, or biology lab.

Do Online Students Fare As Well As Students Who Received Traditional Classroom Instruction?

Whether students in online or hybrid courses fare better than those in a traditional classroom is debatable. Surely, there can be certain challenges and pitfalls in both; for example, self-discipline, commitment and extra motivation to make sure you learn and understand the material is important in either setting, however, a hidden pitfall could be that you might forget to turn in all of your assignments on time without the face-to-face reminder from the instructor and without their classroom peers and face-to-face interaction with faculty some students might not have the extra motivation needed to do the independently study as necessary to excel.

Since online programs utilize the Internet and email students must have access to the Internet (which includes a computer, keyboard, browser, mouse, Internet service and electricity), and have a solid understanding of the computer to access the courses.

Possible Pitfalls When Utilizing Online Program Technologies

One form of technology distance education schools use to facilitate their programs online is the Blackboard e-education platform, to name just one of many, a technology where registered students log in with their assigned user name and password.

When taking a quiz or exam online there are a number of factors to consider, such as using a reliable computer and compatible browser, a reliable connection and having plug in programs installed such as Java(tm) software, Adobe Reader(tm), and often, running some sort of word processing program, such as Microsoft Office Word(tm). If the computer is not operating properly, or the connection is suddenly interrupted, all work could be instantly lost without being submitted and the student is locked out of the test. Often, there are time limits imposed and if a student stays on a page too long the session will time out and renders the student unable to submit the exam.

In addition, there could be an issue with accidentally hitting the Enter button, instead of the space bar or tab. This could lead to having an answer being locked in and submitted with no way to go back. Often, the Back button is disabled or causes work to be lost when utilized. When completing the test be sure to click the SUBMIT button to ensure the test is sent to your instructor. Yes, online students often even forget this.

How to Choose the Right Vocational Training Program for You

Being a smart consumer pays off when choosing vocational training programs especially online. Warning signs and program quality check points do exist... and there are many excellent educational and vocational training programs offered on the Internet. It is the dubious providers of distance and online education that crank out certificates and degrees that are considered worthless on the job market. If you obtain a degree or take a course from a shady non-accredited cyber-school you may find that the paper you receive stamped "Certificate" is not recognized by potential employers, and that the course credits may not transfer to other schools. This is where the term "diploma mill' comes to mind.

Diploma Mills Can Make The Unthinkable Real

It simply blows the mind: doctors, clergymen, police officers, teachers, federal employees, such as White House staffers, National Security Agency employees, FBI agents and a senior State Department officials purchased bogus degrees to seek employment, promotions, higher positions and better pay. Nowadays, almost anybody can become a doctor, or receive college level and advanced degrees, with almost zero effort. Even medical assistants can find gray area online medical assistant programs without any special pre-enrollment conditions, qualification screenings, or passing grade standards... for just a few hundred dollars. Cool??? Not so!

You can learn more at MedicalBillingandCoding.net.

Make The Doctor See that YOU are the Best Candidate for The Job

2011-12-02T19:36:00.001-05:00

Medical assistant, phlebotomy and laboratory technician, medical billing and coding certifications are reaching a new level of recognition with employers. While taking an allied health professional certification exam remains largely voluntary here in the USA, there is definitely a big trend among employers who specifically stipulate in their job ads that a medical office position which needs to be filled requires certified credentials.

Rarely do you see medical assistants being hired without experience and trained directly on the job anymore. Doctors expect more these days. These doctors and medical facilities clearly see the benefits of hiring someone with certified credentials; they want someone who has the knowledge necessary to work side by side with health and medical staff to run their medical office or health care facility efficiently and safely. Hiring competent and well trained medical assisting staff gives them a certain amount of confidence and assurance.
An example of such a job advertisement is this one randomly picked from the Indeed.com jobs bank today:

XYZ Physician Associates, LLC currently has a full time medical assistant position available working in a very fast paced environment. Requirements: Candidates must have six months to one year related experience in a medical office or similar clinical setting. Candidates must also be highly organized, pay attention to detail and be able to multi-task. Computer skills required. Phlebotomy experience preferred. Graduate of a Medical Assisting Program. Certification preferred.

Medical assistant training institutions and community colleges know this and are heeding the call by offering medical assistant training programs that lead to desired diplomas and qualifies their graduates to sit for recognized medical assistant certification exams. Funding and financial assistance for such training programs is readily available for those who qualify, much of it completely free and must never be paid back if you are, for example, presently unemployed and qualify for educational grants and employment rehab programs.
There are a number of different medical assistant and other allied health occupations certification sponsors, each having their own unique certification requirements.

Their certification exams serve as a valid means of assessing an individual’s specific knowledge and competence in the medical assistant occupation. Passing any one of the various offered certification exams adds credibility and credentials to your name by having earned recognized designations in a specific discipline. Once you have earned your credentials they are portable to all places you may work now and in the future. This is important because in today’s economy people may have to move to a different location or across boarders to a different state to go where the jobs, or better jobs are.

You can learn more at MedicalBillingandCoding.net.

Medical Coder's Wages and Pay

2011-11-30T15:40:00.001-05:00

If you are an entry level medical coder in the United States your pay usually starts at $11 to $13 per hour, an individual with experience of 2-5 years can earn $15-$18 per hour, highly experienced medical coders with specialty certifications can earn as much as $23 per hour, or more. Here is a breakdown of typical factors that can strongly affect the medical coder's take home pay:

Training – Industry specific training and credentials are probably the biggest factors influencing take home pay right along with years of experience.

Experience – Your work experience plays another important role. High recommendations from a former employer who attests to your experience and value to the company speaks louder than anything else in the healthcare industry. This could be your strongest negotiation point when discussing pay.

Company Size & Setting – Large companies may be able to offer higher wages than small businesses. The local job market situation also influences pay rates and the value you bring to the businesses.

Geographic Location – The location of the job can have a big influence on salary. Jobs in a metropolitan area is usually higher compared to small cities and urban areas.

Specialization – A specialty also affects wages. Some medical coders are highly specializes, or consultants in specific areas of the medical and healthcare coding and billing industry. Others are mentors at workshops, professional speakers at seminars, or authors of textbooks and teaching materials.

Self-Employed – Your employment type also affects how much money you can make. While as an employee you are likely on a per hour compensation with incremental wage increases over time, you will set your own rates as a self-employed individual.

A few years ago AAPC published a detailed article and charts on their website that shows how much medical coders typically earn along with a separate list of salaries by specialty and salaries by title. You can probably still find the article if you use a search engine and query: "AAPC wage study and comparison for medical coders".

2011-11-17T20:43:00.001-05:00

As of January 1, 2012, medical billing reimbursement claims must be submitted electronically using the Accredited Standards Committee (ASC) X12 Version 5010, the new version of the X12 standards for Health Insurance Portability and Accountability Act (HIPAA) transactions. Implementation of HIPAA Version 5010 will require changes to software, systems and perhaps procedures that you use for billing Medicare and other payers.

Level I compliance means "that a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing."

Level II compliance means "that a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards."

HHS permits dual use of existing standards (4010A1 and 5.1) and the new standards (5010 and D.0) from the March 17, 2009, effective date until the January 1, 2012 compliance date to facilitate testing subject to trading partner agreement.

It is extremely important that all medical billing staff and consultants are aware of this HIPAA change and in compliance. You can learn more at MedicalBillingandCoding.net.

Tough Decisions: Online Medical Assistant Program or Campus Based?

2011-11-14T20:15:00.001-05:00

No one can tell you which type of medical coding and billing training program is right for you. Ultimately, you are the one who must choose which path to take to learn your skills. Part of your decision will be based on how FAST you want to be done and finished with your training, tuition cost and how quickly you hope to land your first real medical assistant job.

Rule of thumb is that self-paced online courses can be finished the fastest if you apply yourself, however, on the flip side, doctors may not be easily persuaded or convinced to hire you without having direct experience and hands on practice which you would have gotten in a campus based training program. All too many former medical coding and billing online students have learned a painful lesson.

Things You MUST Ask Before Signing Up for Anything...

As with any kind of education, there are things to be aware of and different programs have their pros and cons. Making a wise choice and informed decisions puts you into a position where you won't have to regret it later. Should you decide that going with a web based program better fits your schedule, budget and personality than bear in mind that no matter which online school you choose you have to ask certain questions BEFORE signing up for anything. We have put a very detailed list of questions to ask before enrolling in any medical assistant program at MedicalBillingAndCoding.net on the Web.

First and foremost check out the fees that the online nursing charges for their courses and find out their refund policy. It is common practice of all reputable online vocational training schools to be up-front with their fees, since they realize it is important to new students to know how much they will be paying for the course. Putting forth a sincere effort to discuss all fees person-to-person over the phone helps to build trust in the school.

You will need to check out the course requirements before signing up for anything. Each school has different requirements that must be met before entering their program. Almost all online self-study programs to become a medical coder and biller require a high school diploma while a few want you to have specific course studies from other schools. Some online medical assistant programs, especially those approved by the Department of Education, require competency in complex clinical and technical skills to earn their degree, which can only taught under the direct supervision of a qualified instructor or professional in the field who is familiar with a wide range of medical assistant duties.

There are countless medical coding and billing students who have told us that finding their own clinical internship site was EXTREMELY challenging and frustrating and some of them gave up, never earning their medical assistant diploma or degree. Therefore this is probably the most important part of evaluating a prospective online medical assistant school.

Certain online programs operate on the same premise of standard schools and might require that their students complete a minimum number of hours in class room study to be eligible to graduate; so, make sure to ask whether a program is entirely web based, or partially web based. All that is required should be listed in the course description and should be discussed in person during the review process.

Academic degrees is another area where one should put fourth some effort in research before signing up for anything. If the online program does not offer the degree that you need to get the job you want, then it is useless to you as a school. Don't be discouraged, most of the online medical coding and billing schools, and allied health vocational colleges for that matter, allow you to achieve the type of degree that you want.

Worth Your Consideration When Making Career Choices: Phlebotomist

2011-11-14T19:44:00.001-05:00

The phlebotomist, the person who draws blood samples from patients arms or finger tips, is a highly specialized, valuable member of the medical and healthcare team as a whole. Without the phlebotomist's skills and services many diagnoses and health assessments could not be as reliably performed.

Most phlebotomists have a high school education, others have an academic degree in medical technology, some received their training directly on the job under the supervision of a doctor, nurse or experienced phlebotomist, others took a phlebotomy course offered through the American Red Cross, or a community college, others while serving in the military as a combat medic or hospital corpsman role.

A skilled phlebotomist deserves high praise, yet, they are usually paid the least amount of wages on the allied health professional's pay scale, probably because their training is not as extensive as, let's say, an EKG and x-ray technician, or medical assistant. In a way, that is unfair, because there is tremendous value in their services that can never be repaid in money. Phlebotomists draw blood for tests, transfusions, donations, or research and explain the procedure to patients who ask.

They must know the circulatory system anatomy and composition of blood along with the medical terminology that goes with it, be able to access a vein, or artery, or capillary blood bed of all kinds of people from young, to old, to obese, to emaciated, to those with veins that roll, to those who easily faint, or are deadly afraid of needles.

They need to understand different venipuncture techniques and the equipment to be used to draw and preserve the blood sample. Additionally, they must know how to read laboratory requisition slips, follow doctor's orders, work safely with patients, handle blood and other potentially hazardous body fluids and know how to clean up blood spills safely and dispose them in accordance with OSHA regulations. If any of this is not approached with great care and handled properly, it can result in severe injury, if not death.

You can learn more at PhlebotomyPages.com.

Medical Coding and Billing Coding Specialties

2011-11-11T13:10:00.001-05:00

Physicians, Medical Office Managers and Hospital Administration Relies on Medical Coders and Billers

Successful medical coders and coding consultants pride themselves on being personally involved and connected with each and every client and exceeding clients expectations. Wherever there are doctors you find medical coders, some work in house as employees of the facility, others are independent consultants, some specialize in areas such as billing and collection, others become medical coding instructors, or speakers at conferences and seminars; some work long hours, others work part-time telecommuting from home, others start their own business. There are so many variations, opportunities and specialty fields.

CODING SPECIALTIES:

Medical coding professionals can specialize in focus areas such as:

• Family Practice & Internal Medicine

• Ambulatory & General Surgery

• Anesthesia & Pain Management

• Emergency Medicine

• Dermatology

• Gastroenterology

• Neurology & Neurosurgery

• Oncology & Hematology

• Mental Health

• Podiatry

• Ophthalmology

• Dentistry

• Physical rehab

… to name just a few. There are many more.

Healthcare Industry Job Market Outlook

2011-11-08T09:29:00.001-05:00

The allied healthcare industry employs expertly educated professionals that often require many years of training beyond high and graduate school. One estimate by the U.S. Labor Department reported allied health professionals make up 60 percent of the total health workforce and healthcare experts anticipate that health services employment will continue to grow. Jobs in the healthcare industry virtually open and close daily...

Are you ready to enter into one of the largest industries where new
job offers virtually open and close daily?

In addition various healthcare reforms are presently under consideration which may also affect the number of people being treated by healthcare providers. If you ever considered, or were ever interested in starting an allied health career, then now is the time.

Looking for Medical Billing Training?

2011-11-07T15:44:00.003-05:00

Are you looking for vocational training providers or on the job training to become a medical biller, or get a job, a better job, or improve your position in your current workplace?

Finding the right medical assistant program remains difficult if you do not have a clear goal and don't know where to look. The vocational and post-secondary education system for high school graduates and working adults consists of countless campuses across the United States and Canada. Additionally there is a plethora of vocational self-study online programs to choose from online. Without a certain amount of help, finding the right post-secondary school, or medical billing and coding program can quickly become a daunting task.

The quickest and easiest way to find medical billing schools and explore medical billing and coding programs near you is via our medical assistant schools by ZIP code search on MedicalBillingandCoding .NET on the Web, the recommended vocational education and training programs provide qualified training and teach you the skills you need to land medical office and healthcare jobs. The website is ready for all mobile devices. Visit us on your iPhone, BlackBerry, Android tablet, or PDA.

You can learn more at MedicalBillingandCoding.net.

Ahhh, the Medical Biller! How Medical Billers Affordably Eliminate Losses and Free Up Time

2011-11-02T22:50:00.001-04:00

Medical billers and medical billing companies provide essential medical billing and practice management services to local area physicians and other health care providers. While typically these providers routinely file their own Medicare claims electronically they often find themselves tied up and over their head with filing commercial health insurance claims paperwork, red tape and collecting moneys owed. Commercial health insurance carriers represent the majority of their claims and work load and precious time is tied up with following up on denied claims that were coded in-house, filled out manually, submitted by mail and possibly lost.

"Just the mere thought of loosing precious time and hundreds, if not thousands of dollars annually due to medial billing errors, lack of follow up, under pricing, missed charges and claims can send chills down any doctors spine."

Manually submitting health insurance claims for reimbursement ties up precious time that would be better spent focusing on patient care, medical services and making important business decisions. It also seriously ties up cash flow because manually submitted claims take much longer to get paid which affects the practice's financial health. Further more, the office's staff is tied up running patient balance sheets, aging reports and sending reminders in an attempt to collect outstanding monies.

Medical Billing Services are Affordable and Efficient

This is where the medical biller comes into play. Ahhh, the medical biller! The unsung hero of the medical practice. When these complex medical billing and practice management routines are outsourced to a qualified medical billing professional or medical coding and billing firm then these headaches can be avoided. For a very reasonable fee, which is negotiated, medical billing experts provided services that keep the medical office practice running smoothly and eliminating time consuming mundane tasks and saving the doctor precious time.

Financial losses due to medical billing errors can be prevented and more time can be invested in the patient rather than on paperwork. Expertly trained medical billers have the knowledge and expertise to recover revenue that otherwise would be lost by utilizing personalized reimbursement strategies.