Medical Coding and Billing – Is it a critical Role in Health Care Industry

 

 Medical Coding and Billing – Is it a critical Role in Health Care Industry

 

The Medical Coding

Medical coding is the transformation of health care diagnosis, procedures, medical services, and equipment into universal Alpha Numeric codes.

The coding process is carried out by the International Classification of Diseases (ICD) owned by the World Health Organization. Some countries have modified this ICD to suits their research, nature of disease prevalence and their statistical needs. The major modified latest versions are ICD10CM (International Classification 10^th Revision Clinical Modification) and ICD10AM (International Classification 10^th Revision Australian Modification).

Medical Coders take medical documentation from clinical teams, containing patient’s condition, the diagnosis, prescriptions, and procedures the doctor performed on the patient and turn that into codes, which is crucial for medical claims.

Medical coding helps in facilitating the classification of diseases and health problems and ways to treat them, which helps decision-makers at all levels of the health sector to take appropriate decisions based on accurate data and statistics.

Medical Coder must ensure that codes are applied correctly for medical billing process. This includes gathering information from documentation and providing appropriate codes.

Medical Coding professionals ensure the codes are applied correctly during the medical billing process, which includes abstracting the information from the documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.

Medical Codes must tell the whole story of the patient’s encounter with the physician and must be as specific as possible in regards to capturing reimbursement for rendered services.

 

Job Responsibilities of a Coding Specialist

The day-to-day responsibilities of a medical coder vary based on the needs of the employer. However, here is the most common responsibilities that a medical coder can be expected to fulfill

·         Review Medical Documentations and abstract the information about the treatment

·         Assign the correct codes for the diagnosis and procedures by using the classification system the facility is follows.  

·         Do not do over coding or under coding rather assign the optimum level of code assignment

·         Submit the correct and proper information to the insurance companies

·         Retrieve or enter the patient information into a computer system software

·         Keep the confidentiality of information, Keep the data well organized and secure

·         Communicate with physicians and other care givers in case of any documentation deficiencies

·         Review the Medical Records and provide responses to the inquiries from care givers and insurance companies

·         Accurate coding of diagnosis and procedures helps the data analytics team to track the factual health care data

·         Act as a liaison between patient, insurance companies and medical facilities.

·         Use the available classification software, Input the proper codes in the software so that patients can be reimbursed by insurance companies.

·         Support the internal and external regulatory audits

·         Support the analysis, correction, and resubmission of the denied claims

·         Train the physicians about the standard documentation practices

·         Train the physician to document such a way that, how the perfect documentation leads to the revenue impact.

 

Skills of a coder

Other than the strong educational background, the coders must have the below skills as well.

·         Interpersonal abilities, and quality communication skills

·         Decision Making capabilities

·         Computer skills and Electronic Health Record software skills

 

Career Options for a Medical Coder

·         Clinical Coder

·         Clinical Coding Supervisors

·         Case Managers

·         Clinical Documentation Improvement Specialists

·         Coding Auditors

·         Denial Management Specialist

·         Health Information Management Manager

·         Health Information Management Officer

·         Health Information Management Analyst

·         Health Information Management Technician

·         Health Information Management Clerk

·         Insurance Coordinator

·         Insurance Claim Analysist & Insurance Claim Processor

·         Medical Billing and submission Specialist

·         Quality Department Team Leaders

 

The Clinical Coding Benefits to Health Care

 Starting Your Dream Career Today?

If you are serious about starting your career in the medical coding field, it is essential that you complete the proper training and receive a certification to get started. Thankfully, receiving this proper training is now easier than ever! There are options to complete your training in a traditional classroom setting or online with more flexible schedules.

Even if you are starting off as a medical coder and are not interested in working that specific position your entire career, there are several opportunities for growth down the road. Your work as a medical billing and coder might simply open the door for other opportunities at your employer for you down the road.

Come and Join with CHISS, we will make you an efficient clinical coder.

 Why CHISS?

·         Traditional classroom classes and online classes

·         Well-designed curriculum

·         Career oriented Training

·         100% CPC Passing Rate

·         Free Access to Cloud based Learning Platform

·         Job assistance

·         Evening classes for the working staff

·         Well Trained Trainers

·         Grooming sessions to face the interviews

·         State of the art technology