How to Overcome Lack of Work Experience

New Medical Coding and Billing Program Graduates:

How to Overcome Lack of Work Experience

More and more employers who hire medical billing and insurance coding staff are looking for professionals with one to two years experience in the field. New graduates find it hard to land their first job without it. They always seem to fall into the controversial "I can't get work without experience, and I can't get experience without work" rut, which is hard to escape. However...

Although this is always a challenge, there are ways to overcome lack of work experience when applying for a job. The trick is to highlight other selling points and making a good impression.

• Request an appointment with the human resource manager or nurse supervisor to learn what they are looking for. Find out if there is room for exceptions. Tell them what you can offer their facility and how great of an asset you will be.
• Try to offer your service by volunteering. Mention relevant skills you have, such as your accomplishments while you were in school, or college; include scholastic awards and --most importantly: mention your externship! Time spent in a medical office in form of the externship is work experience.
• Never arrive empty handed. Be prepared to mention how satisfied your former employers, field supervisors, clients, andinstructorss were, supported by as many letters of recommendation that you can get.
• Anyone attending a job fair should bring several copies of a well written resume, dress professionally, and be prepared for on-the-spot interviews.
• Southern University Career Services Baton Rouge, Louisiana suggests the following dos and don'ts for women dressing for an interview:
  
  1. Dress in a simple and clean manner.
  2. Select clothing appropriate for the job you are interviewing for.
  3. Wear natural colored hose.
  4. Wear plain shoes with closed heels and toes.
  
  
  Those who do not have a business attire should select clothing appropriate for the job such as crisp clean scrubs, along with a name tag, professional badge, and sparkling white nurse's shoes.
  
• Discuss other valuable skills you've under your belt, such as those acquired through activities in community groups, volunteer work, or even personal interests. Don't forget courses, workshops, or seminars taken outside the medical assisting profession, for example in sales, interpersonal communication, languages, customer services, data entry, computer applications, and word-processing.

All this can help to convince a new employer, that although you may not have the requested amount of work experience in your new role as a medical assistant, you are certainly worth their attention and consideration for the job.

© 2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

Uninsured Awareness

Article by Steve Verno
Reprinted here with expressed permission by the author.


In Florida, there are 3,071,000 people who are uninsured. The place where almost all of these people go for health care is the emergency room. As a result, because they are uninsured, their medical bills go unpaid for various reasons. The average emergency room physician bill is $250.00. Multiply that by the number of uninsured and you see a minimum loss to the physician community of Florida in the amount of $767,750,000 if each person has one emergency room visit, but they don't because uninsured patients must use the emergency room for medical care.

This doesn't count the loss when one of these uninsured decides to sue for financial gain. Like any other business, losses have to be added to the cost of business. My brother is uninsured and spent a week, needlessly, in the hospital. He was medically abandoned because he was uninsured. He should have spent one day in the hospital, but because no doctor would see him, my brother rotted. He was released only after I complained to the CEO of the hospital organization. His medical bill = over $30,000. This is why this hospital chain is involved in a class action lawsuit. Can my brother pay this? No. He is unemployed. With what he was charged, my brother could have flown first class to Las Vegas, stayed in a suite at the Bellagio, and gambled $1,000 per day and it would not have come near what he was charged to stay in a semi-private room and watch TV all day, waiting for someone to see him.

His condition? A cyst on his eyebrow, which opened and he was forced to clean it with toilet paper because the nursing staff refused to come to his room when he called them, telling them that the cyst opened and was draining down his face. When they did give him 4 gauze pads, they charged him $75 for these pads which costs about $5.00 in a drug store.If we took one HMO CEOs salary and bonuses for a one year period, we could pay alot of doctor bills for the uninsured.

I am amazed at how much employers are paying insurance companies in premiums. It's almost criminal. In addition, if the employee has family members, then the employee is contributing to the cost of health care. This is why health care is unaffordable. The insurance companies are charging sky rocketing premiums and giving nothing back. Lets say you are a family of 4 and in excellent health. You pay $250 per month in premiums as your part. Your employer is probably paying $500 per month, but lets keep to the $250. In one year, you paid $3,000. Lets say you have a $1,000 deductible. In that one year timeframe, lets say little Suzy was sick and you took her to the doctor. The visit was $150.00 with a $30 co-pay. Not only have you paid out $250 per month in premiums, but you just shelled out $30 more for the visit.

The insurance company applies the bill to your deductible, so to add insult to injury, now you have to pay $130 more. So, what did paying for insurance get you? Bupkiss! You can't even take this off your income tax.Lets say you get real sick. You have $900 in medical bills. The insurance company still applies this to your deductible and you pay out of pocket for the care. Do you really feel comfortable, knowing you have medical care? So far the insurance company hasn't paid a dime. Now you get sicker. The insurance company denies your claim stating the care was not medically necessary. Who ends up paying the tab - you and your employer. Did you ever wonder where the insurance company gets the money to pay these high priced CEOs? Now you know.

I once signed up for dental care that would cost me $120 per month or $2,400 per year. I looked at what I was given for benefits. One free cleaning per year. I had a $300 deductible. At the most, the insurance company would pay 50% for certain covered services. Root canals were not covered, nor were bridges or crowns. I terminated the policy immediately and put the money in a savings account. My wife had to have a tooth removed. Cost: $190. I took the money from the savings account, asked the dentist for a 10% discount and got it and he was paid right then and there. In one year, I put $2,400 in this account, which paid cash for all of our dental care.

Maybe employers would be better, putting the premiums into a savings account and having the employees put their share in as well. Then go to all of the doctors in the area and work out a deal with them to pay 90% of the medical bill immediately in return for providing their employees with medical care. Lets say you have 10 employees and the provider puts $200 per employee per month and each employee puts in $100 per month. This is $3,000 per month in the account. In one year you will have $36,000 for medical bills. If you have a high risk employee, then work out a deal to get low cost health insurance for that employee. But if you get a few employees visiting the doctor per month, you still have the money to pay for the care and the doctor gets paid better and quicker than if they were dealing with the insurance company.

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About the Author: Steve is a Certified Master Medical Coder and Certified Master Medical Biller and Medical Coding/Billing Instructor. He also is the co-owner of Lucrum Consulting, LLC. which provides training in medical coding and billing issues, and helps physician's practices in areas such as A/R recovery, appeals, and staff training.


© 2005 Steve Verno

Make Your Career Offshore Proof

There has been a lot of talk recently about American jobs moving overseas…offshoring is the buzzword for it. During difficult economic times it is often easy to find a scapegoat to blame for a downturn in jobs. While government reports and politicians try to downplay the impact, offshoring is something to take seriously. This article will discuss the permanent effect offshoring will have on U.S. jobs and what you can do to make sure it doesn't happen to you. Economic crises of the last thirty years have tended to blames overseas competitors for America's financial woes. During the seventies it was foreign steel to blame and during the eighties it was foreign agriculture. The current trend of moving American jobs overseas, particularly to India, The Phillipines and other developing nations has been troubling to many. While some people think this is a temporary situation, shifts in the American economy and world politics indicate otherwise.

One of the effects of the collapse of the Soviet Union and the end of the Cold War has been the increased globalization of trade. On this continent, economic borders have opened up due to the North America Free Trade Act (NAFTA). In Europe, the collapse of the Iron Curtain has opened the borders of the eastern countries. And the European Union has made a significant impact on the economy; standardizing currency in 13 countries in 2000 and adding 10 new member nations last month... mostly former Eastern block nations. Even China has joined the global free market, contributing $620 billion in trade to the world's markets in 2002. China has taken control of Taiwan and regained Asia's economic powerhouse - Hong Kong - after 100 years of British rule.

These global economic changes are big and they will not go away. American companies have taken advantage of the global market, establishing icons of American culture like fast food, retail stores and computer software everywhere. With all these events and situations, it only makes sense that American companies would turn to foreign labor.

Besides, the economic impact of the world's political shift, the American economy has transformed itself. The rise of the computer has shifted the United States economy from an industrial nation to a nation of information and service. This means there will be less jobs in making things and more jobs in marketing and servicing things. Unfortunately the American education system has been ill prepared for this inevitable change. In the mid to late nineties, thousands of well paying computer jobs went to foreign nationals on temporary work visas. Additionally, domestic workers on a whole will move from being permanently hired employees to contract or temporary employees. As a worker, it will be more important to market yourself, keep a good network of contacts and maintain your technical skills.

Although this news sounds grim, it's really not. Most of the jobs going overseas are in the lower salary ranges like customer service and technical support positions. Meanwhile, the new "hot jobs" pay very competitively, even for workers who lack employment experience.

If you're afraid your job may be going overseas, or you want a better paying career with more advancement opportunities, take a look at these hot jobs:
1. IT Security
2. IT Project Management
3. IT Outsource Management
4. IT Database Administrators
5. Health Care - Medical Assistant
6. Health Care - Nursing
7. Health Care - Home Health
8. Health Care - Dental Hygienists
9. Health Care - Medical Coding
10. Health Care - Medical Office Administration

Find out how you can begin the education for one of these great careers!

----------------------------------------------------------------------------------------Author: Max Stein, Salt Lake City, UT, USA http://www.degreesource.com/articles.
Stein is a freelance writer who writes about business, education and marketing.

Contact: maxstein_9@hotmail.com

Why People are Attracted to the Medical Coding and Billing Profession

I. People are attracted to the medical coding and billing career for several reasons:

• they enjoy the healthcare field, medical terminology, and anatomy, and understand numbers and codes
• they like helping people but prefer to work independently, from their own area away from the public's eye
• they are detail oriented and meticulous when it comes to their work
• they know how principles of the computer, and how to find answers to problems
• they prefer intensive accelerated training courses and then get out and hit the workforce fast
• they enjoy learning-by-doing, and learning additional skills through workshops, and online courses
• they are serious about their career and enjoy constantly learning new things as the rules and laws constantly change
• they see the possibility to start their own business down the line
• they want to earn their money doing what they love

Indeed most distance education courses in medical coding and billing programs do not take very long to complete. Students can complete their courses in just a few weeks, or months, and get out making money using new skills fast.

However, anybody serious about their career should consider enrolling in a Medical Coding and Billing course at a vocational training institution, or college, especially if they do not have any prior training in office procedures, keyboarding, health education, biology, anatomy, business math, and simple bookkeeping.

II. A certificate program in medical coding and billing typically requires the following courses, which is followed by a clinical practicum:

1. Medical Terminology
2. Human Anatomy and Physiology
3. Pathology and Disease Processes
4. Keyboarding
5. Health Information Management
6. CPT Coding
7. ICD-9-CM Coding
8. Healthcare Laws and Ethics

Important is to realize that the medical coding and billing specialist's training and learning does not end here! Medical coders and billers always have to keep learning, because the rules and laws in health care, along with the medical coding software programs constantly change! It truly is an interesting, and challenging career.


III. The need for well trained medical coding and billing staff is so great, that students from accredited programs often have jobs before they are completely finished with school. Physicians appreciate well trained, dependable medical coding and billing staff, because not being paid for their services, or being charged large penalties due to improper coding could mean financial disaster, and cost them their livelihood.


IV. Once hired, medical coders and billers hold secure jobs, with good future outlook. Once a position is secured, their supervisors will have to spend a great deal of time training their new medical coder one-on-one, for several weeks, if not months. Once training has stopped and coder is gaining experience by doing and partaking in continuing education classes, chances are good their bosses will want keep them. A medical coder and biller that makes sure the employers are pleased can expect to be handsomely rewarded. This may also include regular pay raises, perks, and other valuable fringe benefits.



Autor: Danni R.
© 2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

Medical Practice Management in the New Millennium

We are witnessing the approach of a new era!

Actually, healthcare computing, IT solutions in disease management, and medical informatics is nothing new, however, because the United States of America's health care system is still largely based on paper and ink, President Bush, many politicians, and health care providers have decided to follow other country's examples, such as the United Kingdom, Canada, Denmark, and Australia, and are collaborating on plans where within the next ten years all people under the care of a physician in the USA will have an electronic patient record!

Inevitably, this means that physicians, clinicians, nurse practitioners, physician assistants, nurses, medical office, health system, and benefit managers, HIPAA, and claims processing professionals, which includes the medical coders, and billers, as well as clinical and administrative medical assistants, and many other professionals working in the various settings of the health care delivering industry will have to prepare and adjust for changes to come!


Learn more about the unique challenges that implementation and maintenance of electronic medical records brings to the medical office. And if you have any comments, please post them here!


© 2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

How I Turned a Snickers Bar Label into a Medical Coding Lesson

Since I am the creator, author, maintainer, and webmaster of a number of medical assisting, medical coding, billing, and phlebotomy web sites I recently enrolled in the IWA "Web Content Writing and Editing" class to enhance and refine my writing skills. I am just starting the second week, but so far it has truly been interesting, and fun, and I have already learned quite a bit. There are new lessons for each week, and for each lesson there is an assignment.

For example, week two-instructions were to read something--anything--that happens to be close at hand and write an article about it that fits into our web site. This exercise was meant to show us that when it comes to creative writing, anything can be an inspiration. For your enjoyment, here is a copy of my assignment response:

Week 2 - Assignment 2:
I am writing an article for my Medical Coding and Billing web site. Since the instructions given for this assignment are to read anything that is nearby I will look no further than my cluttered computer desk. The first thing I spot is a plastic container of Pledge Furniture Cleaning/Polishing wipes way in the back, then to my left, on a stack of papers, an unopened Snickers bar. On the label I read: Hungry? Grab a Snickers. Net Wt. 2.07 oz. That caught my attention!

I guess I could probably work with it. I just would have to be a bit more creative than if I chose the medical terminology and medical coding books stacked on the right-hand side on my computer desk. The Snickers bar seems "doable". To accomplish this writing challenge, a good place to start might be to go over the list of ingredients, define, and analyze them with focus on nutrition and health related issues, then identify adverse reactions, or diseases that could be caused, or perpetuated by certain ingredients, such as sugar, cocoa butter, chocolate, lactose, skim milk, milk fat, soy, lecithin, peanuts, corn syrup, egg whites, and then list associated interventions and treatments.

In the next paragraph I could then show my readers how to turn the diagnoses, and associated treatments into combinations of codes that medical coders use when they submit a claim to tell the health insurance company what was wrong with a patient and the services that were provided. The article would turn out to be a coding lesson based on the ingredients of a Snickers bar. LOL

However, if I wanted to save myself this headache, then I should probably better go with the medical coding books stacked in the back of my desk. I would then simply whip up an article about the basics of medical coding, what it is, and what it is used for, what a medical coder does, and does, where they work, and what they earn; then go into details of their vocational training requirements, and how they can advance in their chosen career, and leave it at that! Simple.

But then again, given the two choices, rather than having to read those darn medical coding books all over again, and winding up with yet another dry article about medical coding, I'd prefer, at this time, to go with the Snickers bar!!! Plus, there is another temping advantage: I can take off the wrapper, analize the label, write my article, and then eat this peanutty, chocolaty, delicioius treat.

--------------------------------------------------

I continued to add the following resources to support my point of unhealthy ingredients in a Snickers bar, that may lead to certain conditions, or diseases, that then can be diagnosed, and coded by medical coders, so that the healthcare provider can be reimbursed for his/her services:

1. To provide basic information on ingredients and their nutritional values: Nutrition Facts and Food Composition Analysis for Candies, M&M MARS, SNICKERS Bar http://www.nutritiondata.com/facts-001-02s047p.html

2. To provide additional information how certain ingredients in a Snickers bar migh have a negative effect on health: Carbs and Fiber in Snickers Bar
http://www.carbs-information.com/candy/carbs-in-snickers.htm

3. To provide more specific information on long-term health effects of eating high-GI foods: Health Effects of High Glycemic Value Carbs
http://www.carbs-information.com/health-effects-high-glycemic-value-carbs.htm

4. And last but not least, now the medical coding part: CIGNA Medicare Part B - ID LMRP 97-011 - Blood Glucose Testing http://www.cignamedicare.com/partb/lmrp_lcd/id/id97011.html

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THIS WAS A FUN ASSIGNMENT!

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What would you have chosen to write a creative medical coding and billing article? The coding books, the Snickers bar, or may be the Pledge Furniture Cleaning Wipes way back on my desk, or something else? Please feel free to comment!


© 2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

OIG Saves American Taxpayer's Money by Cracking down on Fraud

The Office of Inspector General (OIG) of the Department of Health and Human Services continually strives to eliminate fraud, waste, and abuse in HHS programs on every front and follows up on all matters involving fraud, waste and mismanagement in any Health and Human Services programs. In the fiscal year 2004, OIG reported savings to the American taxpayer of almost $30 billion! Fraud and abuse cases OIG investigated and resolved involved the following HHS programs:

Ø Medicare Part-A
Ø Medicare Part-B
Ø Child Support Enforcement
Ø National Institute Of Health
Ø Indian Health Service
Ø Food and Drug Administration
Ø Center for Disease Control
Ø Substance Abuse and Mental Health Services Administration
Ø Health Resources and Services Administration
Ø Aid to Children and Families
Ø All Other HHS agencies or related programs


OIG maintains a hotline which offers a confidential means for reporting fraud and publishes summaries of resolved fraud and abuse cases on their web site throughout the year. The following are a few exples of the types of complaints that OIG investigated and persued:
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In Maine, a registered nurse was sentenced to 18 months in jail with all but 45 days suspended for theft of drugs. While working at a hospital emergency room, the woman stole morphine on at least three occasions.
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In New York, a billing clerk was ordered to pay $2,100 in restitution for health care fraud. The billing clerk systematically upcoded claims. These claims had already been upcoded by nurses who routinely treated patients without any physician involvement, but coded the services as though a physician had rendered them.
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In New York, a physician and his nurse were sentenced for their involvement in a scheme to defraud the Government. The physician was sentenced to three years and 10 months incarceration and ordered to pay $227,000 in restitution. The physician was previously convicted during a jury trial for health care fraud, conspiracy to distribute and dispense controlled substances, illegal distribution and dispensation of controlled substances, and aiding and abetting. The nurse was sentenced to 6 months home confinement for health care fraud and conspiracy to illegally distribute Schedule II controlled substances. The physician submitted claims to Medicare indicating he had treated the patients and performed the service directly, when actually, a nurse treated the patients. To facilitate this scheme, the physician provided presigned prescription pads for her and other nurses to prescribe narcotic drugs to patients.
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In New York, three subjects were sentenced for their roles in a scheme to defraud the Government and private insurers. A podiatrist was sentenced for submitting claims for services that were either upcoded, not rendered, or were medically unnecessary. Also sentenced were two billing clerks who at the direction of the office manager, submitted claims that they knew were fraudulent.
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In New York, after entering a guilty plea, a psychiatrist was sentenced to a conditional discharge for his submission of false filings. The man agreed to repay $502,000 in restitution to Medicare and Medicaid for billing for office consultations and medication dispensing when no consultations actually took place.
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In Indiana a doctor was sentenced to 7 years incarceration, with 3 years suspended, for his scheme involving intimidating Medicaid beneficiaries. The doctor, who was previously found guilty during a 4-day jury trial, intimidated Medicaid recipients by telling them they would lose their benefits if they did not make cash payments.
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In Michigan a dentist was sentenced to 1 year and 1 day incarceration and ordered to pay $743,000 in restitution and fines for mail fraud. The man billed insurers for services not performed and for upcoded dental services.
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In Illinois a doctor and her employee were sentenced for their role in submitting false claims. The doctor was sentenced to 5 months incarceration and ordered to pay $70,000 in restitution; the employee was ordered to pay $7,500 in restitution. Claims submitted were for psychiatric services provided when the doctor was absent from the office and/or were actually provided by the employee, who has never been licensed to practice medicine.
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In Virginia a physician was sentenced to 18 months incarceration and ordered to pay a $10,000 fine and $191,000 in restitution for health care fraud. From approximately January 2000 through October 2003, the physician submitted upcoded claims to Medicare and to a private insurer. In addition, claims submitted reflected comprehensive office visits that did not occur at all, or were for dates of service when the patient was only provided a prescription refill. The investigation began in July 2003 when the private insurer found that the physician’s billings were much higher than the average medical provider in the area. Shortly after the investigation began, a fire occurred at the physician’s medical office, which was determined to be a case of arson. Although a grand jury returned an indictment charging the physician with arson in connection with the fire, the Government dismissed the charge in exchange for his guilty plea to health care fraud.
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In California, a doctor was sentenced for health care fraud and was required to surrender his medical license for billing Medicare and private insurers for diagnostic studies that never occurred. The doctor may not reapply for a 5-year period.



Read more about OIC Criminal Actions!

Coding from Home?

Coders with a number of years of experience may want to set up their own business from the comfort of their home. Thorough understanding of the medical coding and billing industry, as well as technical skills, high self-motivation and organizational ability, and experience will be the foundation upon which this can be achieved.

Also determination, the drive to be independent, and well respected credentials are powerful resources for success. Also, people who are practical, logical, perceptive, observant, methodical, good planners, tennacious, sound decision makers, natural team leaders, good with facts and figures, and have a reputation for firmness and a no-nonsense attitude to life can do well running their own business as an independent contractor or consultant in medical coding and billing.

If this sounds like you, read more!


© 2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

Medical Billing as a Home-Based Business - Reality or Scam?

Medical Billing As A Home-Based Business, Is It Really A Scam?

Hidden Pitfalls of Taking Online Courses

With our modern society's busy schedules and lifestyles distance education over the Internet provides e-learners with the convenience, flexibility, and the ability to study anywhere, any time without being on campus. However, just because a course is offered online and requires a fee to sign up doesn't automatically mean the program is accredited, even if the provider claims it is. Often, the certificate or diploma e-learners will receive upon successful completion of an online course is not even worth the paper it is printed on.

A Simple Word of Caution
Rule of thumb is: online courses are seldom accredited, or approved by the board of education unless they truly have met or exceed established national standards. The application process for reviews and approval is tedious and lengthy. Online training providers, non-traditional universities, and so called virtual colleges who offer distance learning programs have different accreditation standards than brick-and-mortar universities, colleges, and vocational training institutions. These institutions who went through the process and are approved will always have their program's accreditation status visibly posted on their website and online course catalogs.

Awareness is the Key!
The Internet serves as a great information resource and education portal, but at the same time, it also is the perfect breeding ground for different types of scams. It is important that potential students recognize this, and understand the difference between fully accredited vs. illegitimate and non-accredited programs. If not, then the e-learner might be in for a rude awakening in the end, when after successfully completing an online course they find out they have nothing to show, and are not permitted to sit for any national certification examinations.

E-learners should be careful to choose courses that meet their individual educational needs to ensure that they don't waste their money and time. Some just need a refresher course for personal and professional enhancement and a low cost, non-transferrable, non-accredited course will do just fine. Others may need proper vocational training to receive a much desired promotion, or to achieve specific educational goals that will allow them advance into a new position or career. Then it is vitally important that these individuals graduate from courses that are accredited not just by any, but by the right organization, such as, for example the U.S. Department of Education, Council for Higher Education Accreditation (CHEA), Commission on Accreditation of Allied Health Education Programs (CAAHEP), Accrediting Bureau of Health Education Schools (ABHES), or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

But How Can You Tell?
Web page advertisements that contain text, images, seals, and any profound sounding designations that a vocational training school and their programs are accredited containing words such as approved, accredited, accreditation pending, authorized, chartered, licensed, empowered, sponsored, recognized, and registered should be critically examined to determine whether these claims are merely common catch phrases, or the assertions are legit. It is always prudent before joining any programs to get in touch with the provider of the courses to ask questions, and to also contact the accrediting organization to find out whether a program is truly legitimately accredited by them, and to confirm the quality of the online training courses.


What are your past experiences with online distance education courses? Please post your comments!



©2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

Accredited Medial Coding and Billing Training in Illinois

If you live in Illinois I highly encourage you to check out the Computer Systems Institute (CSI).



Here is why: CSI offers comprehensive accredited vocational training programs that lead toward the necessary knowledge and skills to perform proficiently and sucessfully in a medical coding and billing job!



CSI prepares you for industry-recognized certifications. Earned credit hours can be transferred to major institutions and applied toward a desired degree. It's definitely worth taking a look!!!

Illinois CSI Campuses are located in the following communities:

1. Chicago
2. Skokie
3. Lombard
4. Gurne

Every healthcare provider, whether a medical doctor, poditrists, dentist, or surgeon that delivers a service receives money for these services. While most of them prefer to collect payment from patients at the end of the office visit, the majority of their fees are processed by filing a claim with the patient's health insurance provider, managed care organization, or government entities.

Coding for services in healthcare is complicated and therefore employers prefer to hire trained, and often, certified individuals to ascertain that their coder is proficient and familiar with different types of insurance plans and codes, and knows how to process and submit claims electronically, and enter codes into databases. They must also be able to collect payments, make adjustments, interprete EOB's, handle denied claims, and process appeals.

Eventually, an experienced medical record coder and biller may advance into higher more interesting positions, such as a senior technician who specializes in coding, particularly in the realm of Medicare coding, or in tumor registry.

If you are already familiar with CSI, or planning on joining their programs, please feel free to leave us your comments!

©2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

Changes to Medicare Infusion and Injection Coding

I just came across a very interesting web site that should proove to be very helpful to those working in medical coding and billing. I found it while surfing the Internet to find any new rules and important changes in coding and billing.



The article is published at Medical News today and titled: Medicare Infusion and Injection Coding/Payment Changes 2005. Here is a brief summary followed by the URL link to the web page so you can read the full article:



There are new rules and regulations that will affect the way healthcare providers code infectious diseases and reimbursement for office-based outpatient infusions and injections provided to Medicare patients.



Centers for Medicare and Medicaid Services has issued a series of new temporary "G" codes that replace current infusion codes (90780 and 90781) and other injection codes as of January 1, 2005. The 2006 CPT Manual will incorporate these G codes and make them permanent. These new CPT codes will be published in fall of 2005. While the new infusion codes will make billing more complex, they also describe the work being performed more accurately, which should be beneficial in the long-term.



Read full article at http://www.medicalnewstoday.com/medicalnews.php?newsid=18149 and let me know what you think!

©2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

EOB Question

Today I finally received a comment from a person that was NOT a medical coder or working in the medical billing industry. The form was sent through the Medical Coding and Billing .com web site contact form by the other part of medical coding and billing, the consumer (recipient of medical services). Nice to know, that such a broad audience visits my site and finds it useful as well.

The question was: What exactly is the EOB, I mean, what do the letters stand for.

Simple: EOB is short for Explanation of Benefits which is a notification sent by the medical insurance company administrators after processing a medial insurance claim.

The EOB explains the total amount the health care provider billed for medical services, the amount paid under the insurance contract, and who was paid. Patients should keep a copy of their bills from the health care provider of medical services to compare them to the EOB.

Hope this explains it!

©2005 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.

Just Discovered the Idea of Blogging!

Hello Medical Coding and Billing professionals!



My name is Danni R., I am the creator and maintainer of the Medical Coding and Billing .com web site. As you know, the Medical Coding and Billing .com web site is a top ranked reference site dedicated to students and professionals in the medical billing and coding profession. It is a featured profssional resource in the Higher Ed McGraw-Hill Medical Assisting Administrative and Clinical Competencies - 2nd Edition to inspire and mobilize individuals entering the medical coding and billing profession to strive to be the best they can be and to help them find resources for their professional and personal development.



To make these services even better, I just spent about 2 hours of researching and reading articles on "bloggers" and "blogging" on the Internet. I was interested in finding a userfriendly tool, other than a chat box, or bulletin board that would allow me to post interesting news, latest trends, ideas, and receive your feedback, and comments! I came to find that a well working, well designed Blog Log dedicated solely to Medical Coders and Billers is the way to go.



Wouldn't you agree?