Medical Coding Billing As Part and Parcel of Healthcare

Upon diagnosis and treatment of a patient, the doctor is responsible to document the details as part of paperwork. All this information is later utilized in the processes for medical coding, billing and ultimately translated into payment. Although this is a process normally conducted away from the public eye, back office employees who perform the task of medical coding are specialists in selecting medical codes to match the doctors’ diagnoses of patients’ ailments. These codes are important details of reference when it comes to requesting payment from insurance companies and private payers. If a patient has an existing health insurance policy, these coding experts also check to verify whether claims can be made against the policy.

In order to comprehend what medical coding and billing is about, individuals interested in this field need to receive proper training. They can opt to enroll in courses from local educational establishments or distance learning providers. Since certification is required for active practice, it is best to check that the course selected is certified by the medical authorities. A certified coding expert is responsible to check and organize a patient’s records, bills and statements before proceeding for medical coding. Billing is then generated based on correct codes entered into the system. Utilizing computer systems to carry out this task has taken a considerable load off as the coding and billing process is more efficient and effective. Reports on statistics, billing, mortality, morbidity and others are easily produced for submission to relevant authorities as well as for internal scrutiny where required.

In line with constant change in the medical industry, those involved in medical coding and billing are expected to keep themselves updated through continuing medical education. Changes are constantly imposed on billing procedures, insurance schemes offered on a public and private scale, workers’ compensation, disease and diagnosis coding systems, procedure and treatment codes, physicians’ fee scale and many more.

Since these experts are a required workforce by healthcare institutions and practitioners, they can either work within large institutions or offer themselves as outsourced service providers to smaller establishments or clinics.

Medical Assistants Guide

Medical Assistants, or simple MAs, carry out all the clinical and administrative tasks to keep the offices of physicians, chiropractors and other health practitioners running smoothly. Their duties usually depend upon the practitioner’s specialty and location of practice. Usually in small practices, assistants perform different kinds of tasks which include both administrative and clinical duties and reporting directly to the physician, office manager or other health practitioner. In large practices, they usually specialize in one specific area under the supervision of administrators of the department.

MAs usually come under the below three categories

Clinical

Administrative

Specialized

Training and specialization:

Though there is no formal educational requirement, most of them have at least a high school diploma. Some of them are trained on the job, but more than 90% of them complete 1 to 2 year program before applying for a job.

MA trainings are offered in junior colleges, vocational technical high schools, community colleges and post secondary vocational schools.

Once you have completed a diploma or associates degree in medical-assistant and before you rush out to apply for a job in your new field, consider getting a certification first. Although it is not compulsory, certification indicates that you have met the standards of knowledge.

What is medical assistant certification?

MA certification is an exam conducted by American Association for Medical Assistants (AAMA). If a the applicant has passed the certification exam, then he/she will be called as Certified medical-assistant (CMA).

To be eligible to apply for a certification exam, the applicant should have completed a medical-assistant degree from an accredited school and should have completed an externship.

Benefits of Certification:

Though it is not mandatory that a MA has to be certified by AAMA, but more and more employers these days have been preferring certified MA’s. Certification will help in identifying the well trained or experienced assistant from an entry level assistant. The MA certification will definitely help in getting good salary as the latest report from payscale.com state that certified MAs are paid 3 cents more per hour than their counter parts and more job opportunities due to the fact that employers trust in them because they are certified by AAMA.

How to get started:

American Association for Medical Assistants has set some standards which all the MAs have to follow if they wish to be certified. Only those MAs who hold a graduation certificate from a medical-assistant school accredited by Accreditation Bureau of Health Education Schools (ABHES) or Commission on Accreditation of Allied Health Education Programs (CAAHEP) are eligible to apply for certification examination. So, before registering for a MA training program, check whether the school is accredited by any of the two bodies – ABHES or CAAHEP.

How to Get Certified?

There are two steps that you should follow in order to get certified by AAMA

Study: AAMA expects the applicants to be familiar with medical terminology, physiology, anatomy and lab procedures. Complete knowledge on these topics is necessary to pass the certification exam. It advises the applicants to review these subjects in medical-assisting publications. You can contact AAMA for more information on study aid.

Apply for the certification examination: Certification is a continuous program and MAs can apply for the certification examination throughout the year. If you are a member of AAMA or a CCAHEP or ABHES completing student or recent graduate, the fee is $125. All the others have to pay a fee of $250. All the fees will be non refundable. Once your application is approved, AAMA will send you further instructions about examination schedule.

Developing Medical Education Units: Novel and Prolific Educational Intervention

The practice of medicine appears as antique as the human race itself. Teacher-pupil apprentice model was followed for teaching of medicine in the very beginning. Around the 10th century the first modern teaching hospital was established in Baghdad, Iraq. Latter on in 1910 there was an improvement over the old system of unstructured apprenticeship when Abraham Flexner recommended teaching for 1-2 years of basic sciences and for 2-3 years of clinical subjects. By the end of 20th century Flexnerian model was adopted all over the world and it ruled the medical schools for about a century. The Flexnerian model was criticized for its artificial separation between basic and clinical sciences and was faded away by new concept of integration across the disciplines.

In 1992 Johnson Wood made one of his important recommendation to create a central coordinating body within the medical schools to execute the various amendments in medical education and also to plan, implement, monitor, evaluate, review the curriculum and to reward teaching excellence.

Founding of Medical Education Units (MEUs) or Departments in medical colleges can be acknowledged as the pinnacle of advances in medical education in the modern epoch. Keeping up the standards of medical education is not a trivial mission. Medical schools that consider it seriously have established such units across the globe.

MEUs are launched in response to increased public hopes regarding healthcare, trends of society for increased accountability, educational developments, amplified concerns about what to teach and how to teach.

Suppleness is the key to recruitment for a department of medical education. In order to provide a multi-professional and multi-dynamic team with a range of expertise, various contractual arrangements are required. Depending on the needs of individual institution the precise structure of the department will vary. The director provides academic leadership for the department and in addition to other responsibilities also helps promotion of staff collaboration, career fostering and creating local, regional and international links.

External funding agencies, government or university sources may provide financial support for MEUs but there are examples that these departments are financially self-supporting also.

MEUs play a major role in development of faculty by providing training of staff in medical pedagogy, bedside teaching, student assessment and program evaluation. MEUs also train medical students in group dynamics during small group learning activities and Problem Based Learning. MEUs help in monitoring and development of the curriculum providing suitable design and innovations. MEUs assist curriculum committee in areas of instructional methods, clinical teaching and student assessment. MEUs help in restructuring of the educational environment to meet the new curriculum objectives and to encourage students to mature as a self-learner and the teacher to become a facilitator.

MEUs can function as a think-tank to lead research. MEUs can provide required peer support for medical teachers in the sister medical institutions to contribute positively to medical education.

Initiating an MEU does not guarantee the improved state of affairs of medical education in an institute, unless the department is actively executing its well thought and clearly defined objectives to achieve fruitful results.

It is extremely vital for any institution, to know where it wants to be in the next five to ten years and how it plans to reach there. The leading mission for the MEUs should be to develop a strategic plan for the medical college it serves. All the stakeholders must be taken on board for this plan. After developing a strategic plan for the institution it is serving, the Department can then further define a number of tasks it needs to carry out. The priority of task to be carried out should, again, be decided with mutual collaboration.

Medical education will forge ahead, sprouting to harmonize the outburst of biomedical scientific knowledge and become more relevant for changing healthcare needs of the society. For us this is the time to exhibit academic collaboration among various medical colleges of public sector as well as private sector to pull ourselves out of old conventional teaching system and to implement these modern reforms and this should be considered as our supreme national responsibility.