Complete Guide to Medical Billing and Coding Online Schools
The healthcare field is one of the fastest-growing industries in the United States, and it takes all kinds of professionals to keep healthcare organizations functioning properly. Although medical coding and billing specialists are required to spend a relatively short amount of time on formal education and training, they play a very important role in the management of clinical billing procedures. Medical billing and coding programs are available at the associate and certificate level.
While attending accredited medical billing and coding program isn't required to earn professional certification, it is highly recommended. Students who enroll in a medical billing and coding program at an accredited school can feel confident that they are receiving an education from an institution that meets criteria established by the US Department of Education. The Council for Higher Education Accreditation and the Accrediting Commission of Career Schools and Colleges both offer searchable databases of accredited programs and institutions.
Certificates take about one year to complete and include courses in popular coding systems, medical software, medical terminology, and insurance and reimbursement. Students learn how to translate medical diagnoses into codes that can be used for medical payments. The associate degree takes two years to complete and includes the courses required during the certificate program, as well as general education and healthcare courses. Graduates of these programs can become medical coders and health information technicians.
Medical coding and billing specialists gather and process patient information, including medical history, examination results, symptoms, diagnostic tests, treatment history, and more. Once they obtain this history, medical coders are then responsible for ensuring the accuracy and patient confidentiality of these files as they present them to healthcare providers or insurance agencies. he main responsibility of medical coders is to create claims that match diagnoses, treatments, and procedures with the corresponding numeric codes. This information is entered into a database and then sent off to an insurance carrier, where it will be approved or denied. If all of the documentation is accurate, the claim will be approved, and the healthcare provider will be reimbursed. In the case that the claim is denied, the medical coder assumes the additional responsibility of investigating why the claim was rejected and making any updates to the claim.
Comprehensive List of Online Colleges & Universities for a Medical Billing & Coding Degree
Associate degrees in medical billing and coding prepare students for careers in the health information technology sector. Students develop techniques for efficiently collecting, maintaining, retrieving, and analyzing patient health information data. Core areas covered during training include basic medical knowledge, data management, and information technology. An applicant to an associate degree programs in this field should hold a high school diploma, GED, or equivalent, and have acceptable grades in communication, mathematics, and sciences. Most associate degree programs require completion of 60 credits over the course of two years.
Throughout the associate program, students will learn to develop theoretical knowledge in the field and build practical skills through laboratory instruction. Coursework consists of general education courses and field-specific courses in anatomy and physiology, coding, computerized accounting, insurance reimbursement, medical terminology, legal issues, and pharmacology. Students also learn about credit and collections, healthcare quality improvement techniques, integrated medical office software, office procedures, and records systems management. Students learn how to properly complete and file medical billing forms, and they also learn how to perform third-party reimbursement.
Programs usually incorporate an internship component or practicum, which allows students to cement their practical skills. The practicum also enhances employment prospects by demonstrating candidates' professional skills to potential employers. Some associate programs also include a certification option, which is required by some employers. Following completion of the degree, students will be able to interact with insurance claims, providers, and insured patients and will know how to spot potential medical fraud and complications with collection.
Medical billing and coding online schools offer certificate and diploma courses which explore the systems and programs used in medical billing and instruct students on the different fields and varieties of medical billing. Students interested in applying to a certification program typically must have a high school diploma or GED. The school may request official transcripts and general college exam scores as part of the application process. Most certificate programs can be completed in nine months to one year.
Graduates from accredited medical billing and coding certificate programs will be prepared for entry-level positions as a medical billing clerk or specialist, a medical coder, or an insurance claims analyst at doctors' offices, clinics, or insurance companies. Some medical billers and coders choose to work as independent contractors and provide services from their home.
Medical billing and coding programs cover areas such as clinical classification systems, coding practices, data security, computerized patient record systems, health data management, health services organization and delivery, healthcare confidentiality and privacy, information technology and systems, legal and ethical issues in healthcare, quality management procedures, reimbursement methodologies, risk management, and statistical software. Courses will likely include physician-based medical coding, hospital-based medical coding, medical billing and software, medical terminology, and physician-based chart auditing. Other courses in the program may include hospital case studies, classification of diseases, healthcare data quality and management, healthcare reimbursement, and healthcare information management and supervision.
Professional experience is an essential component of the training required to become a medical billing and coding specialist. Depending on the program selected, some certificate completion requirements may include a practicum or internship to reinforce instruction. Through their internships, students are able to build vital skill sets for practice, which also enhances their employment prospects.
Medical coding & billing careers often appeal to those individuals who do not have the time, finances, or desire to pursue bachelor's degrees, as the requirements for admission to a certificate or associate degree program are minimal. Most programs require only a high school diploma or GED to be accepted. Basic keyboarding and word-processing skills, familiarity with technology, and a knack for details are also valuable skills for beginning medical coders. Students can complete their entire education online or at a community college, often on a part-time basis, in two years or less. Specialized professional schools often offer these degrees or training programs and can provide assistance to students who seek internship opportunities or career placement after graduation.
Medical coding & billing programs are characteristically hands-on and practical. Unlike bachelor's degree programs, core classes in mathematics, general sciences, and English are usually not required. Some associate degree programs may mandate on composition course, but in most cases, a student's course load will be specifically geared toward medical coding and billing. Students will take technology classes that help them learn to navigate electronic health record programs correctly. Some programs may also offer classes that deal in paper records, though this is far less common today. Medical billing and coding students develop a comprehensive understanding of healthcare information management systems and health informatics applications.
Basic courses in anatomy and physiology provide medical billing and coding students with a solid introduction to the medical field and help familiarize them with many of the terms they'll eventually come to know very well. Among the most essential classes students will take are those related to medical terminology and billing. Once students learn the medical codes associated with various services and treatments, they may use software to determine how much a patient or insurance company should be billed. There are several coding systems that students must learn, including those used for cancer, ambulatory calls, or long-term patient care. Students learn how to utilize diverse technologies to capture, analyze, store, and retrieve medical data, and they must be able to work efficiently with these systems while also maintaining the confidentiality of their patients' records.
The US Department of Education recognizes several private, nongovernmental accreditation agencies as having the authority to evaluate the academic merit of colleges and universities, including those that offer medical and billing programs. When researching online certificate and associate degree programs, it would be wise to narrow down your options by selecting programs offered at accredited institutions. Accreditation signifies that a school meets high academic standards, maintains current research, and hires highly qualified instructors to teach its courses.
The Council on Higher Education Accreditation is a nationally recognized association of accrediting agencies, and their database of accredited colleges and universities is available on their website. The Accrediting Commission of Career Schools is also recognized by the USDE and specializes in accrediting schools whose primary focus is occupational or career-oriented diploma and degree programs. They, too, offer a database of accredited institutions.
Though certification isn't legally required for medical coders in most states, it is highly recommended. An official certification designation on your resume can increase your job prospects and show potential employers that you are committed to the profession. The American Academy of Professional Coders (AAPC) reports that compared to noncertified coders, Certified Professional Coders (CPC) earn an average of 20 percent more and have a greater chance of being hired.
AAPC offers three certifications for medical billing and coding specialists: Certified Professional Coder (CPC), Certified Professional Coder - Hospital Outpatient (CPC-H), and Certified Professional Coder - Payer (CPC-P). Additional credentials are also available for medical billers and coders to demonstrate superior knowledge in specialized areas such as cardiology, dermatology, pediatrics, emergency department, and internal medicine billing and coding. The requirements to sit for the CPC exams include current AAPC membership, two years of experience working as a medical billing and coding specialist, and 36 hours of continuing education units every two years to maintain the certification. An associate degree is not required, but it is recommended.
The Board of Medical Specialty Coding and Compliance offers a certification for Specialty Coding Professionals (SCP) with at least two years of specialty coding experience and Advanced Coding Specialists (ACS) with at least three to five years of specialty coding experience. To maintain either of these certifications, specialists must complete 20 continuing education units each year.
The Professional Association of Healthcare Coding Specialists (PAHCS) offers a Certified Basic Medical Coding Specialist (CBMCS) certification and specialty certification in many areas, such as pain management, podiatry, family practice, and obstetrics and gynecology. PAHCS does not require applicants to complete an academic program before they take the certification exam, but 24 continuing education units are required every two years to maintain certification.
The American Health Information Management Association currently has two certification options, and each of them is accredited by the National Commission for Certifying Agencies. The Certified Coding Associate (CCA) credential is offered for coding professionals who have experience working in both hospital and physician offices, and applicants must have a high school diploma. The Certified Coding Specialist - Physician-based (CCS-P) credential is for coding professionals who have more experience specifically in outpatient clinics rather than hospitals. The CCS-P certification requires candidates to have either a prior credential, an in-depth coding education, two years of work experience, or a combination of one year of work experience and a prior certification. To maintain certification, AHIMA requires certificate holders to complete 20 continuing education units every two years.
- Accrediting Commission of Career Schools and Colleges. Accessed June 5, 2014. http://www.accsc.org.
- American Academy of Professional Coders. Accessed June 5, 2014. http://www.aapc.com.
- American Health Information Management Association. Accessed June 5, 2014. http://www.ahima.org.
- Certification. PAHCS. Accessed June 5, 2014. http://www.pahcs.org/content/certification.
- Certifications. Board of Medical Specialty Coding and Compliance. Accessed June 5, 2014. http://www.medicalspecialtycoding.com/certifications.aspx.
- Council for Higher Education Accreditation. Accessed June 5, 2014. http://www.chea.org/search/default.asp.
- Occupational Outlook Handbook. Bureau of Labor Statistics of the US Department of Labor. Accessed June 4, 2014. http://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm.
- US Department of Education. Accessed June 5, 2014. http://ope.ed.gov/accreditation.
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