Today it seems that everyone is a specialist. Once, only physicians had specialties, and they signified advanced post-graduate training in a specific medical discipline. Now, everyone from any profession claims to be a specialist in what they do. So why not medical billing companies? Well, they are. And they do.
The American Academy of Professional Coders notes that currently more than 100,000 persons have certifications that the AAPC awards, some more than one, and these are recognized by the medical field across the country. They include, among others, compliance, practice management, billing, auditing, instructor certification, and medical coding.
Certified medical billers hired by medical billing companies today ensure the honesty of their work and their understanding of the financial challenges their clients face. In fact, the financial performance of a medical billing company depends heavily on the aptitude of its medical billers. They are the ones who track the claims they file on behalf of their clients and ensure these claims are paid to the maximum amount allowed under the contract.
In these times of lower, and lowering, reimbursements to physicians, it pays for your medical billers to have a deep understanding of how the insurance process works including insurance regulations, the claims filing process, insurance reimbursement rates, claim denials, the appeal process, and how to work these variables to achieve maximum revenues for their clients. And of course, anything these medical billers can do to shorten their clients’ revenue cycles will be greatly appreciated.
Medical billers who hold a certification show that they have studied and mastered such basics as charge entry, claims transmission, posting of payments, follow up with insurance companies and patients, and managing overdue collections. When it comes to choosing a medical billing company for your office, you will want to be sure that its billers have both a certification and work experience because they will be integral in achieving successful reimbursements for you.
Certified billers will also possess experience working with various types of medical insurance in the marketplace today, what each of them covers, an understanding of how ICD-10 codes work, the different kinds of insurance plans available and what medical services they cover, HIPPA regulations, fraudulent claims, fairness in handling overdue collections, and working effectively with patients on denied claims.
To obtain the certification, candidates take a six hour monitored exam covering insurance types, regulations, compliance with the HIPPA rule, collections, reimbursement, medical coding, medical billing, and case analysis. The new medical coding requirements known as ICD-10 are tested separately in a different exam, to see that medical billers are adept at using the new standards.
All things considered, it is no wonder that medical billing companies today need more and more certified medical billers. The industry is changing too fast and the rules and regulations are many. Aren’t these individuals the ones you want working for you?