On February 16, 2006 the Health Insurance Portability and Accountability Act –HIPAA, was finalized, and enacted. This law is designed to establish national standards for all health care transactions, and to ensure the security and privacy of all health related information. The motivation behind this law is to improve the performance, and efficiency of our health care system.

This type of reform has created a need for qualified individuals who can assure full compliance, and maximum reimbursement. It would  be a prudent move for health care facilities to employ such individuals in order to avoid mistakes that could have dire consequences.

The proliferation of medical knowledge following World War II brought about an explosion of diagnostic, and treatment procedures. As a result, there became a need to organize, and standardize all these developing technologies. Here is where the foundations of medical coding were born. Medical coding met these challenges, and allowed for a more uniform way of communicating health information under a common language.

By January 1979, standardized definitions, and codes were adopted, and used by health care providers, and insurance companies. Since improvements and refinements of medical procedures are constantly being developed, codes must be added and updated to reflect these changes. Today, the number of medical and surgical procedures have become enormous, so too have the codes to describe them. These overwhelming numbers of codes and protocols have made outsourcing medical billing the standard.

Medical Billing and related occupations continue to be the fastest growing opportunities in health care. Insurance institutions and government agencies are investing huge resources to control claims’ fraud, abuse, and establish some degree of reimbursement parity.

As a result, more insurance companies, and health care facilities are looking to medical billing experts for help. These companies and practices are looking for experienced and educated medical billing and coding specialists since the legal consequences of incorrect billing could be devastating. There is a movement in the industry to make medical billing experts responsible for inaccuracies, much they way accountants are for tax returns.

At present, there are only a few standards for educational requirements for medical billing and coding. However, more employers are looking for some formal training at an accredited career training institution. These medical billing and coding schools range in training time from nine months to two years, anything less would not be considered adequate. Medical billing and coding training takes place either in a traditional classroom but may also take place in medical billing courses online.

There is a move for certification, and several organizations are sponsoring medical coding certification examinations in medical billing and coding. Medical billers and coders earn as much as $10 to $12 per hour in the beginning, and could potentially realize $30 to $40 per hours with experience and additional responsibilities.

Today, evolutions in the health care industry are happening at a very high pace. It is only with the assistance of sophisticated computer programs, and standardized coding procedures that medical coders are now able to describe and characterize the tremendous number and various kinds of medical and surgical procedures. These realities coupled with government regulations, and health insurance guidelines have contributed to the strong demand for experienced medical coders and billing specialists.

 

Brief History of Medical Billing and Coding

According to a survey done during 2011, despite the tough economic climate, medical billing and coding salaries for skilled coders are climbing and those who have invested in themselves with further education and professional development can get even more.

Particularly with health reforms and electronic health records (EHRs) coming in as well as the upgrading of ICD-9 codes to ICD-10, coders can work in a variety of careers including coding and billing, auditing, management, compliance, charge entry, educator, consultant, and claims adjudicator. They can also work in a variety of specialities such as family practice, emergency medicine, internal medicine, obstetrics/gynecology general surgery, or a combination of all of the above. The survey showed 62% work as doctor-based coders, while 10% work as hospital coders and 16% do both.

Even with the national employment rates hovering around 9-10%, coders were far less likely to be unemployed and those who were among the unemployed, according to the survey, 75% were new to the industry and looking for their first job in coding.

Now the key question – how much can I earn?

Certification Pays

This survey showed that coders tend to be better educated than most Americans, 88% of those who responded had spent some time at college, with 50%+ having a degree or technical training. And, there was a $10,000/yr. difference in earnings between those with only a high school diploma and those having a bachelor’s degree. Benefits were also considerably better.

According to the 2011 survey, the average salary for a CPC (Certified Professional Coder) was $46,800 and over half said they made more than $40,000/year, even those without the professional coder certification (CPC).

However over half said that the certification (CPC) was required for their position, but only about 25% of those responding actually held any higher certification.

Coders who held both CPC and CPC-H (Certified Professional Coder-Hospital Outpatient) earned more than $54.700 per year and those who had a CPC-I (Certified Professional Coder-Instructor) earned $76,000+ per year.

Salaries (Averages) Vary by Region 2011

Region – Pacific $53,334
States within region – Alaska, Washington, Oregon, California, Hawaii

Region – Mountain $44,330
States within region – Montana, Idaho, Wyoming, Colorado, Nevada, Utah, Arizona, New Mexico,

Region – West North Central $41,848
States within region – North Dakota, South Dakota, Minnesota, Iowa, Nebraska, Kansas, Missouri,

Region – West South Central $43,919
States within region – Texas, Oklahoma, Arkansas, Louisiana,

Region – East North Central $42,434
States within region – Wisconsin, Michigan, Illinois, Indiana, Ohio

Region – East South Central $39,830
States within region – Kentucky, Tennessee, Mississippi, Alabama

Region – Mid Atlantic $47,508
States within region – New York, New Jersey, Delaware

Region – South Atlantic $43,906
States within region – West Virginia, Maryland, Virginia, N. Carolina, S. Carolina, Georgia, Florida

Region – New England $47,852
States within region – Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island

Medical Billing and Coding From Home – Freelance or as a Full Time Business? Can you do medical billing and coding from your home? Realistically many home businesses are in medical billing and medical coding with many new companies growing up overnight. There are still not enough professional medical billing and medical coding specialists to go around.The medical billing and medical coding salary is quite lucrative and the work is typically done in an office.

Currently there is a national shortage in all healthcare facilities of certified professionals doing medical coding and billing, as a consequence, this field is expected to grow faster than many others.

Health reforms and electronic health records (EHRs) are coming in, as well as the upgrading of ICD-9 codes to ICD-10 which means there will be an even greater demand for people to fill medical billing jobs.

This may be a very good time to establish your own medical billing and coding business from home. You will, however, have to do some research to discover:
• What medical coding and billing solutions you could offer.
• What licenses and documentation you need to start a business.
• Who in your area needs your services – healthcare providers, private clinics, hospitals, insurance companies, claims adjusters, etc.?
• Are they already outsourcing the task or could they be encouraged to do so?
• How much competition is there already?
• How much would it cost to set up such a business – for equipment, medical billing software, marketing, etc.?

The flexibility and remuneration are two very good reasons for considering starting your own business.

 

Medical Billing and Coding from Home?

Whichever program of study, school or online course you choose, check with the AAPC (American Academy of Professional Coders) and the AHIMA (American Health Information Management Association) to find out if the school or course is accredited. In this field, accreditation is very important.

Both of these organizations also provide standards, training, ongoing education, certification, job opportunities and professional networking

Designed for motivated learners without easy access to classroom college course, the AHIMA offers an online, self-paced, 12-course program of Coding Basics, which will help teach the skills necessary to become a coding professional. The program includes comprehensive training on inpatient and outpatient coding, as well as the necessary background courses in medical terminology, disease process and the contents of health records.

Students taking the AHIMA Coding Basic, and following the recommended pace, can get their fundamentals in approx.1 year and 3 months. However, each of the 12 basic coding classes can be purchased individually for those who wish to do the program at a slower pace.

The AHIMA review guides and online preparation courses can also help to prepare people for their certification exams.

 

Choosing Accredited Medical Billing and Coding Training