American Medical Billing Association | AMBA - American Medical Billing Association

Time 2020-11-14 12:05:24

Web Name: American Medical Billing Association | AMBA - American Medical Billing Association

WebSite: http://www.ambanet.net

ID:115739

Keywords:

Medical,American,Billing,medicalbilling,medicalcoding,medicalbillingcertificatio

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Learn more about our Certified Medical Reimbursement Specialist certification credential for Physician Office Medical Billers and Medical Billing Professionals. The most comprehensive and most trusted billing exam. FREE Compliance Webinar SeriesAMBA hosts several free webinars throughout the year aimed at providing free CEU credit through AMBA, AAPC and PMI. Register for our next webinar Online Coding SoftwareProfessional Online Coding SoftwareGet your 28 Day Free Trial on AMBACode, our online coding software and resource center. Easy to use, NCDs, LCDs, Billing Guidelines and much more!Medical billingis a payment process within theUnited Stateshealthcare system that is used by doctors and other healthcare providers and insurers to get insurance claims paid. This process involves a medical biller submitting claims, following up on unpaid claims and appealing improper denials withhealth insurancecompanies in order to receive payment for services rendered. Medical billers facilitate the claims paying process and are often viewed as an extension of the doctor's office reimbursement process. Medical billers can work in a doctor's office or in an independent third party billing company. Medical billers are encouraged, but not required by law, to become certified by taking an certification exam, such as the CMRS Exam (Certified Medical Reimbursement Specialist) in which billers demonstrate proficiency in the medical billing process. Employers often require billing certification. HistoryFor several decades, medical billing claims were submitted almost entirely on paper and many of the processes utilized in doctor's and medical billing offices were manually performed. However, with technologically advanced improvements of medical practice management software systems, standardized electronic transactions, EDI, clearinghouses and payer portals, managing the payment process has become much more efficient. Additionally, when Congress mandated that doctors must submit electronic claims in order to be paid in October, 2003 under the Administrative Simplification Compliance Act, it created significant new opportunities for medical billers, software developers, clearinghouses and ancillary services related to the claims process. Physicians and independent third party medical billing companies have a lot more options to help them get claims paid more efficiently and in significantly much less time. Medical Billing ServicesIn many cases, particularly as a practice grows, doctors and other healthcare providers outsource their medical billing to a third party known as a medical billing company. The main goal is to get claims paid with the least amount of resources and at the least amount of cost. Getting claims paid requires a significant amount of time and and continual education. It's a big investment of resources because every payer has their own rules and nuances and it is hard for the staff in a busy medical practice to keep up with the daily changes as well as to follow up on unpaid claims. One of the biggest investments for practices is their billing software. An outsourced medical billing company can significantly reduce a practice's overhead and direct expenses on things like the cost of continual education, computers and billing software, employee expenses and etc. Medical billers are experienced in getting claims paid quickly, so it makes good business sense for practices to outsource their billing to a medical billing company. Related services medical billers offer include compliance, training, credentialing, working on old unpaid claims and more.Medical Billing EarningsAccording to the U.S. Bureau of Labor Statistics, employment prospects for medical insurance billers and health information technicians in the medical billing industry are projected to grow 22 percent from 2012 to 2022, which is a much faster pace than the average for all occupations. The median pay was $34,160 for an insurance specialist in 2012. What is a medical coder?The healthcare reimbursement system, used by doctors and insurers to obtain reimbursement uses specialized code sets to identify services, procedures, diagnoses and conditions for healthcare services based on official, universal classifications. Services and procedures are identified using CPT and HCPCS codes while diagnoses are identified using ICD-10 codes. Medical coders utilize information contained in a patient's medical record (documentation, chart notes, lab and x-ray reports, nurse notes, etc.) to identify the services and treatment rendered by a medical doctor or other healthcare provider. That information is related by assigning the proper procedure and diagnosis code(s) used to bill an insurer for reimbursement. These medical codes explain a patient's encounter with a healthcare provider in a universal language that both doctors and insurers understand. There are thousands of code possibilities, so it is important that the correct code is assigned to be billed. Improper coding causes claims to be denied and requires resubmission, which also costs practices time and money. Improper coding assigned to a patient record can also create unnecessary and costly burdens for patients to get the information corrected in their medical records. Medical coders typically work for larger medical practices and facilities, although busy practices may also employ certified coders. Medical billing and medical coding, although related, are two separate jobs. A medical coder is not necessarily proficient in medical billing and billers are often not proficient in medical coding. Certification in medical coding is important as most employers require a coding credential for employment. Compliance with fraud and abuse detection and prevention is part of the education and training for billing and coding. Auditing medical records is often performed by a certified coder or certified medical coding auditor. Medical Coder EarningsCertified coders are in great demand. The average annual salary of a medical coder is $39,180, according to the U.S. Bureau of Labor Statistics.

TAGS:Medical American Billing medicalbilling medicalcoding medicalbillingcertificatio

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American Medical Billing Association, AMBA, is a professional association for medical billers and coders.

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