Before you enroll in a medical billing and coding training program, it doesn’t hurt to get a sense of what these programs offer as well as require. There are no set educational requirements for medical billing and coding professionals other than a high school diploma, but there are general expectations and areas that are usually covered in a decent program. Here are some of the basics that such a program should include.
Thorough and comprehensive coverage of coding systems and terminology - Coding systems are the basic means by which information on health records is transferred, so it should be covered completely in any billing/coding type program. Codes like ICD-9-CM and CPT/ HCPCS are the basics, so they are the bare minimum. But other systems such as DSM-IV psychiatric codes and the International Classification of Procedures in Medicine (ICPM) should at least be touched on. If they are included in the curriculum that’s a good sign that it’s fairly comprehensive. In addition, pharmaceutical codes and anatomical terminology should be covered.
Medical Billing Software – There are dozens of medical billing programs at all different levels of cost and capability. And they are updated and imporved quickly like most everything else in the world of computer software (and hardware as a matter of fact). A good medical coding/billing prorgram should offer not only general information in this area but practical instruction in how to actually use current programs.
Familiarization with medical document types - There are many types of medical documents that you need to be intimately familiar with if you’re trying to be a medical coder/biller. These should all be covered and you should get practice in filling them out.
Office Procedures – These would include writing reports, data entry, submitting paper as well as online claims, posting payments, and editing documents. These are essential office skills in the medical billing/coding business.
Overview of the insurance claim process - There needs to be a good thorough coverage of the entire process of submitting a claim from the transcription phase in the office or outsourced service through the entering and submission of claims and collecting payments.
Business Operations - Whether you choose to go into business as a biller yourself or will just be working in an actual or remote office, you need to understand the business side of this field. This includes how marketing is done, ways to maximize profits, business structures, writing business plans and so on.
A background in anatomy and physiology - It doesn’t hurt for a program to at least touch on more than just the “office” side of the medical industry. Having a cursory knowledge of anatomy and some general areas of physiological and general medical practice is helpful in this field, so look for programs that don’t skip over this. Few programs will go into this very deeply, since you’re not studying to be a doctor, but they should at least introduce you to it. For instance, you will be dealing with anatomical terms on medical charts and records, so something deeper than just name recognition can help to clarify things.
It should be noted that here we’re basically talking here about diploma and basic associates degree programs. Associates programs are usually 2 years and will go more in depth concerning these main areas. But 4 year (i.e. Bachelors degree programs) will cover more – often going deeply into a variety of topics about the field of medical information and business techniques and technologies as a whole. The above areas are the essentials required for your basic medical billing/coding professional, so try to make sure the medical billing and coding training that you consider does include them, and the more in depth, the better.