What a Billing and Coding Certification Actually Means
As hospitals struggle to deal with rising healthcare costs and benefit cutbacks, many seek to streamline administrative processes. As a billing and coding specialist, you can help hospitals save money and stay in business, but only if you have the proper certification.
Basics of Billing and Coding
Billing and coding is the process by which hospitals assess the cost of medical procedures, figure out who is responsible for paying those costs, and makes sure that the responsible party pays them. Hospitals rely on accurate billing and coding to bring in sufficient revenue to keep running. Without it, patients and insurers who didn’t understand their liabilities or disputed those liabilities with each other would not pay. Since most healthcare providers and technicians are not trained in billing methods, hospitals usually rely on billing and coding specialists to obtain necessary revenue. These specialists’ responsibilities include:
- Looking through patients’ medical records to ensure all of the data are accurate
- Keeping track of patient outcomes
- Organizing hospital information into databases
- Assigning codes for analysis and payment
- Recording, storing, and analyzing hospital and patient data
- Developing security procedures to safeguard confidential information
Competent billing and coding specialists can save hospitals thousands of dollars in recovered revenues, increased efficiency, and reduced legal liabilities. They can also improve the overall quality of patient care, as the clearer the patients’ financial abilities and responsibilities are, the easier it is for doctors to find cost-effective solutions to their health problems. Hospitals won’t trust just anyone to handle sensitive patient data, and most of them only hire specialists who have professional billing and coding certification. The most common nationally-recognized billing and coding certification programs include:
Billing and Coding Specialist (CBCS)
This certification assesses your ability to accurately claim and obtain reimbursements for patient care. To gain this certification, you must be able to:
- Find all documentation related to a patient care
- Designate codes for different healthcare procedures and diagnoses
- File accurate reimbursement claims to patients, insurers, and all other parties
Electronic Health Record Specialist (CEHRS)
This certification designates specialists who can keep confidential information safe, guarding patients’ identities and protecting hospitals from potential lawsuits. Required skills include:
- Making sure patient records are complete and collecting missing information
- Assigning codes for reimbursement claims
- Auditing patient records to ensure they comply with all related regulations and laws
- Including patient information in quality improvement reports
- Processing requests to release medical records
Medical Administrative Assistant (CMAA)
Specialists with this certification have the training to manage and streamline a medical office. They can reduce wait times and keep everyone up to date on clinical information. Their skills include:
- Collecting and preparing reports on clinical attendance, time use, and other operational issues
- Updating patient information
- Providing customer service
- Scheduling appointments and reminding caregivers and patients of them
- Using computers and other office equipment
- Encouraging correspondence between different caregivers and technicians
Microsoft Office Specialist Word (MOS Word)
Though valuable in a wide range of fields, MOS Word certification is particularly important in the medical field, as it allows you to get the most out of hospital software. The MOS Word exam is highly practical, requiring you to complete a project in Word in a limited amount of time. To pass this exam, you must master:
- Creating, formatting, and managing documents
- Including objects in word documents
- Creating lists and tables
- Formatting pages, sections, and paragraphs
To prepare for billing and coding certification exams and pass with flying colors, look for a training program that will provide expert guidance and hands-on experience with hospital billing procedures. Contact SCI today to learn more about training courses in billing and coding.
