You can put your medical billing education to work in a different way - consider a career in debt collection. Medical billing collections have become a vital part of health care offices nationwide. With over 47 million American uninsured and countless others underinsured, there is a need for qualified medical billers to help re-coup outstanding bills.

You may not know that your medical billing courses and related experience prepare you to undertake a career in medical collections. Your knowledge of the medical billing process, practice dealing with insurance carriers, understanding of Medicare, Medicaid and Blue Shield, and compliance with HIPAA guidelines put you in a unique position to succeed in this career

You'll bring an exclusive understanding to a medical billing collections career- something that will make you more effective and efficient. You'll be prepared to address any billing questions or concerns of the patients and bring a more effectual approach to collecting outstanding balances. Additionally, you can effectively deal with delayed payments due to misfiled claims and billing errors.

As a medical billing collections professional, you can choose to build your career in an office for a doctor or health care provider, or you can work in a third-party collection agency. Whatever you choose, you must always practice decorum when interacting with patients. Doctors and health care providers pride themselves on good client relationships - you can help foster these relationships by handling delicate billing matters with patience and understanding.

Medical billing collectors are often the solution to recovering outstanding debts. It's a necessary part of doing business. Doctor's offices and health care providers need these professionals to stay on top of outstanding balances and address billing errors. Having one person dedicated to these efforts can free up other employees to perform necessary medical tasks - also it is helpful for one devoted professional to act as the go-between for billing issues.

With a slowing economy and rising unemployment, health care providers, hospitals and clinics are experiencing a shortage of income from people unable to pay their medical bills. As people continue to get sick and can't pay the costs of medications, hospitalization, as well as preventative care, many health care providers and facilities will seek the help of a medical billing collector.

Apply the knowledge learned from your training to a career in a doctor's office, health care facility or third-party agency. Your insight into the medical field and related practices will provide the gateway to a successful career in the medical field. There's no reason medical debts can't be effectively managed - it just takes someone familiar with the billing process. That someone can be you.




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What is ICD-10-CM and ICD-10-PCS? ICD-10-CM is the new US clinical modification standard of the International Classification of Disease ICD-10. It will replace the current ICD-9-CM by October 1, 2013. ICD-10-CM is maintained by NCHS (National Center for Health Statistics). It includes the level of detail needed for disease classification and diagnostic specification in the United States. It consists of more than 68,000 diagnosis codes while ICD-9-CM has a little more than 13,000 diagnosis codes.

ICD-10-PCS is the new US procedural coding system developed under the direction of CMS ( Medicare & Medicaid Services). It is more detailed than the short volume of procedure codes in ICD-9-CM. It consists of 87,000 procedure codes while ICD-9 CPT has 17,000 codes. It will too replace the current ICD-9-CM procedure coding by January 1, 2012 for inpatient procedures.

What are the differences between ICD-10-CM and ICD-9-CM?

ICD-9-CM: 3-5 characters; first character is numeric or alpha; characters 2-5 are numeric; always at least 3 characters; use of decimal after 3 characters; lacks sufficient capacity; no longer reflect current knowledge of disease and latest medical terminologies.

- ICD-10-CM: 3-7 characters; first character is alpha; characters 2-7 are alpha or numeric; always at least 3 characters; use of decimal after 3 characters; has the capacity for new diseases like SARS and WNV; it will have the capacity to include current and future knowledge of disease and medical terminologies; offers greatest coding accuracy and specificity; ICD-10 codes are broken down into chapters and sub chapters, disease are grouped be letters.

Will ICD-10-CM and ICD-10-PCS affect physician Office billing?
Providers in all healthcare settings will use ICD-10-CM diagnosis codes for reporting, payment, and other purposes. ICD-10-PCS wil be used only for inpatients billing by hospitals. Physicians will continue to use Current Procedural Terminology (CPT-4) and Healthcare Common Procedure Coding System (HCPC) to bill for their services.

Does ICD-10 lend itself to the use of Electronic Medical Record?
Yes, ICD-10-CM and PCS are better suited for use in EMRs because they permit a better mapping from SNOMED-CT the clinical reference terminology and more suited to computer-assisted coding.

How long would it take coders and healthcare providers to learn the ICD-10?
Various studies have suggested that coders and healthcare providers will have a level of proficiency within 6 months of using the new coding system.

Are mapping available between ICD-9-CM and ICD-10-CM?
Yes, for a more detailed mapping visit http://www.cdc.gov/nchs/about/otheract/icd9/icd10cm.htm.
Where can I find more information about ICD-10-CM and ICD-10-PCS?
o For ICD-10-CM visit NCHS website at "http://www.cdc.gov/nchs/about/otheract/icd9/icd10cm.htm.
o ICD-10-PCS information can be found on the CMS website.
o For more ICD-10 resources visit AHIMA Web site.

Where can I find information about estimated costs to my practice for transitioning to ICD-10-CM? A study done by Nachimson Advisors titled "The Impact of Implementing ICD-10 on Physician Practices and Clinical Laboratories" has detailed cost estimates of transitioning to the new coding system.



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Finding the right medical insurance for yourself can be a daunting and complex task. Every insurance company has different models and unique features. In order to get the best coverage for the best value, you need to assess your current situation and know the jargon of the industry. It will also help to understand what the plans truly offers.

Health plan documents are full of technical jargon, but you don't have to be intimidated. Here are some helpful definitions you might see:

Cap: This is the maximum amount of the insurance company will pay over a lifetime.

Claim form: In order to receive payment for services rendered, you or your health care provider must complete this form and send it to the insurance company.

Coinsurance: This is the percentage of the health care bill you have to pay after the deductible.

Co-payment: This is an out of pocket charge for a visit to the doctor or hospital.

Covered expenses: These expenses will be paid for by the insurance company. Remember, not all expenses are covered by the health plan.

Customary fee: This is the amount the health care provider charges for a service. It can also be called a usual and customary fee.

Deductible: This is an expense that you need to pay before the insurance plan begins paying.

Exclusion: Services that are not covered by the insurance company.

In Network: In order to avoid higher costs you can choose from a list of health providers selected by your insurance company.

Maximum out of pocket expenses: This is the most you will ever have to pay during one year of deductibles and coinsurance.

Out of network: These are licensed health care providers who are not on the in network list.

Premium: This is the annual cost of the insurance coverage.


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Doctors and other health care professionals are hard-pressed for time when they have to take good care of their patients as well as conform to the legalities of the medical system. So many administrative tasks like medical billing and insurance claims handling can draw focus away from their main line of expertise. Instead of practicing medicine and saving precious lives, doctors could be forced to chase down payments and submit claims if the proper administrative infrastructure is not in place. Erroneous data entry, delayed claims and a host of other unforeseen contingencies can considerably sap a health care professional's money, time and energy. With the need to adhere to legal requirements in medical practice, doctors are burdened more than ever before with formalities that are totally unrelated to their profession.

One of the most efficient solutions to this issue is to outsource most of the administrative work to professionals who specialize in this area. Right from carefully entering patient records to handling all the legal issues related to insurance claims, every step of the process is efficiently handled by these professional services. Conforming to the Health Insurance Portability and Accountability Act or HIPAA is another important reason why health care professionals need to outsource these administrative tasks. Maintaining the confidentiality of patient records is a highly technical and resource intensive task. And since failure to comply with the HIPAA could mean loss of accreditation or reputation and the possibility of financial penalties, it is of utmost importance for doctors to leave the responsibility of handling patient records with people who know how to do the job efficiently.

Medical billing service providers utilize highly efficient software to enter patients' medical data as precisely as possible. Error free records get processed much faster which minimizes the risk of claims being denied. This results in faster and better payments for doctors. All changes in legal requirements are immediately incorporated into the software by service providers, thus relieving doctors from the headache of restructuring their systems every time there is a change made in the law.



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