Medical office billing is done using standard medical codes to define diagnoses, procedures, levels of care, etc. It is a vital part of any medical practice and an excellent career choice currently with many new jobs being created in the area.

More than three million new jobs in the field were expected to be created in the decade from 2006, and new jobs are available in this field at a rate greater than the average increase in jobs nationally. Wages are generally good in this field. At the time of writing an average wage would be around $35000 in this field. Billers can work regular hours unlike most other staff of medical businesses, and can sometimes even work from home.

Medical billing and medical coding are closely related and many people train in both subjects. Billing could be considered a sub-area of coding, and is vital for revenue management in the current competitive business world.

Billing is the submission of medical codes from a medical or healthcare facility to the appropriate insurance agencies who in turn pay the medical or healthcare facility. This process is somewhat complex and prone to errors. It was found that a significant percentage of money claimed as part of the Medicare system included errors but this finding was by the company who are paid more if they find more errors, which itself is a practice which is obviously controversial.

One method of reducing errors in medical submissions is to submit via a clearing-house rather than directly. This can also speed up the submission process, but some insurance companies still process claims using a paper-based system which results in major delays as well as additional errors.

Almost all bill submission in this field is done electronically, and the use of specialist software is one of the areas that employees are trained in.

Medical office billing is an important function today, and a good career choice as the percentage of elderly in the population increases.



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The process of medical claim billing involves first converting medical data into standard medical codes which are then submitted as a bill consisting of those codes to the relevant insurance companies who then pay the claim using pre-agreed payments for particular combinations of codes.

The job of medical billing is considered a sub-area of medical coding as the information in the medical bills is sent in the form of these standard medical codes. These professions are great career choices right now due to the rising percentage of elderly people in the populations of western world countries. The number of jobs in these areas is rising significantly faster than the average.

The interaction between the medical billing of claims and the insurance company paying for those claims is not always straightforward or simple. There are often disagreements about how much can be claimed for and other sources of error in the process. Some insurance companies still process claims using a paper-based system instead of doing things electronically, which leads to additional errors as well as considerable delays.

One method of helping get claims processed quickly and effectively is to submit the bills via a clearing house instead of directly. This reduces the amount of errors and speeds up the process.

There is now a company given the task of finding errors in medical claims. Large numbers of errors are found, mostly concerning over payment. The fact that the company involved gets paid according to the amount of money it recovers by correcting errors is controversial for obvious reasons.

Most medical claims are currently submitted electronically, mostly using specialist software. Ability to use this software is one of the areas medical billing employees are trained in.

Medical claim billing is a vital part of any healthcare business, and a good career choice currently.


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The 2003 Health Insurance Portability and Accountability Act (HIPAA) privacy rules mandate the behavior of healthcare providers towards the flow of health information. HIPAA advocates electronic submission of bills, and has been instrumental in bringing about a great change in medical billing practices. Electronic billing enables medical providers to get more returns in less time.

HIPAA compels healthcare providers to improve their administrative processes. An increasing number of medical providers are turning to third party medical billing providers to implement the new standards. Medical billing providers are experts in HIPAA compliance and industry best practices. Hiring a billing service saves medical providers the trouble of learning a new system while reaping the immediate benefits of an improved revenue management cycle.

Advantages of electronic claim filing

Medical billing providers file claims electronically for their clients. There are many advantages to this:

* An online records management system reduces the chances of errors in the forms, radically increasing the collections.
* Filing claims electronically is fast as the interface is data intuitive.
* Managing and tracking electronic claims is easy.
* Electronic claims are processed and paid in less than 21 days. Manual submission and payment of claims takes 90 days on an average.
* Unpaid claims are reduced by almost 60%.
* Filing claims electronically saves cost. The cost of filing a claim electronically is half the cost of paper submission, and the cost of reviewing an electronic claim is one third of the manual process.

All these advantages are making more and more healthcare providers take to electronic submission of claims. More than 75% of the medical claims submitted are electronic.

Medical coding and billing services and HIPAA compliance

HIPAA requires healthcare providers to implement security procedures to meet government regulations and ensure the faith of patients. Medical practitioners should work only with professional medical billing providers who are experts in HIPAA compliance. Before signing up your potential billing partner, ask the following questions:

* What processes are in place to ensure HIPAA compliance?
* Is the billing provider's staff trained in HIPAA compliance?
* Does the staff appreciate the difference HIPAA compliance brings to billing services?
* How is the security of health information assured?
* Which medical billing software does the billing provider use?
* Does the medical billing software incorporate all the critical HIPAA-related requirements?
* Is the billing provider's software compatible with your records management application?
* Does the billing provider offer comprehensive patient records management services?

HIPAA has enforced standardization of billing transactions. While this was initially perceived as a needless time-consuming procedure, HIPAA has helped the medical industry increase revenue by billions of dollars. Administrative efficiency and effective record management systems help healthcare providers reduce time to payments and improve their bottom line dramatically.



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A medical billing course will train the student for employment in the field of medical billing. There are various courses available, both in classrooms and online. Such courses can train a newcomer to the area so that they can get a job in this field, or can offer advanced specialize training for those already in the field or can serve to certify knowledge and skills for someone who is already working in this career.

This career is a good choice as the "baby-boomer" generation is now beginning to retire, thus creating more need for medical and healthcare facilities, and a corresponding need for billing for those facilities. So courses in this subject are popular and widely available. If you are interested in a specific career or in working with a specific medical or healthcare facility, do make sure you check that the certifications delivered by a course will be satisfactory for that particular employment.

This field involves medical and healthcare facilities assessing the value of the services they provide by using standard medical codes, which are derived from data such as patient examinations, doctor's notes, lab results, X-ray data etc. These codes then define the level of service rendered, which then determines the bill which is sent to the insurance company which then remits the money back to the medical or healthcare facility.

However there are various ways in which this procedure can become more complex. One factor is that not all bills are submitted directly from the medical or healthcare facility to the relevant insurance company. The submission can be done via clearing house which can help lessen the degree of errors and rejected claims as well as speeding up the submission process. Specialist software can streamline the process of either direct billing or billing via a clearing house.

Other issues are that sometimes multiple submissions are needed before a claim is approved, and often the insurance company initially only agrees to pay part of what is billed for, so negotiations and re-submissions are often necessary.

A medical billing course will train the student in all such matters, preparing them for employment in this field.



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While you could learn medical billing yourself and possibly obtain employment it is far more common to study classes in the subject either in a classroom setting or online, or maybe a combination of both approaches. Then it is typical to take one of the various recognized qualifications in the field. Some courses make waive any fees until the student passes the relevant qualification, which can make it a no-lose option financially for the student.

There are a variety of different specialist subjects within this field and study courses for all of them, whether the student is a beginner in the field or someone experienced in the practice of medical billing who is looking to get formal qualifications to support their existing experience, skills and knowledge.

Careers in this area are a good choice currently, as the number of positions in this area is increasing faster than the average in the USA, as the population tends more heavily towards the older age-groups. The practice of medical billing is to submit requests for payment from a medical or heath practice, to the relevant insurance companies which make the payments. The process can be complex, with multiple submissions sometimes being necessary, and sometimes long delays as some insurance companies still process the bills on paper.

The aims of the healthcare provider, and the aims of the insurance company are inevitably somewhat in conflict with the former wanting to maximize the money they receive for the work they do, and the latter wanting to minimize the payments they have to make. There is often some degree of negotiation between the two before an agreement is reached.

This job is mostly done using specialist software, which submits the bills either directly or via a clearing-house system. The use of the clearing-house system can reduce errors and rejected claims and speed up the process. The decision to learn medical billing can be a good one in today's increasingly aged society, with readily available training from a variety of suppliers, and an increasing number of employment opportunities.



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