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Position of a biller/coder in a physician's office or hospital business office - Research Paper Example

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Position of a Biller/Coder in a Physician’s Office or Hospital Business Office Introduction It is important for billing and coding professionals to acquire an understanding of the billing, coding and reimbursement guidelines and procedures. They are also required to ensure that proper reimbursement is maintained…
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Position of a biller/coder in a physicians office or hospital business office
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Download file to see previous pages Having worked as a coder in the hospital’s business office, I have acquired a broader experience in billing and coding. The various procedures and guidelines are, however, bound to be frequently reviewed due to the changing insurance policies. My main responsibility as a coder in the hospital’s business is to assign codes to the medical services and procedures, which are later used in the billing process. Being a new employee, one’s main duties include examining the medical charts and records of the patients, and then assigning codes to the products and services offered to the patients. It is important for one to keep in mind that accuracy is highly required in this field, as simple errors could result to severe effects; hence, one is required to ensure that the codes assigned to the various treatments are as correct as possible (Wanda, 2008). One is also required to cooperatively work with the physicians and other professionals to ensure accuracy of the patients’ charts (Richards, 2009). Additionally one’s computer skills are essential in this field as the job includes interacting with different coding software. The coding and billing process begins when a patient reports to the hospital for diagnosis for a certain condition, disease or injury. The coder is required to obtain the patient’s demographic and insurance information. The insurance information is essential in determining how payment for the treatment will be made. In other cases, the patients could be self sponsored or sponsored by some government programs. After these details have been obtained from the patient, they are registered into the hospital’s information systems. The physician then specifies the treatment and care services that the patient requires, and they are recorded on the patient’s account (Wanda, 2008). After treatment has been administered on the patient, the different charges are posted to the patient’s account by the various departments. When the patient is leaving the hospital, all the information is gathered from their account for billing. The process of billing also involves the submission of the patient’s bill to the third party payer, such as insurance firms or the government programs, so as to get the reimbursement. In summary, a coder’s main responsibilities includes registering the patients using their details as specified, posting the details and charges to the patient’s account, reviewing the charts, preparing claim forms, submitting the forms and following up for the payment of the outstanding accounts (Richards, 2009). One is also required to fill a medical claim that is later submitted to the third party payer of the hospital bill. The coder must ensure that the information filled in the claim form has no errors. The information required on the claim form includes the patient’s name, address, age, date of birth, group number and identification number. The claim form also includes all the procedure code and diagnosis code to clearly show the medical requirements of the patient. It should also identify the payer of the medical bills, as well as the payer’s identification number and mailing address (Wanda, 2008). Additionally, a coder should ensure that the claim form is submitted to the payer on time, which in most cases involves Medicare. Medicare is a health coverage plan that caters for all the health care needs of the patient including diagnosis and ...Download file to see next pagesRead More
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