Medical Insurance Billing and Coding

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By Colin McLean

It's not hard to imagine the possibility of an accident while visiting a city or other state. You're rushed to a nearby hospital and the attending physician has no immediate knowledge of the current medications or pharmaceuticals you may be allergic to. In such a critical moment, does the technology to retrieve vital information from your doctor's office or your local pharmacy exist?

It's anyone's guess at the number of deaths that may result each year as the result of preventable medical errors. However, beyond mere statistics it's easy to understand why a retrievable infrastructure of health information is so vital to achieve.

A number of health care venues today are organized to maintain local active patient medication lists for emergency medical scenarios as the one mentioned above. Leaving visitors from out of state at the mercy of the attending physician's experience and expertise is a very real scenario.

It's not difficult for anyone to imagine how expanding the replication of patient information of medications and allergies can serve as a bottom-up means for providing the essential elements of an informational structure on the national health level.

Pending Operational Challenges

There are still a lot of operational questions left unanswered, such as how to identify records that belong to the same person, or identifying information that is made available to a patient's providers.

Relevant Concerns:

  • Retrieving and consolidating patient information prior to service delivery
  • Methodology for conducting audits across a network
  • The assurance of data integrity
  • Identifying best practices for data identification, corrections and data non-duplication
  • Incentives that encourage provides to share medical information
  • Developing a medical informational infrastructure that allows easy provider access and authentication
  • A standard measurement for national healthcare quality

The adoption of additional traditional standards may be required because the above concerns describe and deal with data flow mechanisms; and not what is necessarily deemed appropriate content: as in actual medical billing and coding data input.

Medical billing and coding training can play a pivotal role in the submission of claims to health insurance companies across the board. Payment for medical care services provided by doctors or other licensed healthcare professionals is necessary to keep the system running smoothly and efficiently.

Medical billing coders, who often work away from the eye of the public in billing departments of medical practices, clinics, hospitals or claims processing offices, are quite often the un-sung heroes in the health care management process.

Organizing medical bills and statements, auditing for errors, conducting negotiations with collection agencies and working with insurance companies on a client's behalf are just a few of the many duties of medical billing and coding practitioners.

The nature and complexity of critical health care management dictates a need for a steady supply of qualified and experienced medical insurance billing and coding professionals to fill industry job openings as they occur.


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