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Tuesday, March 1, 2016

By Lioness Burgerwood


When you were in school, your teacher made medical billing sound so easy. He/She said to learn ICD-10 coding and then go out and land a client. After that, it sounds like success would just come to you. You could work from home in your pajamas getting clients to call you. The doctors made it sound like it was going to be so busy. In reality, you are now wondering why you don't have many clients. It is understandable why you are not having a lot of clients. For starters, it is extremely difficult to find physicians' offices to trust your services. This is mainly because so many people claim to know and understand ICD-10 coding. However, doctors are finding out that most billers do not understand or know how to do this work properly.

It takes a lot of education to learn ICD-10 properly. A person must spend years in training before they can call themselves and expert. Many billers today are expected to have at least a bachelor's degree and certification in ICD-10. Doctors, hospitals and medical practitioners expect you to understand utilization management as well. Utilization management is a process in which you have assistance with effective clinical documentation, an intensity in services and program scheduling. There are peer to peer reviews and eligibility verifications. Medical billing today also involves benefit verification and revenue cycle management.

It is important to learn more about the future through proper billing techniques. Learning how to understand billing is the life lesson that most people don't understand or know about. It is important to learn about utilization management as well. It takes a lot of peer to peer reviews in order to figure out coding and eligibility of benefits.

If you want to stay in business, make sure to work with the doctors that you represent. Doctors have to worry about using medical treatment for necessary ailments. Doctors can't just give people random blood tests for no reason and expect the insurance company to pay for it. Today, those day as over with.

Today, insurance companies are asking doctors to be more responsible and don't give a patient what they don't need. Insurance companies are trying to put a stop to bogus billing. Bogus billing was popular under ICD-9. Many blood labs would take multiple blood tests from a client just to get money from the insurance companies. Today, this has changed completely. Your business must have benefit verification and revenue cycle management as well.




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