Learn medical billing and coding with our experienced experts' advice and tutorials. You'll find guides to every sort of issue and step involved in the actual day-to-day work of billing and coding.
Our experts' knowledge is gleaned from years and years in the industry - use it to flatten your learning curve and improve your job skills. Consider this your virtual mentor!
This step-by-step guide to the basic medical billing process shows you a typical run though.
There are many common medical billing errors, and we've listed some of them for you and described how you can avoid them.
Learn how to appeal a denied insurance claim, a skill which is almost as important as being able to submit a claim! You should also learn which supporting documentation you might need to provide to appeal a claim.
If a claim you send gets denied because of timely filing, we've created a sample appeals letter for timely filing and explained the process in this article.
You also need to be able to collect patient balances, without being rude or pushy. Click the link for our advice on being polite but firm and getting the patient to pay.
Of course, it also helps to know why claims are denied in the first place! These tips for avoiding denied and delayed claims can help.
You'll need to learn basic anatomy of the human body, and how medical terminology is constructed. These are hugely important since you'll be drawing on this medical knowledge every time you bill or code a claim - which you'll be doing often!
The accounts receivable management guide explains the best way to manage your patient balances, which to collect first, and how to manage time frames.
You also need to learn how coordination of benefits works, and how to determine the primary payer when a patient has multiple insurance plans
Evaluation and management codes describe the physical examination components of a doctor's visit. This guide shows you which factors to consider when figuring out the level of an office visit.
These are introductions to the unique needs of billing and coding for various medical specialties, and other areas which have different requirements. These areas usually have extremely specific guidelines, and it may be worth your while specialising in one of these fields to further your career:
Here are tutorials and guides for the some of the various forms and documents you'll encounter when you learn medical billing:
Our CMS 1500 claim form tutorial shows you how to fill in the standard form used to bill all medical claims to insurance companies.
You may also find it useful to learn about how the CMS 1500 claim form was changed from the outdated HCFA 1500 form, and why.
Our UB-04 claim form tutorial describes how to use this inpatient facility claim form, which is also known as the CMS 1450. This is a much more complicated form than the CMS 1500.
Encounter forms record the codes assigned by the doctor during an encounter with a patient, and contains demographic and insurance information. This article describes how to design and use your own encounter form to fit your needs.
Finally, we've written a guide to reading an insurance EOB (explanation of benefits). This is the form sent by insurance detailing how a successful claim was processed and how much was paid.
You should become familiar with provider identifiers. This article on other provider identifiers looks at the different types of ID numbers which exist.
How is patient insurance coverage verified? And what is verification of benefits, and how does it differ?
Learn why it may pay to become an Article 28 facility, despite the strict requirements, in the article on Medical Billing and Article 28.
We also recommend the ebook The Basics of Medical Billing for getting a good grasp of the industry.
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