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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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AAPC Planning Great Things for Members

Credentialing, training, resources, business solutions … what’s next, job recruiting? Hmmm. AAPC’s Social Hour host and marketing communications director Alex McKinley interviewed CEO Bevan Erickson, Feb. 23, about the past, present, and future of the world’s largest training and credentialing organization for the business of healthcare. What began as a casual chat about the weather […]

The post AAPC Planning Great Things for Members appeared first on AAPC Knowledge Center.

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DOJ Pursues a Number Of EHR Cases: Five Things For You to Understand

The United States DOJ is initiating direct legal proceedings against Hospitals, Health Care systems, and Medical Technology Corporations for submitting an exhaustive number of false claims to both Medicare and Medicaid. This action is in concordance with the Electronic Health Records (EHR) incentive program, per the National Law Review.

Click Here to Read the Full Story!

The post DOJ Pursues a Number Of EHR Cases: Five Things For You to Understand appeared first on The Coding Network.

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10 things you should know to ensure successful discharge planning

10 things you should know to ensure successful discharge planning

Learning objective

At the completion of this educational activity, the learner will be able to:

  • Identify strategies to comply with proposed Medicare changes to the discharge process

 

One of the more challenging aspects of a case manager’s job is helping to ensure a patient successfully transfers from the hospital to the next level of care. Under a set of proposed revisions to Medicare’s Conditions of Participation (CoP) announced in November 2015. This job may get even harder, more specific, and apply to more patients. The changes, among other things, will require hospitals, including critical access hospitals, to create discharge plans for more patients. Case managers will need a more direct plan to include patients and their caregivers in the discharge planning process, in particular taking into account their individual "goals and preferences." This discharge planning process will also need to start sooner?within 24 hours of admission instead.

So what can you do to ensure your organization is up for the challenge? In an April webinar titled "Discharge Planning: Realignment of Standards and Workflow," speaker Jackie Birmingham, RN, BSN, MS, CMAC, vice president emerita of clinical leadership for Curaspan Health Group in Newton, Massachusetts, and Janet L. Blondo, MSW, LCSW-C, LICSW, CMAC, ACM, CCM, the manager of case management at Washington Adventist Hospital in Takoma Park, Maryland, offered up some compliance tips that you can use to ensure your hospital is ready:

1.Assess your current discharge process. Under the proposed changes, the discharge planning process needs to start in the first 24 hours after the patient arrives at the facility. You’ll need to identify how your current processes work in order to make sure they comply with this timeline. Identify your current workflow?specifically, who does what, why they do it, and how it’s done. Ask the following questions:

  • What is your current case management model?
  • Who’s on your team?
  • What’s their role?
  • Who does the screening right now in the current
  • Who does the patient assessment?
  • Who makes referrals when you need to refer patients for services?
  • In your current model, do the nurses perform the assessment for patients who go home while the social workers do the placements? Or do you have nurses and social workers assess everyone? "If you’re having all your patients assessed right now, well, you’re ahead of the game already, because that’s the new proposal," said Blondo.

 

Also think about why your processes were designed the way they are. "If you have it on one unit a certain way and not on another, think about what you need to do to change your practice so that perhaps every unit you can do assessment on every patient," said Blondo. "If your model is something that doesn’t seem to make sense with the proposal, what can you do to change it?"

Changes to bring the model in line could include adding technology (e.g., laptops, tablets) to speed up the process, adding staff members, or reassigning current staff members. "Perhaps some of your social workers can do UR," said Blondo. Alternatively, maybe a staff nurse can do an initial assessment instead of a case manager, or perhaps a nonclinical staff member can take over certain tasks. Taking the time to examine your current processes and think about how they can be switched up to meet the new requirements will give you the foundation for a new plan.

2.Drill documentation. Hold physicians accountable for following through and documenting discharge plans and dates. "If they’re documenting in the chart the discharge date and plan, that makes your job a little easier, because you have that in the chart already and can discuss that with the patient and their family," said Blondo. Take advantage of pre-procedure assessments by ensuring they are included in the chart, then making sure staff members follow through on that plan. "You don’t want Joint Commission or the state coming to do their survey and then you find out the assessment is not getting done because your staff has decided they want to do something different. So make sure everyone is doing the same," said Blondo.

3.Focus on delays. Use these potential discharge changes in the CoPs as an opportunity for process improvement. Look at what’s causing delays in your current process?use this information to improve systems and boost patient satisfaction. "You’re going to improve, perhaps, length of stay with this increased attention with discharge planning," said Blondo.

4.Make rounds count. If you are currently using rounds, examine what they’re being used for and how they’re working. Blondo says it’s important to ask:

  • Are rounds being used for discharge planning?
  • Are they used for the patient experience to improve your scores?
  • Are they used for throughput or for some other reason?

 

After thinking about the current purpose your rounds serve, consider how they can be modified to fit your new objectives. "Many people just do one type of rounds per day, but you could actually be creative with these. There are some hospitals that I know of that divide rounds into different parts of the day," said Blondo. "For instance, you might want to think about doing rounds early in the morning for those patients that will be discharged [later] that day." The discussion could center on determining whether those patients are prepared to leave and have the right resources. Another idea is to add rounds to the short-stay area or outpatient area for procedures done late in the day. "And if you have case managers in the emergency room, you could ask them to round for those areas, catching any patients that might need something late in the day after your regular case management staff have left," said Blondo.

5.Understand patient options. This topic includes both big-picture and smaller issues. Case managers should focus on patient-based issues, which relate to talking to the patient, as well as on setting the patient’s broader goals and preferences. The organization’s systems must be set up to give patients a choice of postacute options. But keep in mind, when working with patients, you’ll always come across those who don’t like what you’re doing or who don’t agree with you and want to go another direction. "You need to have something standardized and something that you can fall back on when you’re presented with a patient and family who, in their eyes, have a reasonable goal and clinically or medically or psychosocially, they don’t," said Birmingham. Staff members must understand the concept of patient choice. "The staff must be comfortable that they are doing the right thing for the patient and the right thing for networks and the right thing for the organization."

It’s also important for staff to understand that the patient has the right to refuse the plan. "[The patient] may be in denial. They may be suffering grief," said Birmingham. The hospital should have a policy for patients leaving against medical advice (AMA), but case management must have its own discharge planning policy for those leaving AMA. In these instances, it’s not just enough to have the patient sign a paper, but rather actively assist the patient with the transition by ensuring that he or she has transportation and needed prescriptions. Even though there is an exemption for patients who signed out AMA and are readmitted the hospital, the hospital should have a plan for how to work with these patients, said Birmingham., said Birmingham.

You should also consider planning for a patient’s deficits related to loss of functioning, whether it be ADLs or IADLs. Birmingham recommended asking the following questions:

  • Is the patient medicated and therefore unable to participate in planning?
  • Does the patient need to have a conservatorship?
  • Is there conflict among the patient’s children or the patient’s siblings?
  • Does the patient have a family or responsible person?
  • Is the patient appealing the discharge?

 

A plan should be in place to address the answers to these questions.

6.Help patients achieve their goals. This is something that organizations should have been doing all along, but there is much more emphasis on it now. A problem arises when the patient’s goals and preferences don’t align with what is medically necessary or what is reasonable and necessary. In these instances, it may be wise to involve social workers. "Look at some of the things that patients might be going through?denial, grief that might affect their decision-making at the time," said Birmingham. "With the family dynamics, there might be family members trying to convince the patient to make a decision that isn’t really what the patient wants." Ultimately, the goal is to help the patient make the decision that is best for him or her, but also to think about what is medically the best option.

7.Involve the physician. Physicians are an integral part of discharge planning, so it’s important to make sure they are actively involved in the process. This communication between the patient and the physician needs to be sensitive to generational and cultural differences. "To involve perhaps some of the older patients, just have the doctor come in and say, ‘We want you to do this,’ " said Blondo. "That might not work for younger generation or baby boomers who are used to rebelling, but if you have the doctor come in and say, ‘This is what we’re recommending and this is why’ and help the patient to understand why it is recommended."

While it may be easier to foster good communication if you’re working with a hospitalist, it can be more of a challenge if the physician is community based. "How will you manage when the patient is transferred to another facility? It’s not been a problem if you’re transferring the patient to another hospital, but if that patient is being transferred to a SNF, there haven’t been that many times when the doctors have called to the doctor in that SNF to give them an update," said Blondo. Have a plan in place to ensure the communication lines are always open.

8.Work to decrease unplanned readmissions and improve patient outcomes. "Readmissions are an old problem with new incentives," said Birmingham. Readmissions can be strongly linked to location and patient access to resources, which shows that they often depend on factors other than the medical treatment the patient received. This underscores the importance of ensuring your patients have access to things like food and transportation when they leave the facility. "Is your [patient’s] area in a food desert? No car, no supermarket store within a mile?and that makes a huge difference," said Birmingham. If this is the case, your organization might want to develop or contact an existing program that delivers food to the homes of qualifying individuals. "Home health agencies could do that too for some programs to be able to provide some fresh groceries to some patients," she said.

Also find out if your patient has been readmitted in the past, a risk factor for readmissions. "You can look to see if a patient is readmitted from an acute level of care, but you’ll need to ask the patient if they’ve been in the emergency room in the past 30 days, if they were admitted from a facility SNF," said Blondo. "Often, that information is sent with them to the hospital, but you can ask them." Ask if the patient was receiving home health services prior to admission. Encourage physicians to include this type of information in the history and physical to ensure it won’t be missed.

"We’re never going to be perfect and have no readmissions, because some patients have a legitimate need to come back to the hospital within those 30 days, but look at your readmissions. Learn from who is coming back and think about what strategies you can put in place for that," said Blondo.

9.Keep the focus where it belongs. "Discharge planning is a patient-centered function," said Birmingham. "You can do utilization review without talking to the patient. You can do quality improvement without talking to the patient and family, but you can’t do discharge planning." For this reason, discharge planning can be very rewarding to clinicians who want to be involved in the patient’s care, and to be there for them when they’re at their most vulnerable.

10.Take your cues from the experts. While Medicare’s CoPs aren’t a cookbook on how to run your organization, they are a good place to start because they’re based on years of evidence. "Many of the changes in the original CoPs happen because commenters send in a comment to CMS and CMS responded and actually changed the proposed rule," said Birmingham. "Now, will they change these proposed [discharge planning] rules? I don’t think so, and I think that’s because they’ve been published as interpretive guidelines for over two years." That means these discharge changes are likely here to stay. Like all other CoPs, they should be blended into your workflow and your strategies and partnerships with other departments, said Birmingham.

HCPro.com – Case Management Monthly

Medical Internships: Things to Learn and Know

The learning period in one’s life never ends. This is also the reason that after twelve years of learning in a school, 4 rigorous years of study in a college and 4 laborious years in any medical school, one still requires to learn a lot. What is the reason behind this? Well, the school years offer us just the foundation. Thereafter, one requires learning about vital information and requisite skills to use upon workplace medical training. This is after which one can start his/her medical career as a licensed practitioner.

 

Medical internships actually bridge the gap between schooling and a career as a licensed physician. These internships last for one year. A medical internship can also be referred to as a period where a student is given hospital-based training that takes place under the strict supervision of experienced attending physicians. The internship is designed in a fashion to transform a college student into a serious medical practitioner. This practitioner is equipped with vital knowledge about daily requirements, workload and pressures related to a physician’s job.

 

Interns are trained via exposure to a wide variety of conditions. An intern is supposed to see different patients. The more they get in touch with patients, the more they become knowledgeable and experienced. They also become capable of handling different health conditions and diseases. They also acquire proficiency at both diagnosis and taking prudent decisions about a specific.

 

Attending important lectures and conferences is crucial fro a student during medical internship. The information gained in these conferences can help them in their workplace in the future.

 

Mainly there are two types of medical internships:

Transitional internship
Specialty track internship

 

Transitional is a straightforward internship process. The successful completion of this internship in conjunction with stage three of the USMLE or COMLEX-USA allows a licensed medical practitioner to work in a general capacity.

 

Chris has written this article and he likes to write and share articles on topics like medical internships

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5 Things You Didn’t Know About Medical Billers and Coders in Teaching Hospitals

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Medical billers and coders are responsible for translating details in patients’ records to insurance companies for gaining proper reimbursement. Every healthcare organization depends on medical coding and billing staff to remain profitable. Yet teaching hospitals are one of the leading employers of HIT professionals. In general, teaching hospitals are nonprofit medical centers affiliated with a university to train clinicians. They provide round-the-clock care in various specialties, from pediatrics to neurology and cardiac care. Interns and residents treat patients under close supervision from attending physicians. For medical coding and billing graduates, working for a teaching hospital can provide both rewards and challenges. Read on to learn five things you should know about medical billers and coders in teaching hospitals.

1. Medical Coding and Billing Jobs Abound in Teaching Hospitals

The American Hospital Association reports that there are 5,627 registered U.S. hospitals total. Of these, 1,038 are teaching hospitals with high patient numbers. Some of the best are Yale-New Haven Hospital, NYU Langone Medical Center, and Johns Hopkins Hospital. Teaching hospitals employ more than 2.7 million healthcare professionals nationwide. It’s no surprise that medical billers and coders find less competition for jobs in teaching hospitals. After all, university-affiliated hospitals house 82 percent of the country’s ACS-designated Level I trauma centers. Teaching hospitals need large medical records management offices to protect inpatient and outpatient data. Medical coding and billing specialists can expect jobs in teaching hospitals to multiply because the field projects 10-year job growth at 15 percent.

2. Teaching Hospitals Provide Higher Salaries to Medical Coders and Billers

In comparison to several other healthcare settings, teaching hospitals grant above-average salaries to their medical billing and coding staff. According to the AAPC 2015 Salary Survey, medical billers and coders make $ 50,925 on average at inpatient teaching hospitals. That’s more than the $ 44,870 at mid-sized medical groups and $ 45,722 at independent physician offices. Teaching hospitals on the Pacific Coast from Hawaii to Washington report the highest medical coding and billing salaries nationwide at $ 57,021. Landing a job at a teaching hospital can considerably pad your paycheck, especially if overtime is offered. Due to their large size, teaching hospitals are also more likely to hire clinical coding directors with lucrative salaries.

3. Medical Billers and Coders Benefit from Learning Support

Teaching hospitals offer an academic-focused work environment where cutting-edge education and research is prioritized. Medical coding and billing jobs may require less post-graduation employment experience because on-the-job training is included. Teaching hospitals encourage staff to sharpen their skills with continuing education. For instance, Rush University Medical Center provides full-time employees with $ 5,000 in tuition assistance each year. This makes attending college online or during evenings more affordable. Medical coders and billers in teaching hospitals also join an active research community. Teaching hospitals receive approximately $ 2.2 billion in NIH research funding annually. Therefore, the HIM department will continually search for the latest tech advancements to streamline medical coding and billing.

4. Teaching Hospitals Require Extra Vigilance in Medical Coding and Billing

Being careful and attaining high accuracy is important for every medical coder. But those employed in teaching hospitals often have extra responsibility in checking over patient records. Teaching hospitals always experience new rotations of interns and residents who are unfamiliar with record protocols. New waves of med school students can mean patient records accessed by coders and billers are less orderly. One study found 10 percent reduced mortality risk at teaching hospitals, so they don’t compromise quality of care. However, clinical documentation can get muddled in the process. Teaching hospitals may hire experienced coders and billers to conduct medical auditing. Pursuing the AAPC’s Certified Professional Medical Auditor (CPMA) credential would come in handy here.

5. Medical Coders and Billers Frequently Process Larger Claims in Teaching Hospitals

Teaching hospitals typically charge more for medical services because they treat higher acuity patients with complex conditions. Funds are also included for the hospital’s research and academic instruction. For example, George Washington University Hospital charges $ 69,000 on average for lower joint replacement. Sibley Memorial Hospital, a nearby community hospital, charged under $ 30,000 in comparison. Medical coders and billers must be prepared to figure the dollar signs with higher hospital rates. Considerable time will be devoted to coding for diagnostic tests because teaching hospitals order 7.1 percent more tests than their non-academic counterparts. Medical billing specialists should be aware that teaching hospitals are largely urban and accommodate vast numbers of Medicaid or uninsured patients.

Related Links

    The 10 Best Online Medical Coding Programs
    Top 10 Medical Billing and Coding Schools
    15 Best Remote Medical Coding Training Programs Online

Top Medical Coding Schools

Important things to Consider before Medical Travel or Medical Tourism

Now days, individuals or even corporate have taken radical steps to save with the high cost of medical care in some countries such as the United States by considering medical tourism, oversee surgeries and medical travel. Many have visited to other destinations or countries to get health care healing at a lower price. This is known as medical travel, health care tourism or medical tourism. In other type of cases individuals in developing or poorer countries travels to a richer country to get medical treatment that is not accessible in their own country. An another motive for medical travel is to go from a country with long waits for some treatments as happens sometimes with national medical care to one with less waiting. Following are few reasons one should consider before setting up medical travel and health tourism.

Firstly, people of expensive medical cost countries, like United States and United Kingdom in specific, can save a lot of medical bills with oversee treatment. Surgeries in India, Cost Rica and Mexico are many times cheaper than in the USA, and the same is valid of many other countries. The expensive can be quite noteworthy, especially for treatment that are not covered by medical insurance, or for individuals who are not insured.

Secondly it is becoming frequent for medical insurance companies, agents or employers who want to cut medical expensive to encourage their consumers or employees to practice medical tourism. In this way they can save a lot of funds this way. They may pay partial refunds, or at least cover transportation and housing.

Thirdly, if someone is worried about the standards of medical care oversees; there is good amount assistance and information available. Many international associations and agencies, including the medical tourism associations study medical care facilities, infrastructure and hospitals around the world. They have grant accreditation to many international centers. The standards of medical treatment are a very complicated issue and may differ a lot within a country or states. Accreditation given to international medical centers at least provides some comfort in knowing there is a lower bound on the worth of an accredited facility.

Fourthly, be cautions that it may be hard or not possible to get reparation for misconduct in some medical centers in different countries. Occasionally misconduct claims are not permissible or very incomplete. In some cases, a negligence suit may be likely, but it may be very tricky to collect if you even win. Negligence should be exceptional, but it is fine to understand that the covers one has at home might not exist abroad.

Lastly, medical tourism and medical travel has some risks of its own. You might come across some diseases that are seldom if ever present at home. Communicable disease during recovery from operation or other treatments is a risky fixation. But the good thing is that medical care staff in the area you are visiting are certainly familiar with the diseases you could catch while there.

There are even risks from the general traveling. The idiom economy class condition refers to the danger of developing blood clots in the lower body due to being seated and unmoving during a long plane flight. Traveling while recovering from surgery raises the risk of this. This is also the one of the factor to consider when thinking about health travel.

Medical tourism and health tourism may be best alternative for many people, for non-emergency treatments of course. It is regularly used for hip, joint and knee replacement or dental surgery. Cosmetic treatment is another possibility. There are medical tourism consultants and facilitators who could provide guidance at every level. They can guide you about the options available in popular medical tourism destinations. These medical tourism consultants act much like a travel agency and set almost the whole things up for you.

Medical Tourism and Health Tourism consultancy are offered by Global Benefit Options. GBO is a skilled medical tourism consultant with wide industry relationships with insurance companies, brokers and hospitals globally. For more information visit http://www.globalbenefitoptions.com

Related Medical Coding Articles

10 Things to Watch as Trump Changes Healthcare

President-elect Donald Trump and a Republican Congress will take control of the country’s healthcare system in January, but don’t expect a quick or iconoclastic revamp, healthcare experts at Leavitt Partners recently told webinar attendees. However, when the executive and legislative branches of government are unified by party, major change is likely to happen, meaning that […]
AAPC Blog

3 Things You Need to Know about CPT 99490 and the CCM Patient Agreement

3 Things You Need to Know About CPT 99490

3 things you need to know about CPT 99490

To bill Medicare’s Chronic Care Management (CCM) reimbursement code, CPT 99490, you’re required to first have a valid patient agreement in place. There are several critical components to the patient agreement that you must include to comply with Medicare’s guidelines for reimbursement. If you don’t follow these rules, it can result in non-reimbursement of fees billed and potential legal consequences.

What is the CCM Patient Agreement?

Chronic Care Management Patient AgreementThe patient agreement is written authorization from your patient allowing you to bill Medicare for services rendered under CPT code 99490. The patient’s consent must be included as a part of the medical record, whether that is an electronic or paper-based system.

  1. Written consent for participation in the program must first be obtained before any CCM services can be billed to Medicare. In the patient’s medical record, document your initial discussion with the patient regarding their eligibility for CCM services and if they chose to participate. Explain your CCM services, how patients can access services, and how their medical information will be shared.
  2.  As a part of the patient agreement, patients must agree to electronic communication of healthcare information among all providers involved in their care. It’s also important to explain that patients can revoke their agreement for participation in CCM service at any time, but their withdrawal from the program must be in writing and their signature is required.
  3. Patients also need to know they can choose only one provider to furnish them with CCM services each calendar month. If they are offered CCM services from multiple providers, they’ll have to choose who they’d like to coordinate their care and bill Medicare for providing the service. The patient should be informed that they can change providers at any time, but that changing providers will require a new, signed patient agreement.

Co-pays, Deductibles and Co-insurance

As a part of the initial discussion for services, be sure to explain that patients will still be responsible for their deductibles and co-insurance requirements as determined by their individual Medicare coverage. Patients will be responsible for copayments and deductibles when providers bill Medicare for CCM services every month. The patient’s secondary insurance may cover these balances.

Vendor Toolkits

In order to maximize your success with CPT code 99490, there are a few options for toolkits and templates for CCM documentation. There are no standardized patient agreement forms, but you can access a patient agreement form template that the Capture Billing team created just for you here. One toolkit is provided by the American College of Physicians free of charge. Another toolkit is provided by the American Academy of Family Physicians (AAFP) at a cost of $ 69 for AAFP members ($ 199 for non-members).

Your practice can use the templates provided here, or you can take a template and use it as a guide for creating your own document. Looking for a Chronic Care Management software partner to assist you?  You will want to check out our recent post: “6 Chronic Care Management Software Companies that can Help Your Practice”

As long as you adhere to Medicare’s requirements, you should have no trouble getting reimbursed for your CCM services to patients.

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How is your Chronic Care Management program at your practice going? I would love to hear about it. Leave a comment below.

— This post 3 Things You Need to Know about CPT 99490 and the CCM Patient Agreement was written by Manny Oliverez and first appeared on Capture Billing. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.

Capture Billing

5 Things You Didn’t Know About Medical Billers and Coders in Teaching Hospitals

top medical coding

Image Source

Medical billers and coders are responsible for translating details in patients’ records to insurance companies for gaining proper reimbursement. Every healthcare organization depends on medical coding and billing staff to remain profitable. Yet teaching hospitals are one of the leading employers of HIT professionals. In general, teaching hospitals are nonprofit medical centers affiliated with a university to train clinicians. They provide round-the-clock care in various specialties, from pediatrics to neurology and cardiac care. Interns and residents treat patients under close supervision from attending physicians. For medical coding and billing graduates, working for a teaching hospital can provide both rewards and challenges. Read on to learn five things you should know about medical billers and coders in teaching hospitals.

1. Medical Coding and Billing Jobs Abound in Teaching Hospitals

The American Hospital Association reports that there are 5,627 registered U.S. hospitals total. Of these, 1,038 are teaching hospitals with high patient numbers. Some of the best are Yale-New Haven Hospital, NYU Langone Medical Center, and Johns Hopkins Hospital. Teaching hospitals employ more than 2.7 million healthcare professionals nationwide. It’s no surprise that medical billers and coders find less competition for jobs in teaching hospitals. After all, university-affiliated hospitals house 82 percent of the country’s ACS-designated Level I trauma centers. Teaching hospitals need large medical records management offices to protect inpatient and outpatient data. Medical coding and billing specialists can expect jobs in teaching hospitals to multiply because the field projects 10-year job growth at 15 percent.

2. Teaching Hospitals Provide Higher Salaries to Medical Coders and Billers

In comparison to several other healthcare settings, teaching hospitals grant above-average salaries to their medical billing and coding staff. According to the AAPC 2015 Salary Survey, medical billers and coders make $ 50,925 on average at inpatient teaching hospitals. That’s more than the $ 44,870 at mid-sized medical groups and $ 45,722 at independent physician offices. Teaching hospitals on the Pacific Coast from Hawaii to Washington report the highest medical coding and billing salaries nationwide at $ 57,021. Landing a job at a teaching hospital can considerably pad your paycheck, especially if overtime is offered. Due to their large size, teaching hospitals are also more likely to hire clinical coding directors with lucrative salaries.

3. Medical Billers and Coders Benefit from Learning Support

Teaching hospitals offer an academic-focused work environment where cutting-edge education and research is prioritized. Medical coding and billing jobs may require less post-graduation employment experience because on-the-job training is included. Teaching hospitals encourage staff to sharpen their skills with continuing education. For instance, Rush University Medical Center provides full-time employees with $ 5,000 in tuition assistance each year. This makes attending college online or during evenings more affordable. Medical coders and billers in teaching hospitals also join an active research community. Teaching hospitals receive approximately $ 2.2 billion in NIH research funding annually. Therefore, the HIM department will continually search for the latest tech advancements to streamline medical coding and billing.

4. Teaching Hospitals Require Extra Vigilance in Medical Coding and Billing

Being careful and attaining high accuracy is important for every medical coder. But those employed in teaching hospitals often have extra responsibility in checking over patient records. Teaching hospitals always experience new rotations of interns and residents who are unfamiliar with record protocols. New waves of med school students can mean patient records accessed by coders and billers are less orderly. One study found 10 percent reduced mortality risk at teaching hospitals, so they don’t compromise quality of care. However, clinical documentation can get muddled in the process. Teaching hospitals may hire experienced coders and billers to conduct medical auditing. Pursuing the AAPC’s Certified Professional Medical Auditor (CPMA) credential would come in handy here.

5. Medical Coders and Billers Frequently Process Larger Claims in Teaching Hospitals

Teaching hospitals typically charge more for medical services because they treat higher acuity patients with complex conditions. Funds are also included for the hospital’s research and academic instruction. For example, George Washington University Hospital charges $ 69,000 on average for lower joint replacement. Sibley Memorial Hospital, a nearby community hospital, charged under $ 30,000 in comparison. Medical coders and billers must be prepared to figure the dollar signs with higher hospital rates. Considerable time will be devoted to coding for diagnostic tests because teaching hospitals order 7.1 percent more tests than their non-academic counterparts. Medical billing specialists should be aware that teaching hospitals are largely urban and accommodate vast numbers of Medicaid or uninsured patients.

Related Links

    The 10 Best Online Medical Coding Programs
    Top 10 Medical Billing and Coding Schools
    15 Best Remote Medical Coding Training Programs Online

Top Medical Coding Schools