Coder Interview

1019 Words Oct 29th, 2013 5 Pages
Kristin Barry
September 13, 2013
HCA 245
Moiz Lalani

Interview with a Medical Coder Medicine is an art, it is science and business. There are scientific and artistic aspects those doctors learn in the profession of medicine. Doctors have to be paid which requires a different skill that is complex and comes with administrative professional. Hint a Medical Biller and Coding. Medical Billers and Coders work with clinics, doctors, hospitals, patients, and other medical facilities. Submitting claims to insurance companies help ensure that supporting staff and doctors are properly reimbursed for services rendered. When one is a Medical Biller there are abbreviations and acronyms that help save time when filing a claim.
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It is crucial for the ICD and CPT codes match with the services rendered or a claim will be rejected, many claims are initially rejected. The cost of healthcare is on the rise and the demand for services has increased of required and specialty services feed into the financial greed among HMOs. The major bulk of hospital bills are paid directly by the patient’s health insurance provider which are termed the payer. 68% of the United States population has private insurance which is provided by their employer or self-pay. Around 9% of the population are self-payers who direct-purchase their insurance. There are two main categories of third- party payers they are government and private. Medicaid and Medicare are the largest government issued payers. Reimbursements for both private and governmental have policies that support therapeutics, diagnostics and new medical medicines and technologies. It is clinically evidence based approvals such as diagnostic test, prescription medicines, clinical trials and however insurers are using to help with their life cycle. With reimbursements there are incentives for medical facilities and doctors.
Reimbursements are a source of revenue for hospitals; payers do not pay a full price for services.
Healthcare has become the economy’s largest force. Healthcare services are very
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