Who are Medical Billers and Coders? Medical Billing and Coding Specialist (MBCS) are the invisible engines of the healthcare system. They create invoices for all medical costs provided by healthcare providers and then submit the claims to patients’ insurance companies. They are also responsible for collecting co-payment s for a portion of the healthcare costs. A medical biller is responsible for processing insurance claims so the physicians and office staff get paid. Medical billing is done in a hospital, clinic or physician office. A medical coder work with ICD-9-CM, CPT, HCPCS, and/or ICD-10-CM medical codes making sure the procedures don for that patient are consistent with the diagnosis in the patient’s chart.
Costs included insured direct medical costs of inpatient, outpatient, laboratory and pharmacy in health insurance claims data. To assess the costs, patients diagnosed with lung cancer (C34) using the Korean Standard Classification of Diseases version 6 (KCD-6) codes were selected. To select patients with NSCLC IIIb and IV, an operational definition of all the cases excluding the patients who had have surgery of patients having received chemotherapy was used. The main assumption in the cost assessment was that costs only depended on the treatment regimen regardless of first-line or second-line, or regardless of EGFR mutation status.
Our Healthcare system is clearly business based according to the article “Cost Conundrum” and on the movie “Escape Fire”. In the movie it had an impacting story of an older lady who had heart problems where she went to a doctor and they were going to charge her thousands of dollars were later she went to a different doctor and they charged her a couple hundred dollars for t he same procedure. I couldn’t believe that in a different office she would get the same procedure done for a lot cheaper than in the other doctor’s office. Also, it surprised me how the medical staff are giving all these medications to our soldiers were they are clearly
The bottom line we need to concentrate on cutting cost of health care and quality care, which we all deserve as human beings. There is not just one factor that contributes to the health expenditure but several pieces to this puzzle that makes this a major health cost issue. We need to find ways to decrease spending too much, so people can benefit from their health plan. The nation should consider cutting hospital care, clinical services and prescription drugs, since these are the top expenses for health care. This would definitely clear a path for reduced cost. The public can barely afford to pay premiums to their private health insurance companies but if they want coverage they have to pay. The one’s who qualify for Medicare and Medicaid will get help from this government program for health care cost and yes some
|National Health Expenditures and Selected Economic Indicators, Levels and Annual Percent Change: Calendar Years 2004-2019 1 Projected |
A great opportunity to discover whether or not you actually want to do the job you have been dreaming about your whole life is to explore that career field. I was granted the opportunity to job shadow a medical records technician, also known as a medical biller. I haven’t always wanted to be a medical biller, but I have had an interested in the medical field. The chance to shadow Mrs. Latoya West at Advantage Medical Billing allowed me to see that the medical field was something that I would like to continue to pursue, but not as a medical biller. During my time, I did discover a few interesting things.
The national health care spending in the United States has been growing faster than the national economy for many years, yet many United States citizens are without sufficient health care. Not only is it representing a challenge not only for the government’s two major health insurance programs (Medicare and Medicaid), but with the private sector insurance also. As health care spending rises for the nation’s economic production in the future, United States citizen may/will be faced with difficult choices between health care and other priorities to their everyday living. Nevertheless, an assortment of data suggests that opportunities exist to limit health care
Medicare focuses on medical acute care such as doctors visit, hospital stays and drugs. Also, it focuses on short-term services such as physical therapy after a fall or stroke (U.S. Department of Health & Human Services, 2013). Medicare covers services for long term care such as short stay in a skilled nursing facility, home heath services and hospice/respite care, but it does not cover costs for personal/custodial care such as help with bathing, dressing, eating, etc.. In 2015, Forbes reported that Medicare will pay for some of the costs only if a patient meets the following conditions:
The Christian faith views death and disease as byproducts of sin and are a part of life due to sinful human nature. Jesus was a healer of people and the followers have followed in His footsteps. The early health care system was started by nuns and other followers in the church (Preston, 2000). By following the teachings of their religion they sought to address health and suffering by taking a holistic approach to healing. By taking into consideration the mental and spiritual, along side the physical, they believe a deeper level of healing can be given. Health is not just addressing the physical symptoms but, helping achieve a peaceful state of mind and having meaningful relationships with those
I 've learned while conducting these interviews that both individuals have similar issues with the healthcare system.
The Healthcare Cost and Utilization Project (HCUP) records would not be possible without the followers’ establishments that subsidize information to HCUP. Many of these organizations have websites to recite their information or provide statistics based on their state data. Pennsylvania is my state, and it is one of these states that participates in the Healthcare Cost and Utilization Project (HCUP). The name of the Pennsylvania state contact person and contact information is
The cost of medicine is closely related to the general public, so good financial incentives and health care systems have different influences on public health. In the article, ‘Corruption of pharmaceutical Markets: Addressing the Misalignment of Financial Incentives and Public Health’, Marc-Andre Gagnon argues that the commercialization of medical and financial incentives cause the corruption of the pharmaceutical system, and at the same time he explores the incentive measures to promote medical innovation and the rational use of medicines . Meanwhile, another article by Jennifer Trueland, ‘The cost of giving’ focuses on how to increase the number of organ donors and while should money be used to encourage organ donations or not. Comparing
During the Great Depression, the pre-paid services began to grow rapidly and BCBS began to provide doctors with reimbursement for services as well as providing discounted services to the hospitals (Lichtenstein, n.d.). This helped to increase the prompt payment and volume of need to these hospitals. While increasing the availability of need and the need for prompt payment after services, “several large life insurance companies entered the health insurance field in the 1930’s and 1940’s as the popularity of health insurance increased” (Northern California Neurosurgery Medical Group, Inc). While there was a huge increase after the Great Depression, it “inadvertently inspired the spread of employer-based health insurance, World War II accidently
Germany does not rely on a single source of revenue. The statutory funds also referred as the sickness fund covers about 90% of the populations. The rest of the population (10%) purchase their own private health insurance. Contributions to the healthcare funds, which are based on income are made by both employers and employees. Germany has some 180 statutory health insurance funds, and they account for approximately 70 percent of the health system’s revenue (McKinsey, 2010).
Health care costs are continually rising, particularly in the richest countries of the European community. According to research done by Burge, Monnin, Berchtold, and Allet, the increasing number of people approaching the age of retirement and the decreasing number of people engaged in professional life is the reason why health care costs are so high. Costs for different treatments varies depending on insurance and treatment. Nationally, the economic burden of Parkinson’s disease is high. According to research done by Anderson, estimates vary between $5.6 billion and $25 billion in cost of illness for Parkinson’s disease. A cost of illness analysis examines the total cost that are a result the result of a specific disease. So as you can see,