Large hospitals employ medical coders who do what is known as inpatient medical coding. They must accurately code procedures, diagnoses, and treatments patients receive in order to submit that information to health insurance companies so the hospitals they work for are properly paid for the services they provide. When a person first enters the field of medical coding they will often start out as an outpatient medical coder. This just means that the medical coding they handle is for people who do not stay overnight in the hospital or who are seen at an outpatient clinic. Most people who seek a position as an inpatient medical coder must learn the skill over time through both classroom and on the job training because of the more advanced nature of the work.

Over the years as medicine has advanced and more and more patients are seen on an outcare basis there has been a decline in the need for medical coding for inpatients. For example gall bladder surgery used to require and 3 day stay in the hospital but now most people are sent home shortly after the procedure is completed. Because they did not stay overnight at the hospital their case is assigned to an outpatient medical coder. On the other hand open heart surgery requires inpatient medical coding.

The major difference between inpatient and outpatient medical coding is the complexity of the situations that they must code. Someone who needs stitches in their hand is a lot less coding work than someone who has multiple traumatic injuries sustained in a car wreck. Because there is so much more coding work to do, and it must all be accurate, for a patient with inpatient care needs the inpatient medical coding expert will have noticeably more expertise than their outpatient counterparts. It should be noted that hospitals employ both outpatient and inpatient medical coding workers because many hospitals visits do not require an overnight visit.

Medical billing and coding training can open up a lot of good job opportunities for you. Since the health care field is expanding and there are no signs it is going to slow down that means that there is steady work available to those with the right kind of skills. In this article we will take a look at 2 things.

1. How medical billing and medical coding differ from one another
2. What is required to work in each field
3. What kind of jobs you can expect to do after you’ve trained for a career in medical billing or a career in medical coding

Differences between medical billing and medical coding

While they are often used interchangably there is a difference between the two skill sets. Medical billing deals with submitting claims to insurance companies on behalf of health care providers and then following up on those claims so they can get paid for the services they have provided. Medical coding on the other hand is changing what a doctor or nurse has said or written into a universally accepted standard format of numbers that are meant to classify what was done. In other words medical coding changes the strange written language of the doctors in “plain english”

Requirements to work in medical billing

From an educational perspective there really are no standard requirements, but individual companies you might work for will very likely have some in place. It’s common that anyone wanting a career in medical billing should complete a 9 month to 2 year certification course. The more training in medical billing you have the more valuable you are to an employer.

In more general terms you need to be able to do the following tasks in order to be successful at medical billing.

• Read and write in clear, concise English
• Sit in front of a computer for extended periods of time
• Type upwards of 60+ words per minute
• Deal with doctors, insurance companies and sometimes patients
• Be able to work in a variety of different health care environments including: hospitals, clinics, insurance agencies, long term care facilities, and sometimes even from your own home
• Must be able to reliably and accurately do repetitive tasks

Requirements to work in medical coding

There is no educational requirements for medical coding, but because of the very strong regulations and heavy oversight of medical coders most employers require that someone working for them be certified through a recognized agency. This certification is a good idea even if you find an employer who will hire without it. The more training you can get the better chance you have at advancement into higher paying positions. As far as the work environment it is very similar to what a medical billing professional finds themselves doing day to day.

Medical billing and coding training can go a long way towards furthering your career in the health care field. While neither requires advanced degrees to enter the more training and certifications you can get the better prepared you will be to meet the needs of employers.

Free medical billing software is available, but that doesn’t mean it won’t cost you anything. In order to get an idea of how much it could cost you we need to consider it from a couple of perspectives.

The free software business model

First it is important to understand how the concept of free software works. We won’t get into the technicalities of describing differences between terms like

• Open source
• GNU
• Freeware
• Shareware
• and any number of others that you might come across

In your quest for free software you will often come across a quote that goes like this – Free software is a matter of liberty, not price. To understand the concept, you should think of ‘free’ as in ‘free speech’, not as in ‘free beer’” by Richard Stallman creator of the popular GNU Project. What Stallman is saying in the proceeding quote is that you should look at the idea of free in terms of software to mean that you are free to-

1. Run the program for any purpose you wish
2. Study and modify the program to suit your own needs
3. Freedom to copy and distribute the program to other people
4. Freedom to make changes, and improve the program and release those modifications to everyone else

Notice in those four freedoms, Stallman never once mentions free in terms of price, or time, or maintenance. Free software means you have liberties with that software you don’t have with licensed software. It does not mean it is free of monetary cost.

How free medical billing software makes money

If you go looking for free medical billing software you’ll find one thing in common across the board. It isn’t really free. Sure, you can download and install it free of charge but things like general support, being able to use it on a network, and upgrades so it is fully functional require you to pay something out of pocket. In other words they sell you a plain, white box with the word free medical billing software on the top of it. What you do with it is up to you. How you use it and how you figure out the way it works is totally on your shoulders.

Before I scare anyone off the idea of using free software for your medical billing practice that is not my intention. I’m a huge proponent of the open source licensing model. I’m just being honest about how these things work. If you download free software and then spend a few thousand dollars getting someone to come in and setup your system to use it have you really saved any money? $800, $900, $5000 are all appreciable sums of money for most health care practices but you need to consider what comes packaged with that cost.

• Support for the product. Free software support usually consists of searching on Google and then spending hours reading message forums. When I first began to learn about the Linux operating system I was constantly assaulted with RTFM!!!! NUB!!!!. Translation: Read the F’ing manual, new guy! If you go the free software route be prepared to deal with that mentality. A disadvantage that should be noted is that when a commercial software product reaches it’s “end of life” the support generally goes away.
• Compatibility of the product. If the programs who make, and/or maintain free software don’t see a need to make it work with certain other software it isn’t going to happen. Sure, you have the option of having a programmer modify the code to suit your needs, but then any savings you might have realized by using free software is erradicated. With commercial software they want to keep their customers happy. They’re going to be much more inclined to implement the changes that make your life easier
• Easier to get management to agree to it. If you need to change, upgrade, or even begin using medical billing software a commercial product is going to be a lot more appealing to the people who make the money decisions. You’d think the opposite would be true, but in reality people equate the idea of free to mean poorly made and can’t be sold because it is so bad. After you’ve made about 5 or 6 power point presentations and walked senior staff through the most basic of usage for a free program you begin to appreciate commerical medical billing software even more than before.

Risks involved with free medical billing software

There are several risks that health care provider should be concerned with regarding their billing software. We will just take a brief look at two of them.

• Legal protection
  
  Is it HIPPA compliant? Some is and some isn’t. With free billing software it will be up to you and your staff to figure that out. With commercial medical billing programs that is almost always guaranteed by the developer.
• Updated regularly
  
  In this case I’m talking about things like medical terms, and common accepted practices. Developing a piece of software is the easy part. Keeping that software updated and functioning according to “today’s” standard can be a little more tricky.