The basics of medical billing

Hey there. I'm Heather with AAPC.

Welcome to our intro to medical billing course. Whether you're just curious about medical billing or thinking about diving into this career, you're in the right place. In this video, we're gonna cover the basics, what medical billing is, what medical billers actually do, and how they play a critical role in health care.

Plus, we'll chat about where medical billers work and whether you can do it from home. Sound good? Let's get into it.

Alright. Let's start with the most important question first. What is medical billing? At its core, medical billing is the process of translating health care services into a bill that gets sent to the insurance company or patient for payment.

Let's break that down a bit. Imagine you go to the doctor for a checkup. The doctor provides a service. Right?

Well, the insurance company needs to know what exactly that service was so they can pay the doctor for their work. But doctors and nurses don't send the bills themselves. That's where the medical biller steps in. Their job is to make sure the doctor gets paid by the insurance company or, if necessary, by the patient.

They're the middle person who helps the health care providers get compensated for their time and expertise.

So now that we know what medical billing is, you might be wondering how a medical biller gets their job done. Well, here are some of their main tasks.

Review information from health care providers.

After a patient visit, the biller gets details about the services provided, such as a checkup, surgery, or lab work.

Create a claim. Using special software, the biller translates those details into a claim that includes the cost of services and any relevant codes. We won't get too deep into the medical coding part in this video, but just know it's part of the process.

Submit claims to insurance.

Once the claim is ready, it gets sent to the insurance company. Then the biller waits to see if the claim gets approved or denied.

Follow-up and make corrections.

If the claim gets denied, which happens, the biller steps in to figure out what went wrong, make any corrections, and resubmit it. Medical billers also follow-up on any unpaid claims, making sure nothing falls through the cracks.

Now let's talk about why medical billers are so important.

Think about this. Health care providers, whether they're doctors, physical therapists, or hospitals, focus on one main thing, patient care. That's their expertise.

But the business side of things, that's not really their world. Medical billers are the ones who ensure that the business side of health care runs smoothly.

They make sure the health care providers get paid for their work and that insurance companies are billed correctly.

Without medical billers, health care providers would be stuck doing a ton of paperwork and patient care could take a hit. So in many ways, medical billers keep the whole system running. They also help patients. How? By making sure bills are accurate so patients aren't overcharged or hit with unexpected costs.

It's a behind the scenes job, but it has a huge impact on both the health care providers and the people receiving care.

So where exactly do medical billers work? They can be found in all sorts of settings, including hospitals, doctors' offices, clinics, nursing homes, and specialized billing companies.

Some billers work on-site at these locations, while others work in an office for billing service companies that handle multiple health care providers.

But here's the cool part. Many medical billers get to work from the comfort of their own home, especially if they're working for a billing company or as a freelancer.

But this often depends on a few things. Some companies prefer you to have experience before they offer remote options, while others provide full training and let you work from home right off the bat.

The technology for this career makes remote work easily accessible. As long as you have a reliable computer, good Internet, and access to billing software, you're set.

That said, if you're just starting out, it can be helpful to work in an office setting first. Why? Well, it's easier to ask questions, learn from your peers, and get a feel for the job when you're in a more structured environment.

So there you have it. Medical billing is a rewarding, detail oriented career where you can work in a variety of settings, even from home. Whether you're looking for flexibility or you're passionate about playing a key role in health care, there are many reasons to find satisfaction in this profession.

Next up in this course is a day in the life of a medical biller. We'll be taking a deeper dive into the many details that go into this profession. Give it a watch to get a better understanding of what to expect on the job.