Question

Sandy is a high school student considering a career in health insurance and billing. How would you explain the career to her? Provide her with examples of job responsibilities. Also discuss the current state of healthcare and challenges faced in the career.

Answer 1

Health insurance billing specialist is also called coding specialist. Insurance companies determine the reimbursement owed to patients based on the diagnosis and health condition codes assigned by these specialist.

RESPONSIBILITY:They are health care professionals and their duty is to proceds the patient data. They request for payment from the patient's insurance company.

*Read patient's chart to determine diagnosis and treatment given

*Transcribe the history of patient into a short note that will be used by both insurance companies and health care providers

*Determine correct codes for patient's record.

*Interact with doctor's to ensure accuracy.

*They keeping track of patient's data over multiple visits.

*Maintain patient's confidentiality.

CHALLENGES:

4 main cchallenges

INACCURATE CODING

_Mismatched coding

_Entering mistakes

_Insufficient documents

_Missing documents

_Error in patient's information

_Fail to use correct code set

2.USING MANUAL CLAIM MANAGEMENT

_They lead to more inaccuracies.Using vender solutions helps to better identify the actual cause of claims denial and boosting overall revenue.

3.FAILING TO CAPTURE PATIENT INFORMATION

Having good script is neccneces for employees who schedule and registered patient can ensure you capture the information needed to make billing and collection as effective and efficient as possible.

FAILING TO INFORM PATIENT OF FINANCIAL RESPONSIBILITY

To improve your chance of collecting,you need to not only have a good payment policy,but you need to inform patient of their financial responsibility and your payment policy.