Medical Billing Coding Certification Is Necessary to Reduce Bogus Charges and Improve Reimbursement

Without professionals who operate using high standards and who have received medical billing and coding certification, a suspicious charge on your bill may end up damaging your credit score. Health finance professionals believe that up to 40% of hospital bills will contain billing errors. A Boston-based health care advocacy group, the Access Project, believes that number is closer to 80%.

Medical billing errors can reduce your credit score. Results from a study from the Federal Reserve indicate that medical bills account for more than half of all the debt currently in collection. Inaccurate billing by a physician office and hospital can increase your financial debt and can be more than just an inconvenience.

Hospitals and physician offices are looking for professionals who have received certification in order to demonstrate their knowledge and reduce the potential that they will produce in billing errors. These billing errors impact, not only the patients and their credit score, but also the trust that patients have in their hospitals and physicians.

Interestingly, some healthcare experts believe that the number of errors may jump in the coming years because of the electronic health records included in the $19 billion stimulus package. The US Department of Health and Human Services hopes that by 2014 at least 80% of hospitals will be using electronic records. Although the intent is to reduce the number of errors, logistically these errors may increase exponentially.

This is because electronic record-keeping in the hospital begins on the hospital floor with nurses and certified nursing assistants entering information into the computer records that generates codes for reimbursement. Any time dressings, fluids, antibiotics or medications are administered, the information is entered into a medical record but also generates a code for insurance reimbursement. If the certified nursing assistant, nurse or physician enters the wrong item and patient can be overcharged or under charged.

The good news is that these billing errors can be corrected when patients are willing to look through their hospital billing records to ensure that they received everything that was charged. Unfortunately, if you do find an error, it can take serious legwork and long hours on the phone in order to resolve the issue. However, without resolution, these billing errors can significantly impact your credit rating.

Hospitals and physician offices to use electronic medical billing services will find that employment of individuals who have received certification can help to reduce their overall errors. Conscientious professionals must spend hours pouring over bills and medical records to ensure that the correct coding is sent to insurance companies and third-party payers.