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Significance of Medical Coding and Billing

Medical billing and coding are two of the most critical components in any medical practice. Accuracy in both of these areas is critical to patient safety, rapid payment, and efficient operations. With a major portion of health care expenses being taken care of by health insurance, there is a huge demand for accurate and reliable medical coding and billing process.

As the payment for medical services provided is directly influenced by this process, health care facilities and medical practitioners cannot afford errors in it. Failure to implement accurate medical coding and billing system proves detrimental to the administration of any health care facility. On the other hand, affordable medical claims management, when implemented, provides enhanced collectible revenue of the practice.

Difference between a medical biller and medical coder

A medical coder’s main role is to decode the service or procedure written on the patient’s documentation provided by the healthcare provider, and then determines the appropriate procedure (CPT) and diagnosis code to submit. Medical coding workers spend time in assessing and properly coding the data, in order to ensure an accurate billing procedure is free of any errors.

Then, the medical biller inputs the claims with the appropriate codes and submits the claim to the insurance company for billing. The medical biller then, follows-up with the insurance company to make sure the claim has been approved, if there are any discrepancies or missing information, they reach out to the patient and let them know what is happening with their claim.

Importance of Accuracy in Medical Billing and Coding

Accuracy in medical coding and billing prove to be crucial for medical practices for perfect and timely submission of medical claims. Error-free and timely claim submission ensures getting reimbursement and reducing accounts receivable.

Impact of Inaccurate Billing on Patients

Errors in medical billing lead to patients being put under hardship. This, in turn, enrages them. Errors may impact patients in several ways, such as having to face financial trouble, having to spend precious time on the phone for explaining things, or being pushed to pay for services that actually were not provided. Apart from causing unwanted issues, medical billing errors result in patient dissatisfaction that doesn’t go well for the medical practice at all.

Some errors that can be avoided

Careless use of balance billing:

The practice of balance billing refers to a physician’s ability to bill patients for outstanding balances after the insurance company submits its portion of the bill. Out-of-network physicians, not bound by in-network rate agreements, have the ability to bill patients for the entire remaining balance. Balance billing may occur when a patient receives a bill for an episode of care previously believed to be in-network and therefore covered by the insurance company, or when an insurance company contributes less money than expected for a medical service.

Duplicate billing:

“Double billing” (sometimes referred to as Duplicate Billing) occurs when a provider attempts to bill Medicare / Medicaid and either a private insurance company or the patient for the same treatment, or when two providers attempt to get paid for services rendered to the same patient for the same procedure on the same date.


Overcoding and undercoding are two coding mistakes that can have damaging results in the medical office. Overcoding leads to insurance companies making much higher reimbursements than what the actual reimbursement should be. However, the penalties of getting caught far outweigh the advantages of getting a higher paycheck. Undercoding can result in the loss of revenue.

Why Medical Coders are the Superheroes in the Healthcare Industry

A medical coder typically codes the claims of a physician, hospital or a therapist. Unfortunately, it is understood that the responsibility of a coder ends with coding alone.

This is not true at all!

Medical Coders do much more than just coding. The job of the coder can vary and grow to more extents, based on the facility or organization that he/she works for. The Healthcare Insurance industry can never function without them. In short, they are the superheroes of the industry.

Let us look at some of the non-coding activities performed by Medical Coders:

1. They act as mentors

The medical coders are the right people to teach and mentor the healthcare industry and the healthcare insurance industry about the coding fundamentals and guidelines. The doctors and administrators also often get coached and receive a lot of crucial information from them about the guidelines.

2. They are on a learning curve always

Getting a job in coding does not mean that the coder has an easy job to do now and he can put his feet up in the air for life. On the contrary, a medical coder has to keep learning how to code unlearn and relearn periodically. Because the coding guidelines keep changing. Like the recent one, ICD 10 transition is going to affect medical coding. Learning new codes, additional guidelines, and mentoring the same across the industry are some of the major responsibilities of the coder. A minor issue in coding can mean that the claims getting denied or underpaid, which no physician or facility appreciates.

3. Deal with the denials

Speaking about denials and underpaid claims remind yet another job of the coders. They are often left to deal with denials, as same as the billing staff. Senior coders are often part of the denial management team. If a claim faces an issue, often coding is checked and, in case of continuous denials, a coder gets into action. He or she would have to check with the insurance company, if the codes are wrong, or reassure them why the specific code is present in the claim.

4. Coders have their plateful

Now, if the coders have received the appreciation of dealing with the codes, insurance knowledge, it is time to extend the applause. For they also take time to learn about LCD, NCD, policy guidelines, HIPAA rules, State and Federal laws and much more. They come handy to them, to keep off from errors.

5. They understand what the doctors mean

Pharmacists are often valued for understanding the writings of a doctor. Next time, the coders should never be forgotten. Pharmacists have the opportunity of reading the names of the pills and medication from the boxes. Sadly, the coders have a lot of patience to decipher what the doctor has prescribed. If there are nursing assistants taking a note of the procedure and treatment process, they have a great day dealing with different set of handwritings for a single claim.

Apart from these, the best struggle of the coder can be considered to have knowledge about the case studies, surgeries, and codes. Coders are often life science background or someone who has something to do with the healthcare industry. That does not mean they can understand all these, and yet, they often are required to discuss these topics, though not a physician.

Is Medical Transcription the right career for you? Find out!

When we think of medical transcription, a topsy-turvy handwriting on a piece of paper which very few people dare to read and understand pops up in our mind. But medical transcription is so much more.

What is Medical Transcription?

A simplified definition of medical transcription goes like this – ”Medical transcription, popularly known as MT, is an allied health profession dealing with the process of transcribing voice-recorded medical reports that are dictated by physicians, nurses and other healthcare practitioners.”

What are the goals of Medical Transcription?

The primary objective of medical transcription is accessibility or the easy availability of medical information. For instance, medical records of a patient can be made easily available once the audio-visual material of procedure performed on them get transcribed. The second goal is successful online marketing. A health provider advertises its business with the help of the story of its success in different cases backed by the carefully drafted and designed fact. And the third main goal is organizing the information for further purposes of research.

How does Medical Transcription work?

Doctors, nurses and other professionals working in the healthcare sector can use computer applications such as word processors to create reports, articles, and charts etc. Many don’t have enough time, skill or the desire to learn or deal with such programmes. When they need assistance to write for official purposes, they turn to the medical transcription services.

Medical reports can be voice files, notes taken during a lecture, or other spoken material. These reports are dictated over the phone or uploaded digitally via the Internet or through smartphone applications.

Given the complexity of the procedure involved in preparing medical transcription reports, there is high demand for manpower who can render and edit reports, procedures, and notes dictated by doctors in an electronic format, in order to create files representing the treatment history of any particular patient. People who render this service are known as Medical Transcriber (MT) or Medical Language Specialist (MLS). Health practitioners dictate what they have done after performing treatment procedures on patients and medical transcriptionists, or MTs, transcribe the oral dictation and/or edit reports that have gone through speech recognition software. A confidential and up-to-date medical information about a patient is converted to a written text document by a medical transcriptionist. Healthcare providers often prefer to store medical records electronically due to the whopping volume of hospital patients and the paperwork it needs. The electronic storage gives immediate access to subsequent departments of the service provider i.e hospitals regarding the patient’s care to date, notation of medications, their allergies etc. It helps establish a history on the patient to facilitate quality healthcare delivery regardless of geographical distance or location.The transcription text may be printed and placed in the patient’s record. It may also be retained only in its electronic format depending upon the need arisen. The transcription can be done by medical transcriptionists employed in a hospital, or by people who work at home as telecommuting persons for the hospital. MTs also work as telecommuting employees or independent contractors for an outsourced service that performs the work offsite under contract for a hospital, clinic, physician group or other healthcare services provider. They sometimes work directly for the service providers such as doctors or their group onsite.

How can you become a Medical Transcriptionist?

You can easily become a medical transcriptionist by earning a certificate degree in Medical Transcription. You will study and master medical terminology, business writing, typing skills, computer applications, and legal issues on healthcare documentation. Some certification programs include internships and fieldwork opportunities, giving them on-the-job training and helping them apply what they learned in the program. The certification lasts for a certain valid period and earned by passing an examination. To maintain the certification, transcriptionists need to participate in on-going education courses.


Medical Transcription is a critical aspect of healthcare services. A certificate or associate degree in the medical transcription field is necessary and along with good experience, it can help your employment prospects.

5 Reasons why Medical Billing is one of the best career options in the healthcare industry

A plethora of options are available in the career market, but choosing the right one will give excellent exposure and lets you earn at leisure. Medical Coding is an excellent option in the healthcare industry given their growing demand.

If you have considered a fresh start or a career shift in the healthcare sector, then Medical Billing is an excellent choice for you. The job roles include analyzing the patient reports and records using specific codes to bill the insurance providers.

If you assume that you are not career-ready for the same, then one can seek the assistance and guidance of Medical Coding Training institutes that are training candidates who aspire to become a Medical Billing professional.

Unlike other professions, Medical Billing gives you the flexibility that makes a work-life balance.

Let us walk through various reasons, that will help you analyze why Medical billing is one of the right career opportunities for you.

1. No prior experience is mandatory: You don’t need previous experience for  Medical coding and billing. All you need is just to get certified through an accredited Medical coding Training Institute.

2. The wide range of employment opportunities: From medical healthcare institutes, hospitals, medical centers, nursing homes, administrative departments, and physiotherapy centers, there is always a steady demand for accredited Medical coding professionals.

3. The job market is welcoming: A wide range of option can be stumbled upon as you are researching the career options for Medical Coding professionals.

4. Flexibility: Most health care centers work 24/7 offering uninterrupted medical services. Hence, every health care center requires one or more medical coding employees to work during every shift. The steady demand along with shift timings gives work flexibility to many professionals.

5. Competitive Salaries: Unlike the earlier times, the growing demand for healthcare professionals in the healthcare sector have led to many opportunities and attractive salary packages for Medical Coding and Billing roles. Every year, a group of professionals land in the career market from the Medical Coding Training Institute raising the bar of competition and hence, the overall quality of medical professionals.

Conclusion: Medical Billing is a great career option for you as it offers stability, steady growth, work-life balance, exciting opportunities, and a lucrative salary.

5 Awesome reasons to join the Medical Coding and Billing industry

If you are thinking about a career in the healthcare industry, Medical Billing and Coding is an excellent option. We list a few reasons for you to make the switch:

1. A crucial and irreplaceable job

Medical Billing and Coding authorities are necessary for the healthcare industry as they help in minimizing expenses, lessening therapeutic slip-ups and for the most part, guaranteeing that there’s a free stream of data about the patients’ restorative narratives. They are an irreplaceable faction in the healthcare industry that keeps the health services offices running smoothly and saving lives in the bargain as well.

2. No need to graduate from a medical college

Probably the biggest obstacle for individuals who desire to work in the healthcare industry is the high cost and lengthy period of studying in a medical school. Anyone with a keen interest can learn Medical Coding and Billing in just a few months at a reputed training institute and get a professional certification.

3. Making that career switch is easy

Medical Coding and BIlling is a welcoming profession for anyone who is keen to enter the healthcare industry at any stage of their life. You can switch your career to this field with tremendous ease. You can complete the Medical billing and coding program in less than a year. After that, you can take certification exams offered by the National Healthcareer Association (NHA) or the American Health Information Management Association (AHIMA), and you’re all set a booming career ahead in this field.

4. Flexible shifts

Medical Billing and Coding work is a 24/7 job. Hence, another advantage is the option of shift timings in this profession. Whether you are a morning or night person, this is a career that is for anyone who prefers to work at their optimal capacity and time.

5. Work from home is available

A vast majority of the work is done on a PC by medical billing and coding experts. A few companies offer the choice to telecommute or work from home on some if not for all the days in a week. Thus, Medical coding and billing is an excellent career option for whom working in a typical 9-5 corporate office is not an option.

Top 5 reasons to become a Medical Coding and Billing Specialist

Being part of the medical team, Medical Billing and Coding professionals acquire an important set of skill and knowledge of various medical terminologies and anatomy, as well as proficiency in the field of Medical coding and billing software.

To meet the rising medical needs of people, companies dealing with insurance and similar criteria are continually updating their claims processing procedures, thus, fueling the job explosion for Medical coding and billing specialists.

For many, this occupation can be very advantageous. Let’s look at the top five reasons to consider before getting into this field.

Working in the healthcare industry is satisfying

You would be able to say that you are directly contributing to saving lives every day? Not really!

On a serious note though, one great benefit of getting into the Medical coding industry is the immense job satisfaction that you get. Another advantage is that is you get to complete the specialized training in just a few months.

Medical billing and coding specialists are effectively trained in reducing medical mistakes, keeping the costs down, and ensuring the free flow of information about the patient’s medical history.

These specialists are crucial in keeping the medical facilities up and running for saving precious lives.

Be a niche member of the rapidly evolving industry

Medical billing and coding are experiencing the most significant evolution today. The legislation is attempting to reform the healthcare industry by motivating more use of electronic medical records. By improving the way patients’ medical records are managed, the healthcare industry is looking to cut costs and increase revenues significantly. The nature of the Medical coding and billing job is getting increasingly sophisticated and niche with these evolutionary changes within the industry.

You are saving lives too

When thinking of life-saving work, you don’t think about the medical coders and billing professionals. For instance, medical coding errors can be deadly sometimes. This is the case when an incorrect code can lead to wrong diagnosis and treatment.

That’s why medical coding and billing professionals are essential to the industry. Making sure the data is prompt and accurate is the core part of their responsibility.

High recruitment

This is one of those rare fields that is witnessing an invariable increase in the way hiring is done. The medical billing and coding specialists are expected to see a 15% rise by the year 2024. That’s a “much faster than average” statistical figure.

In comparison, the average jobs in good healthcare countries are going to see an increase over the coming years. That translates to great things in store for medical billing and coding specialists.

Call yourself a cool ‘coder’ too

The reason might seem trivial. But if you are in India and under the pressure of having a designation of ‘coder’ before your name, this field is worth a try.

It’s true that the medical coding and billing specialists are entirely different than the software developers. Software developers write codes to develop software, wherein, you would be inputting correct codes for various medical conditions into the software. Still, let’s face it, not enough jobs have cool short versions of their titles to make you sound awesome.

If you are now curious to learn more about the subject and get into a job like medical coding and billing, then hopefully this article has given you important insights. Given the volatile nature of the profession, the field requires experienced personnel to perform the tasks on time and help patients have smooth medical treatment. Accuracy, precision, and attention are essential for the job. Hence, if you fulfill all the criteria, we highly recommend that you try getting into medical coding and billing.

Career Opportunities for Pharmacovigilance

Pharmacovigilance, in layman’s terms, is drug safety which is defined as science and activities related to adverse effects caused by drug and pharmaceutical products. Pharmacovigilance is the reason, why many drugs are withdrawn from or not even brought into the market at times.

Students who wish to pursue a career in the pharmacovigilance are required to be a medical professional or should hold a degree in pharmacy and Bio-Sciences. Further studies such as postgraduate qualifications or diploma can be advantageous for a candidate wishing to pursue a career in this industry.

Some institutions offer pharmacovigilance certification program specializing in Pharmacovigilance, which is highly valued by many employers within the pharmaceutical industry. The course will provide students with essential knowledge and understanding of what a career in this industry entails, including experience of risk assessment, report writing, and signal detection.

Experience is essential when getting ahead of other candidates fighting for a position in drug safety and Pharmacovigilance. Observing and partaking in the industry first-hand as a placement student, or even shadowing a nurse or pharmacist demonstrates an applicant’s interest and willingness to work in a clinical background.

Careers in Pharmacovigilance

There are many different roles and job titles in medical regulatory affairs. Employees would typically begin their career as a drug safety associate, scientist or coordinator which advances to specialty, senior and management positions in a particular area of Pharmacovigilance.

Quality assurance, medical writing, and medical affairs are some of the main areas of focus for advanced employees; however, these positions come with increased responsibility and require immense experience.

Also if candidates are willing, there are many other opportunities abroad focusing on drug safety. These tend to be positioned in larger companies and so offers scope for progression into authoritative roles.

The yearly salary for a career in Pharmacovigilance can vary substantially, but earnings usually fall between the figures of Rs.3.5 – Rs.8 lakhs per annum. This depends much on factors such as the regulatory body, location, experience, position, and responsibility.

Types of jobs in the pharmaceutical industry

Drug safety officer: Responsible for tracking and observing reactions and effects during drug trials and studies. A report on the study is submitted to regulatory authorities, and once the report has been submitted drug safety managers must organize and review the reports to monitor the profile of specific medical products.

Drug safety physicians: Assess and obtain information about the product safety. They are also required to carry out medical case reviews and evaluate product safety during clinical trialing.

Pharmacovigilance job may either be permanent or on contract agreements; with impermanent positions usually lasting between three to twelve months.

If Pharmacovigilance is your dream career, then let us make it true by getting trained at Joshi Medicode. We offer a comprehensive range of training for various courses related to health care and life science like medical coding, billing, transcription, healthcare business analyst, and pharmacovigilance.

Visit our website www.joshimedicode.com  or contact us at +91 984 926 6033 for further details about the Pharmacovigilance training, classes, demo and many more.

What is the Scope of Pharmacovigilance?

Over a past few years, there is a fast pace increase in the number of domains in the healthcare industry which is indeed the reason for the trajectory growth of the healthcare industry.  One such domain that has shown positive growth is Pharmacovigilance.

Pharmacovigilance, defined by the WHO is ‘the science and activities relating to the detection, assessment, understanding, and prevention of adverse effects of drugs’.

Why all pharmaceutical markets across the nations need Pharmacovigilance services?

Did you know? Infectious and parasitic disease and respiratory infection were the two leading causes of death in 2017, and interestingly enough, a massive 48.7% of the population have been on at least one prescription drug.

According to WHO Report on Life Expectancy, the rate of chronic disease has increased by 18% between 2008 and 2015, while the non-chronic diseases are up at 15% over the same period.

Despite the full range of benefits we get from modern medicine, there are adverse drug reactions (ADR) which may cause permanent serious illnesses, side effects, paralysis and even death. The field of Pharmacovigilance is essential for monitoring public health and institutionalizing the safe use of medicine.

The global pharmaceutical market worth over $1 trillion. It is said that there is a cumulative annual growth rate (CAGR) of 6% from 2014 to 2020. Added to this the increasing geriatric population, and rising burden of chronic and non-chronic diseases, it is no surprise that the worldwide market for Pharmacovigilance services is forecasted to be worth $6.1 billion in revenue by 2020.

How does this affect Pharmacovigilance?

The increase in both chronic and non-chronic diseases are the main driver of demand for the production of medicines. Therefore, the global growth of various health conditions is equivalent to the consumption of drug and pharmaceutical products and the consequent appearance of ADRs. With thousands of drugs expected to hit the pharmaceuticals market in the next few years, there is an increased clamor for drug monitoring and regulating, hence driving the Pharmacovigilance industry to grow at a CAGR of 14.2%.

With the increased demand for drug safety and monitoring, a growing number of multinational pharmaceutical companies are turning to Pharmacovigilance services. If you are planning for a career in Pharmacovigilance, then this is the best time.

At Joshi Medicode, we offer a comprehensive range of training for various courses related to healthcare and life science like medical coding, billing, transcription, healthcare business analyst, and pharmacovigilance.

Visit our website www.joshimedicode.com  or contact us at +91 984 926 6033 for further details about the Pharmacovigilance training, classes, demo and many more.

Opportunities and career advancement for women in Medical coding.

Ladies out there!! When it comes to obtaining a new career, do consider medical coding and billing- a highly demanded profession in a growing industry.

The U.S. Bureau of Labor Statistics expects that three million healthcare jobs will be created in the decade leading up to 2019. Employment in medical coding and billing is expected to increase by 18% in the same time, which is faster than the average for all other occupations.

Medical coding and billing in the healthcare industry is not just a great option because it’s fast-tracked; it also opens up infinite future opportunities, especially if you want to move elsewhere in the healthcare industry. Medical coding and billing can provide you with a career while you take further studies in nursing or even medical school. Medical Coding can also be useful for future pharmacists or general caregivers.

Job responsibilities

Medical coding and professional billing specialists work hand-in-hand to make sure that all of the medical invoices are coded and paid correctly. As companies shift to electronic medical records, workers who have a strong understanding of technology and computer software will be in high demand.

To make sure that all medical services are billed correctly and are paid on time, medical billers need to communicate with patients and insurance companies frequently. In contrast, professional medical coders have less interaction with patients and insurance companies but work closely with physicians. They are accountable for assigning a code to each procedure and diagnosis for insurance purposes.

Medical coders work in a mixture of environments. Some coders work in hospitals, doctors’ offices,  or outpatient facilities for full-time or part-time. Many coders even provide their services from home this is especially an advantage for women who seek for the job from home. Few coders work for insurance companies. Some medical coders work as employees, while others do their work as a freelancer, this is also another great opportunity that women can grab. There are many work environments available to medical coding professionals, which makes medical coding a convenient career.

Required skills and training

The medical coding and billing profession requires a strong knowledge of medical terminology, anatomy, coding procedures, the laws in concern to health information, medical billing software, and quality improvement measures.

Medical coding and medical billing training can take anywhere from about 6 to 9 months for a certificate, the majority of which prepare students for certification exams.

As medical coding and billing offer many opportunities and benefits, it is a great opportunity for women who seek for career advancement. Medical coding and billing training at Joshi Medicode is a smart decision for motivated women who want to enter the healthcare industry quickly. If you would like to know more information about medical billing and coding, contact us today to discuss upcoming demos, enrollments, and take the first step towards a bright future and a rewarding career.

Preparation tips for the CPC Exam

A number of preparation materials for Certified Professional Coding exam are available with the AAPC. Though they are available through the AAPC’s website, they are very expensive. You can also learn everything you need to pass the CPC exam in a coding course at a university or institute. And there is a need to purchase the AAPC’s training materials if you are out of practice.

Here are few tips for preparing CPC exam

Prep Strategies

The CPC exam has many topics and it’s very easy to get overwhelmed in the preparation stages. Following are the few ways to cope with this intimidating exam:

During the exam, you need to spend most of your time with the CPT manual. Though there are some questions on ICD-10-CM codes and HCPCS, there are more questions that relate to the CPT code set, so focus your study efforts there. You need to also have the knowledge back to front, and be comfortable navigating it and also use its numerous appendices.  There are many people who take the exam only after they work for a while in medical coding. Remember that to be certified, the CPC needs a passing score and two years of professional experience. If you have already gathered that experience you may be relatively familiar with medical terminology and anatomy and physiology. But then it is best to brush up with the information through the review courses.

There will be various questions in the exam that have reference to medical or anatomical terminology, but if you have a strong medical vocabulary will help you in deciphering other questions too.

Taking the Exam

While you take the CPC exam, you can bring along each of the code manuals (the ICD, CPT, and HCPCS manuals).  You can make notes in the margins of these manuals, but these notes cannot have any test specific information.

On your code manuals, you can mark the most important or frequently used sections. As CPT manual comes with a number of tabs you can place in the book to mark certain important places. While you take the CPC exam, you may be asked to perform as if you were coding at your regular coding job, so all you need to do is set up your manual in a way that makes the most sense to you.

Time Management

The CPC exam is almost for six hours and consists of 150 questions. Hence it is good to break things down so that they are very manageable. You can separate the questions into various blocks of time, and then start working on one block of questions for a fixed amount of time before starting the next.  For example, the entire CPC exam can be divided into five groups of 30 questions. You can allot one hour for every thirty questions.

Understand Your Goals

Always keep in mind that If you want to pass the CPC exam, all you need to get is 70% or better. The lengthy, multi-part questions that make you look up three, four or five codes are worth the same as the general knowledge questions. In case, you are stuck with one question, you can always come back to it later. You should remember that while you take the test, you get 35 questions wrong. You need not waste a lot of time on a question that’s totally confusing you. All you need to do is move on to another question and try with easier, less intensive questions.


Now become a certified Medical coder by getting trained at Joshi Medicode, we offer comprehensive training in medical coding, billing, and transcription. For further details visit our website….. or call us at….

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