Outsourcing of Medical Billing - A Sunrise Opportunity in Health Care

The Health Insurance Portability and Accountability Act came into being on February 16, 2006. The aim of this law is to define and establish national standards for health care transactions and also provide security and privacy of health care information. The Act's purpose is to substantially improve the delivery of the health care system. This advanced, reformed system demands qualified individuals who can put it to use to maximize effective implementation of the legislation as well as to allow for thorough compliance at the same time ensuring maximum reimbursement to the needy. All the health care providers must employ qualified persons so that mistakes that can result in serious consequences are avoided.

World over, medical knowledge has progressed after the World War II bringing about fresh, insights and techniques in diagnostic and treatment processes. There is therefore a pressing need to organize and standardize these technologies. Thus evolved the medical code which not only met these challenges but also allowed for a system of uniform communication of health information. A common medical language evolved and standardized definitions and codes were formulated for use of health care providers and insurance companies. In this age of high technology, these codes and medical procedures have increased tremendously and they have to be constantly updated. This process is best achieved through outsourcing of medical billing.

With the explosive growth in health care, the medical billing and associated occupations are on the rise. Government agencies and insurance companies are striving to control frivolous claims, fraud, misuse and abuse of reimbursement policies. The role of medical billing experts is critical in this process. Because the legal consequences of incorrect billing can be disastrous there is a dire need for medical billers who can ensure accuracy in billing and also be held accountable for any mistakes, in the same manner as the tax accountants who file the returns for clients.

Currently, no educational standards have been laid down for medical billers and coders. The employers are in search of formal training through accredited training institutes that offer training courses of 9 months to two year duration. This will ensure that the certified persons are capable of understanding the issues involved and deliver proper service to the clients. Many organizations have come forward to sponsor such certification courses in the interest of the industry. There are several institutes offering courses in medical billing and coding. A medical biller / coder can expect to earn $8 to $10 per hour to start with, which could go up to $30 to $40 after gaining some experience.

The health care industry is evolving at an enormous pace, and so are the complex medical and surgical procedures. The medical coders can only standardize them with the help of sophisticated software programs and make the services easy for outsourcing. Such a scenario means an on going demand for qualified and experienced medical coders and billers who can play a vital role in the outsourcing industry.