Billers and Coders Benefit from Complexities of Healthcare Reforms


Healthcare reforms are being introduced to enhance the quality of care and reduce costs; however, these reforms are also posing challenges for providers. It is making it difficult for them to procure payments and focus on quality care. Failure to comply with the coding and billing changes is leading to revenue loss and in order to get paid and stay abreast in business, demand for skilled coders and billers has gone up.

Practices are hiring skilled and certified coders and billers to ensure timely reimbursements amidst all the changes in regulations, complex coding, escalating costs and reduced reimbursement rates.

Industry facts

Career opportunities for coders and billers are expected to increase by 20% by the year 2018
Skilled billers and coders will be required to handle the responsibilities associated with EHR
Coding complexities will increase with ICD-10 implementation in 2015
Affordable Care Act will pose several challenges for practices in 2014
According to the Bureau of Labor Statistics Occupational Outlook Handbook, employment rate of medical billers are set increase by 21% by the year 2020
Increase in aging population will continue to increase demand for coders and billers

Healthcare Reforms that will Affect billing, coding and reimbursement

  • ICD-9 will get replaced by ICD-10 in October 2015, adding approximately 65,000 new codes that describe medical conditions and treatments
  • Practices will have to implement HIPAA-5010 in place of HIPAA-4010 to submit claims with the new set of codes in ICD-10
  • Level of accuracy in documentation should increase for complying with the CMS payment updates for physicians treating patients for Medicare Advantage Plan
  • Yearly updates are scheduled for the CPT Code Book
  • Classification of medical procedures will also change due to rising federal regulations
  • Number of claims filed will increase because of insurance coverage expansion

More Job Opportunities with more Responsibilities

Job opportunities are definitely on the rise for coders and billers but it is coming with additional job responsibilities. They will need certification and be trained in handling larger sets of codes and data. It is required for applying codes appropriately so that practices get paid on time.

Coders and billers also need knowledge of denial management, tracking rejections and generating claims rejection reports because these factors play an important role in obtaining maximum revenue for physicians and thus reducing the scope of losing thousands of dollars.

Preparing for billing and coding Complexities with MBC

MedicalBillersandCoders.com is the largest consortium of certified, well-trained coders and billers offering billing solutions to practices. MBC has its own job portal that provides job opportunities to coders and billers across all the 50 states. Their coding and billing newsletter provides opportunities as well as knowledge to coders about the changes in industry.

The coding experts at MBC are vigilant about the industry updates and are also aware of the preferred area of training. They provide accurate solutions to healthcare providers of all medical specialties.

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