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Most health care facilities in this country accept responsibility for filing health insurance claims.  This is done either in the office, or forms are sent to a billing company that provides medical billing services for a fee.  Because of the increasing complexity of medical billing and the increased number of managed care insurance programs, the need for additional skilled medical billing specialists is growing rapidly. 

Because billing has become more complex, more training is required than ever before.  Untrained personnel can no longer cope with the myriad of programs, regulations, and updates in the field.  Likewise, medical facilities cannot operate with the loss of revenue resulting from inaccurate billing and inexperienced personnel. This is especially true since carriers, including and especially the government (Medicare), have consistently cut payment amounts over the last 10 years.  It follows that since most health care facilities are dealing with reduced payment revenue, poor billing practices cannot be tolerated. 

In addition to the typical doctor’s office situation, there are opportunities with the health insurance carriers, malpractice and liability insurance companies, state, local, and federal government agencies, medical consulting companies, law offices, private insurance billing companies, hospitals, clinics, schools, computer companies specializing in medical software, and self-employed consulting and/or billing companies. The actual duties may vary from position to position, as we discussed earlier, but the basic knowledge needed is the same. 

A career in medical billing should be considered for many reasons. First, it represents a good, solid, stable job, with varying salary ranges, depending on such variables as specific duties, geographic region, experience, and the company itself.  A medical billing specialist is a respected member of the health care team.  And, as is true of all health care careers, you will be able to help people every day.  It certainly is a career worth working for!

John E. Long
Medical Billing Program Instructor
Ashworth School of Health Care

I wasn’t sure at first if Ashworth was going to be the best school for me to take this program. And I wasn’t sure if the program would be good and really help me in the near future.  I was confused, but I made the best decision. Their program is good and you will learn the program if you really pay attention to it and take every lesson seriously.   

I got my package one week after enrolling.  It was fast and everything was there.  I’m new in the medical field, so I was kind of nervous yet excited at the same time.  I’m now on Lesson 4.  Getting there and loving it!

It’s pretty hard for me, but I am very motivated and looking forward to finishing my program.  I hope to be able to start working in a hospital or home health environment—doing what I love to do.

To all my fellow Medical Billing/Claims students, keep motivating yourself.  

It’s all worth it!  Good Luck!

Amanda
Student
Ashworth Medical Billing/Claims Program 

I am currently enrolled in Ashworth University’s Medical Billing program. I am pleased with the content that is covered and the program offers so much more than a local or community college. However; I would like to see the Medical Billing program go into more detail about insurance programs like Etna and Cigna.  

I would also love to see the school develop a Bachelor’s degree in Human Resource Management. If Ashworth would offer an Associate, Bachelor’s, and Master’s degree in this field, I would sign up for the program in a heartbeat. If a school has an opportunity for you to receive an Associate degree—then you should be able to continue on with that same school to obtain your higher degrees.  

Additionally, I think it would be great if the school offered medical coding and an online internship that allows you to apply the knowledge you have learned to gain “virtual” hands on experience. The best thing I like about Ashworth is that it is affordable and you can pay as you go. There is always room for improvement, but overall, I am very pleased with my experience with Ashworth University and would recommend this school to anyone.

Crystal
Medical Billing Program Student
Ashworth University School of Health Care

              
             Thanks to Javier Belmont for permission to use this Photo.

While working as a pharmacy technician, you will see that most muscle relaxants and hormones are available only as prescription (or legend) drugs.  A few years ago, I was working at a retail store late on a Friday evening.  A person walked slowly up to the pharmacy counter and asked me to sell him some carisoprodol (a muscle relaxant).  Being pretty naïve, I asked for his name so I could pull up his refills on the computer.  He replied, “I don’t have a prescription.”  After I informed him that carisoprodol required a prescription, he left the pharmacy.  Without a valid prescription I could neither provide the man with carisoprodol nor appropriately assess his intentions for use.  

Be aware that, even though many muscle relaxants are not controlled substances, they do have the potential for being abused.  You can perform a valuable service by assisting the pharmacist in monitoring the quantity and frequency of refills your customers purchase.  If you notice a possible abuse situation, notify the pharmacist.  If it’s a case of the original prescription being no longer adequate, it may be time for the patient’s doctor to try a higher dose or another medication altogether. 

Tina Boyd Stacy
Pharmacy Technology Instructor
Ashworth University

 
              Thanks to Gisela Giardino for permission to use this Photo.

I enrolled in April of last year, but I had to set my studies aside for a few months due to a sprained left ankle and a fractured right ankle.  It was kind of hard to study when you’re constantly sleeping!

I’m now back to work and studying…

The medical billing course has been extremely helpful in my present job working for the “Insurance” company.  It has really opened my eyes to the health-care industry as a whole. I can now see why doctors, hospitals, and insurance companies do what they do—not saying that either side is right or wrong.  I have worked both sides of the fence. 

However; I now have a greater understanding of the whole concept and I really do think that Ashworth has been my greatest teacher EVER!!

I highly recommend that all who are studying this course to not get discouraged. There is light (and a great job) at the end of the tunnel!!

Good Luck and Be Blessed…

Dani
Medical Billing Student
Ashworth University School of Health Care

Let’s face it, not everyone is an effective communicator.  Some people are more reserved and must put forth a great deal of effort to be sociable and interact with others on a daily basis.  For other people, it’s not difficult at all to put on a smile, chat with, and listen to others. And although sometimes it’s tough to listen to the problems of others, especially when we’re distracted by our own troubles, the bottom line is that as health care workers, our own needs and desires take a back seat to those of our patients.  Put yourself in their shoes:  When we’re not feeling well, or must have a procedure performed, we certainly don’t want to encounter a grumpy, rude, or disinterested medical office employee.  We want to be considered important, and we want to be able to interact  with caring medical staff members who act as though they truly are concerned with our well-being.  Therefore, as a medical assistant, it is imperative that you keep your own expectations and requirements in mind when you are dealing with patients.  Remember, you represent the physicians and the entire office staff.  The attention and impression you give will improve or detract from the quality of the patient’s encounter, as well as the overall success of the health-care facility.

As the key link between the office and the patient, you must learn to give patients the individual care that they require and deserve.  You must learn to assess a patient’s needs quickly so that you can address their problems and concerns effectively. Part of this process is being able to tailor your response to each individual.  For example, you certainly would not communicate with a sick child the same way you communicate with an 80-year-old patient.  Think about how would you deal with a patient who speaks little or no English.  Would you greet a patient coming to the office for an immunization shot differently than you would treat a patient coming in to be treated for HIV?  Throughout your Medical Office Assisting program, we’ll consider the answers to these critical questions.

In learning how to individualize your approach to helping each patient, you will also learn about Abraham Maslow’s hierarchy of needs in this program.  As well as being able to assess the needs of a patient, you must also understand how those needs can be met.  To determine this, you must decide where you perceive those needs falls in the hierarchy of needs.  Maslow believed that basic, physiological needs must be met before higher goals can be reached.  For example, if a patient is homeless, his primary concern will be that he has something to eat and a place to sleep tonight, not that his blood pressure is elevated and he may have a stroke someday.

With respect to terminally ill patients, we will focus a lot on Elisabeth Kubler-Ross’s five Stages of Dying.  You should take note of her highly insightful theories.  The chances are very good that you will at some point manage patients who are terminally ill (these five stages also apply to patients suffering from grief).  Knowing the emotional state of the patient makes empathy and communication easier.  The stages also explain why a patient might be cooperative and pleasant one day and angry and combative another day. 

Remember, it’s a privilege to work in a medical office.  I never take this privilege for granted and encourage you to demonstrate the same kind of pride when dealing with your patients.  At the end of the day, we’re here for the patients and are held to standards of excellence that should never be compromised.

John E. Long
Medical Office Assisting Program Instructor
Ashworth University School of Health Care

From Hannah Waight of Experience:

No longer is healthcare confined to doctors and nurses - now more than ever jobs are available for people with all types of interests within this highly diverse industry. Although you may not look forward to that trip to the dentist or those yearly shots from the doctor, no one can deny that healthcare is an essential aspect of all of our lives.  People who are willing and able to work in the health industry will always be in demand.  In fact, healthcare has long been one of the biggest industries in the nation, and now, because of the aging population of the United States and advances in medical technology, the need for qualified workers is only going to increase.  Your ideal job is within your grasp as long as you have the appropriate background and inside information.

As an industry, healthcare offers a diverse range of jobs for many different types of people.  You can work in the traditional health provision sector as a doctor or nurse, or in a wide variety of medical fields.  Preventative medicine and recovery is getting increasing attention from insurance companies looking to keep their costs down: dietitians, counselors, and physical therapists all play key roles in keeping people healthy. Research in academic medicine and biotechnology provides opportunities for professionals interested in discovering the next generation of treatment.  The people- and paperwork-oriented are needed to run the business and administrative side of the industry.

Copyright © 1996 - 2008 Experience, Inc. - All Rights Reserved

To read more of Hannah’s great article, login to the Ashworth University Career Center through the student portal and click here.

Ryan Rode
Interactive Services Manager
Ashworth University

Photo courtesy of Sonia_Fantoli

Ahnald is angry and calling for tighter medical record security after his records, his wife’s and those of 32 other celebrities were breached.  The ex-Terminator told the Los Angeles Times that he’s been a victim of unauthorized snooping following heart, hip and shoulder operations.

Is that any surprise? I’m sure it happens all the time, whether it be medical, police or other public institution records. It’s politically convenient to raise the issue as part of a broader healthcare platform.

The former Conan the Barbarian said that every time he left the operating room he was told that people were going through his file. They had white coats on and snuck into the hospital, “They had nothing to do with the hospital staff at all,” he told the Times.

California’s health department said the agency would sanction the UCLA Medical Center after confirmation that improper hospital workers had accessed medical records of more than 60 patients.  In the past, a handful of UCLA employees were fired after an audit showed patients medical records had been violated. 

What UCLA Medical Center points to when asked about HIPAA

Does “sanction” mean fines? It should. Let’s hope the toothless HIPAA laws decide to take a bite into UCLA.

“I’ll be back – for Connor’s medical record”

Shawn Whalen
Contributing Blogger
Ashworth University

*Shawn Whalen is the Senior Vice President of Schwartz Communications, where he manages a variety of clients in healthcare IT and communications.  Mr. Whalen is nationally recognized as one of the leading experts in the healthcare technology industry.  We would like to thank Shawn Whalen for giving us the opportunity to share his vast knowledge and experience with the AU student community.  Visit Shawn’s Schwartz Healthcare IT Blog for additional insights.  Thanks Shawn!

          Thanks to Lorianne DiSabato for permission to use this Photo. 

It is time, I think, to face the realpolitik of health care reform. That means asking a question few reformers dare to discuss:  How will we win the Congressional votes needed to pass serious health care reform? The American Prospect’s Ezra Klein put this question on the table at the “Take Back America” conference last week.  A pragmatic progressive (in the best sense), Klein pulled no punches:  “There are so many people in this town [D.C.] who do such smart policy thinking,” he observed. But “what we don’t give enough thought to is the politics of reform. This is a political problem. Until we have the votes in the Senate, we can’t get anything done.”Without the votes, Klein told reformers, “you don’t have a plan; you have a position.”

Some assume that, if we elect a progressive president, he will “put the votes together” to achieve reform. But the fact is that even an optimistic, charismatic JFK wasn’t able to persuade Congress to unite behind healthcare for the elderly in the early 1960s—a time when seniors were the poorest group in America. It was only after Kennedy was assassinated that a wily LBJ (who had grown up in Congress and knew where all of the bodies were buried on the Hill) was able to leverage a martyred president’s last wishes to help pass Medicare in 1965. The fact that LBJ had won by a landslide sealed the deal.

This time around, nailing the votes that would secure something like “Medicare for Everyone Who Wants It” will be much tougher. As I noted in my first post in this series, “Obstacles to Health Care Reform,” the lobbyists representing the for-profit health care industry enjoy enormous power. The money at stake in the health care industry has grown exponentially since 1965. And thanks to generous campaign contributions, the industry’s lobbyists wield great influence, even among liberal politicians.                  

Who can counter that kind of power?  Citizens who vote.  Lobbyists have dollars, but a billion dollars won’t help a politician if his constituency has made it clear that it won’t re-elect him unless he passes a particular piece of legislation that voters want. Nevertheless, any hope that pressure from voters will give Congressmen the spine to stand up to the lobbyists turns on the assumption that voters share common goals. With that assumption in mind, I decided to take a hard look at where most voters stand on health care reform. Polls show that the majority of Americans say that they want universal healthcare—but drill a little deeper, and you’ll find that different groups have very different priorities.

(more…)

Photo courtesy of Greg_Reser

Google announced the launch of a pilot project in collaboration with the Cleveland Clinic to provide select patients access to their medical record using the Google health platform.

According to the Associated Press, Google will:

begin storing the medical records of a few thousand people as it tests a long-awaited health service that’s likely to raise more concerns about the volume of sensitive information entrusted to the Internet search leader.

The pilot project to be announced Thursday will involve 1,500 to 10,000 patients at the Cleveland Clinic who volunteered to an electronic transfer of their personal health records so they can be retrieved through Google’s new service, which won’t be open to the general public.

Each health profile, including information about prescriptions, allergies and medical histories, will be protected by a password that’s also required to use other Google services such as e-mail and personalized search tools. (more…)