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Have you ever seen a doctor's handwritten medical notes and wondered how that information actually gets translated from doctor-speak to something patients, office and hospital staff, and  insurance companies can read and understand? Moreover, have you ever wondered how health insurance providers know the specific types of medical services to bill for after you鈥檝e been to the doctor? Of course, we all ponder this upon receiving an insurance provider鈥檚 explanation of benefits statement in the mail. A defined billing and coding system in place allows these various entities to communicate and assess patient charges accurately. This is where certified medical billing and coding professionals come in.

If you鈥檙e considering pursuing a career in medical billing and coding, it鈥檚 important to have a thorough understanding of the different specialty areas in which you can earn medical billing and coding certifications and how doing so can impact your career path.

Billing and coding are actually separate practices, but they work in tandem 鈥� often with one individual performing both tasks. Each function relies on a complex, global classification system of codes, which build patient health records by categorizing illnesses, injuries, and medical procedures. A medical coder's primary role is to read patient records, as transcribed by clinicians, and apply the correct codes to capture patient data. These codes translate information numerically for billing and analytical purposes, serving as a language between medical, insurance, and government entities. Medical billers are responsible for the financial side of the business. They decipher these codes to create patient bills and file insurance claims for payment.

To enter either field, you'll need a certificate or , either of which you can earn online. Students who opt for online certificates will learn about medical terminology, code systems, healthcare administration, healthcare information privacy laws and procedures, billing, and bookkeeping fundamentals. The most affordable certificate programs are usually offered through , but some four-year colleges also feature online certificates.

An online medical billing and coding certificate equips students with the skills to manage healthcare records and billing processes. The curriculum covers medical terminology, coding systems, and healthcare regulations, making it an efficient pathway into the healthcare field. Flexible online certificate options enable students to balance their education with other commitments, providing a solid foundation for career advancement. 

An individual with a medical billing and coding certification has gained in-depth knowledge and skills that demonstrate professional expertise in a respective niche. Although medical billing and coding professionals are often tasked with the billing and coding aspects of their job, certifications tend to reflect either one aspect or the other.

In short, medical coders are responsible for translating clinicians' medical notes and diagnoses concerning a patient and assigning medical codes that confirm the medical records. Once a patient鈥檚 medical codes have been assigned, medical billers create the patient鈥檚 bill and file the relevant health insurance claims. Online medical billing and coding programs help prepare you for certification in your desired area.

Because medical coding and billing careers only require certificates, they often appeal to individuals who don't have the time, finances, or desire to pursue associate or bachelor's degrees. Whether you are enrolled online or in person, certificate programs are typically designed to take 27-30 credit hours. This works out to 9-12 months of full-time study. Additionally, these certificate programs require only a high school diploma or GED.

Technically, you can pass a certification exam with no time commitment, though this is rare. Most candidates complete a test preparation program that takes a few months of intensive study, and others choose to earn a one-year certificate or two-year associate degree first.

The first step to becoming a certified medical biller or coder is to participate in an online or in-person educational program specific to your desired type of certification. Individuals with a high school diploma or GED are eligible to pursue any number of professional coding certifications.

Although certification programs include content that is unique to their respective certifications, a common curriculum taught across programs includes topics such as professional ethics, billing and coding technologies, medical terminology, and patient confidentiality. Common curriculum elements are aimed at educating participants with healthcare industry knowledge, specifically. Some examples include coursework that coversthe Healthcare Common Procedure Coding System (HCPCS) and associated and . Certificate programs may also cover more generalized online courses in areas such as anatomy and physiology.

The final steps to earn a professional certification and begin your coding career involves registering for and successfully passing the respective certification exam. Most participants spend a couple of weeks studying and taking practice exams before sitting for their certification exam.

Students interested in niche areas of medical billing and coding can choose from over 20 . Through these programs, students can become  certified Ambulatory Surgery Center Coders, Certified Family Practice Coders, Certified Rheumatology Coders, and more. Because billing and coding graduates have so many choices of certifications, it's important to discuss the options with faculty and professionals currently working in the field.

Several professional organizations provide specialty certifications for medical coders and billers, so it can be difficult to know which one to obtain. Each group has different requirements for its certifications, but most require students to graduate from an accredited coding or billing program, work a set amount of time in the field, and join the organization as a dues-paying member.

We've detailed the two largest certification organizations below:

• AAPC: The (AAPC) has 200,000 members and offers one biller certification and six coder certifications. AAPC exam requirements include current AAPC membership and two years of coding or billing experience for entry-level credentials. An associate degree is recommended but not required.
• AHIMA: The (AHIMA) is the second-largest medical coding and biller certification body, with 103,000 members. It provides three certification options. First, AHIMA offers a Certified Coding Associate credential for professionals with at least six months of experience. It also offers two Certified Coding Specialist credentials for those with at least two years of experience.

When reviewing the cost of obtaining a particular certification, there are several things you鈥檒l want to include in your calculations, such as the program cost and certification exam fee. The exam fee alone runs anywhere from $200 to $400. If you are acquiring an industry certification through a certification-granting organization, you may also be required to purchase an association membership.

Beyond the minimal requirement of having a high school diploma or GED, there are multiple educational paths you can take in order to sit for your certification exam. The costs vary depending on your approach.

Certification-granting organizations, like the AAPC, offer customized industry certification prep programs that range from $2,500 to $3,500. Since these programs do not require the same time commitment and well-rounded education in healthcare and science topics, they are not considered as prestigious.

Ultimately, you want to choose a program that meets your personal and professional needs and provides a healthy work/life balance. Therefore, it's important to think about the potential indirect costs, financial and otherwise, for each option:

• What type of time commitment should you expect?
• If you work full-time, can you continue working at the same pace during your studies?
• Will a program's curriculum be sufficient to help you pass the certification exam at the end?
• Will you need to borrow students loans or apply for to pay for the program?

Aside from the functional knowledge gained and official recognition of career field expertise, being a certified medical biller, coder, or specialist can make you a more marketable professional in your chosen specialty area. While a well-respected certification is an excellent resume booster at the most basic level, the benefits extend far beyond this new line of ink on your resume. 

Put yourself in the shoes of a hiring manager reviewing your application for a new job. The employer has combed through almost all of the applications, but nothing has really stood out. Most applicants have similar educational backgrounds, relevant work experience, and put together a visually-appealing and grammatically-correct resume. And suddenly, your application comes up in the review queue. 

Similar to two previously-reviewed applicant resumes, yours checks all the boxes: education, experience, and intangibles. However, there鈥檚 one thing in particular that clearly differentiates you from the other candidates, which is that you鈥檙e a (CCC).

A CCC certification shows your commitment to excellence in the medical coding niche, a strong professional drive, and a feeling that you鈥檒l bring actual value to a cardiology clinic.

Becoming a certified coder can serve as a catalyst for career growth. However, it鈥檚 always wise to weigh the potential benefits and drawbacks as you consider your options.

There isn't necessarily one certification that's better than all others; it all depends on what type of role you want to perform. Read job posts in your preferred area of expertise, such as inpatient coding or document improvement, to see what employers are looking for. You can also read AAPC and AHIMA salary surveys to find the certifications that tend to lead to higher wages.

In an through a college, a high school diploma or GED is often the only requirement. Depending on the school, you may also need to show SAT or ACT scores at a certain level and/or a minimum GPA. Additionally, colleges may request some prerequisite courses.

For industry certifications, on the other hand, you must have at least one year of professional medical coding experience. You can pass with a certification exam score of 70% or greater, and then 12 hours of continuing education is required each year to subsequently maintain the certification.