Medical Coding And Billing Course for Beginners | 1st step in Medical Coding - 2

So welcome to great online training.

Good morning everyone. So this is day

two. We'll discuss in uh in this session

we'll discuss about first step in

medical coding. Means uh today I'll give

you information about each and

everything about medical coding. Okay.

What types of medical course we need to

use in medical coding? what are

different medical code sets that we'll

discuss and I'll also show you how to

find out the code. Okay. So topics

covered in this class are what is

medical coding, what is RCM and

different steps involved in RCM. Then

we'll see what is ICD, what is CPD, what

is HCPCS, what is modifier and lastly

we'll see examples of medical coding. So

what is medical coding? What do you know

about medical coding? Can you tell me

because we have discussed about it

yesterday also. What do you understand

about medical

coding? So medical coding is the process

of converting patients health

information. This information means uh

patient sign symptoms or any health

related issue any disease or syndrome

anything and any procedure or treatment

given to that that patient or any

medical supplies is provided to to that

patient that everything is called

medical uh sorry health information that

we have to convert into alpha numeric

course okay as a medical code. So

medical coding is the process of

converting patients health information

into alpha numeric codes and these codes

are universally accepted. Codus stakes

medical report from doctor which may

include a patient's condition the

doctor's diagnosis and prescription and

whatever procedures or health care

provider perform on the patient and turn

that into a set of codes which make up a

crucial part of the medical claim. Okay.

So this is called medical coding. Now

we'll see revenue cycle management.

Revenue cycle management also known as

RCM. Okay. Uh if you go for interview

they may ask you this question. What is

RCM? What is full form of RCM? And full

form of RCM is revenue cycle management.

Okay. And medical coding is one of the

step one of the important step in

revenue cycle management. Okay. So this

is diagrammatic representation of

revenue cycle management. It has several

steps and medical coding is one of the

steps. Each year health care provider

perform million of procedures on

patients from simple checkups to complex

surgeries. And to collect revenue for

these services, health system must work

with patients, doctors and health

insurance companies. Right? This process

of revenue collection for health

organization is called revenue cycle

management. So basically revenue cycle

management is of is the process of

collection of revenue for healthare

organization is called revenue cycle

management. If anybody ask you about

what is revenue cycle management, you

can simply say that this is the cycle to

uh to collect revenue for healthcare

organiz. Okay. It starts

withuling and patients registration.

Okay. Then insurance verification and

eligibility. Medical coding. Then charge

capture and demographic data entry.

Claim submission. Payment posting.

Account receivable and denial

management. Correspondence followup.

Patient phone call management and

collections. We I have already explained

you in simple language this RCM. How the

revenue cycle management happen in India

versus how revenue cycle happen

in US that I have already discussed in

previous session. If you miss that

session you can get recorded session you

can go through it. Today we'll going to

learn about different steps in. So first

step is patient

registration. Okay. Collection uh

collecting patients demographic

information including insurance

information is called patients

registration. If uh any patient has any

health related issues suppose one

patient has knee knee he will call into

the hospital and schedule his

appointment. Okay. When they call into

the hospital, the medical billing staff

collect patients demographic information

which includes insurance information

also. Then they'll see uh then next step

is insurance verification. The health

care providers must verify patients

insurance coverage and benefits. This

involves checking the patient's

insurance plan for payments, deductibles

and other payment details. Okay. Then

actual encounter happen when patient

consults healthcare provider. The

details of condition and service

performed is recorded either by video or

audio. Okay. So after uh scheduling his

appointment and verifying his insurance

the p actual encounter happen. Patient

goes to the doctor and they discuss

about patient's problem. Suppose that

patient has knee pain and doctor doubts

that that is due to osteoporosis. Knee

pain is due to osteoporosis. So doctor

doctor ordered knee X. Okay. Doctor

order knee X-ray and then

explain explain that patient about that

knee X-ray and confirm the diagnosis of

osteoporosis.

So during this encounter the

conversation between doctor and patient

is being recorded uh either by audio or

video. Then these recordings are shared

then doctor shared that recording with

insurance company. Okay. And insurance

company hired so many people. Okay.

Medical coding trans medical

transcripttor is one of them.

So insurance provider or insurance

company shared that audio video

recorded conversation between doctor and

patient with that medical transcription

team. Okay. Then medical transcription

team convert that recorded audio video

into medical script. Okay. The process

of transferring voice recorded or video

recorded medical reports by healthcare

providers is termed as medical

transcription. Okay. Then medical coder

comes in picture whose job is to

transform patients condition, medical

services, medical prescription into

medical codes. Okay. So medical coder

get that

health health report of that particular

patient and he read that report

carefully and select necessary diagnosis

from that report and what are the

procedure performed. Suppose in our

patient we are discussing about

uh the knee X-ray they perform knee

X-ray. So the medical coder select

procedure as a knee X-ray. Okay. And he

will select code for knee X-ray. Okay.

From CPT CPT code or CPT course plus our

patient has final diagnosis as

osteoporosis of knee. Okay. So in that

case we have to select code for

osteoporosis. Okay as from ICD 10 cm

course then that medical coder assign

those code for that patient's report.

Then medical biller comes in picture.

Okay. So next step is medical billing or

charge entry. The charge entry is the

process by which charges of medical

services are submitted to the

appropriate payers for bill. Okay. So it

is the pro the medical coder assign

codes for diagnosis and procedure and

medical supplies. Okay. And medical

biller use those codes as those codes

contains some certain charges bill

amount on it. So medical biller use

those codes and enter those code into

billing system. That process is called

charge entry. Next step is the account

receivables follow. This procedure

medical coding responsible for looking

after denied or rejected claims.

Sometimes some claims get rejected.

Okay. Because of some issue in course,

some issue in insurance verification or

something. Okay. So account receivable

followup or ARS also known as AR their

job is to work looking after rejected or

denied claims and refiling them to

receive maximum reimbursement from the

insurance company. Then deny management.