Medical Billing

The United States is a world leader in healthcare services and an innovator in cutting edge diagnostics and treatments. The United States has the largest healthcare services market in the world, representing a significant portion of the U.S. economy. In 2010, the healthcare services industry accounted for approximately $1.75 trillion in revenues and employed over 14 million people, or nine percent of the U.S. workforce. The U.S. Bureau of Labor Statistics estimates that growth in the industry will yield 3.2 million new jobs between 2008 and 2018.

The medical billing industry evolved from the medical industry’s need to outsource tedious and complex-billing procedures to specialized firms. Billing firms gather patient information, such as procedures and insurance coverage, and then submit this information to insurance companies for reimbursement. These firms track the payment process from submission to final payment to ensure payment is actually received. Since insurance companies deny payments for many minor ‘problems,’ such as a wrong procedure code, this follow through alleviates a major labor intensive, and error prone, activity for most medical facilities.

For several decades, medical billing was done almost entirely on paper. However, with the advent of medical practice management software also known as health information systems it has become possible to efficiently manage large amounts of claims. Many software companies have arisen to provide medical billing software to this particularly lucrative segment of the market. Several companies also offer full portal solutions through their own web-interfaces, which negates the cost of individually licensed software packages. Due to the rapidly changing requirements by U.S. health insurance companies, several aspects of medical billing and medical office management have created the necessity for specialized training. Medical office personnel may obtain certification through various institutions which may...