Read classmates post and respond with 150 words:
As to Billing and coding specialists, our job will be to understand insurance contracts, types of coverage, plan types, and payors. That is a vital part of being a billing and coding specialist. Every office has different fee schedules, with insurance companies, it will be our responsibility to understand those contracts not to overbill. A Billing and coding specialist will need to understand the difference between each insurance company like BCBS and Medicaid. An example between BCBS and Medicaid would be to know you are not allowed to bill a copay under any circumstance to a Medicaid patient. Whereas, a BCBS depending on plan coverage, will have a copay for every service provided and will be different for different services. Such as primary care, dermatology, and so on. A Medical Assistant from my work experience does not need to know all of the above, although required to understand basic insurance needs. Bayes states, “Administrative medical assistants should be familiar with basic terms and concepts of medical insurance, including coding and compliance. Insurance carriers may use different terminology, and medical office personnel need to know current terminology” (pg. 302). Being able to understand all of the basics helps medical practices flow properly and causes less confusion to patients with questions.
Bayes, N. L. (2019). Medical office procedures with insurance (9th ed.). New York, NY: McGraw-Hill.