week 1 CheckPoint Health Care Terminology

Explain why, in terms of job performance and efficiency, knowing medical billing terms is critical for working in the health care field. Respond in at least 150 words and provide specific examples.


When doing medical billing it is critical to know the terms for several reasons. The most important reason is making sure that all of the diagnosis codes and the procedure codes are done properly. Without these codes being on the claim the company will not get paid correctly. For an example, if a claim had a procedure code that the physician did a blood sample and the billing specialist put the code that he did an injection. Then the company is not going to get paid correctly, because one cost more than the other one does.  It is the same for the diagnosis code.

It is important to know what the difference between co-payments and co-insurance also. For an example, if a patient comes in with a co-insurance the office staff may think that the patient owes that payment when they come into the office. This usually isn’t determined until after the bill is processed.
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