Medical billing in the health care industry is discussed as the field where health care services are considered within the financial context. The problem is in the fact that many health care facilities need to hire outside medical billing professionals because of the specifics of the sphere and impossibility to document all the necessary information appropriately.
The cost-effective and comprehensive solution to this problem is the focus on training the health care facility’s staff in medical billing (Beik, 2014, p. 32-33).
The issue of implementing the effective and complete training for all the staff working in a healthcare facility and specializing in medical billing is important to be discussed in detail because the results of the effective training directly influence the financial status of the facility.
Nevertheless, the process of implementing the effective training for the staff specializing in medical billing is associated with a range of such challenges and trends as the focus on the program’s necessity; the choice of the type of training; the choice of tools to use; and the implementation of programs for older employees.
Thus, the purpose of the literature review is to examine the current sources on the topic and to organize the discussion of the researchers’ conclusions according to the determined challenges.
Important recommendations regarding the necessity of focusing on training in medical billing and coding are observed in the article written by Harrison and the group of researchers specializing in genetic counseling. According to the authors, the volume of services provided by physicians and other health care practitioners increases in correlation with the increase in the number of billing concerns (Harrison et al., 2010, p. 38).
The problem is in the fact that physicians have no opportunity to document medical records and other issues adequately, and the special staff is hired to be responsible for the medical billing in healthcare facilities. However, the staff’s improper billing skills as well as the physicians’ inattentiveness lead to fixing the incorrect information in important documents.
Changes in codes also cause more problems in billing and coding because professionals do not receive all the necessary information regarding the use of the changed codes (Harrison et al., 2010, p. 39). Thus, it is stated in the article that the number of billing concerns increases each year, and to reduce billing errors, more attention should be paid to training the staff in relation to the medical billing question.
The next trend discussed in the scholarly literature is the choice of the training program to implement in health care facilities. Focusing on the problem of choosing the most effective form of training for the health care facility’s personnel, it is important to refer to the research completed by Benke, Lin, and Ishman.
According to the researchers, the personnel’s billings skills can be significantly improved after the first directed education session (Benke, Lin, & Ishman, 2013, p. 399). Benke, Lin, and Ishman note that the effectiveness of the training program depends on its results in improving the staff’s limited experience.
Thus, directed education sessions can be discussed as the appropriate choice to be implemented in health care facilities because these programs are oriented to training concrete skills determined with the help of the needs assessment (Benke et al, 2013, p. 400).
In addition to Benke, Lin, and Ishman’s discussion, Beik states that in order to guarantee that specialists in medical billing are adequately educated in relation to the principles of coding and billing, it is important to implement programs which provide the focused education when the improvement of skills in billing is the priority (Beik, 2014, p. 32-33).
Therefore, the effective training which responds to the current standards and norms in the sphere should be focused and properly directed.
The implementation of the appropriate training for health care facilities’ employees is a challenging task because it is necessary to pay much attention to the choice of the most effective tools and materials to use.
Following conclusions provided by Moisio in the work on medical billing and the aspects of health care insurance system, medical billing is one of the most complicated fields of knowledge in the health care industry because of the focus on documentation and financial issues (Moisio, 2013, p. 12).
As a result, the need for additional training in the area is discussed as the priority by many health care administrators. However, the problem is in the fact that there are no effective tools proposed by the government to follow as adequate patterns or use in the training sessions (Benke et al, 2013, p. 400; Harrison et al., 2010, p. 40).
Therefore, the implementation of the effective training becomes a real challenge for health care facilities which are oriented to increasing the educational level of their employees in relation to the important questions of medical billing.
One more issue associated with the implementation of effective and complete training programs and systems in health care facilities is the problem of educating older employees.
Following the research conducted by Mantzana, Themistocleous, and Morabito in 2010, it is possible to note that modern training programs based on the combination of new technologies, use of computers, and traditional training activities are effective enough to train employees belonging to different age categories (Mantzana, Themistocleous, & Morabito, 2010, p. 680).
Nevertheless, the researchers state only the necessity and effectiveness related to using this computerized program, but there are few alternative variants to educate the employees in the other facilities, such as health care facilities. That is why, more research in the field is necessary to answer the question about the choice of training programs for different categories of employees.
Answering this question, Moisio proposes focusing on increasing the professionals’ qualifications with the help of the organization’s own resources because the process of hiring the outside specialist can become the complicated procedure (Moisio, 2013, p. 10). However, the problem of differentiating training programs for employees is not resolved in the health care industry, and organizations choose to solve it independently.
In order to implement effective and complete training programs in health care industries for the staff specializing in medical billing, it is necessary to overcome such challenges as the necessity to choose the adequate program because there are few programs proposed for health care facilities today and the necessity to choose the tools to use in training with the focus on the organization’s resources.
Following the current trends in the industry, it is important to note that today much attention is paid to the implementation of effective training for different categories of employees, depending on their current skills and knowledge of the system of medical billing.
References
Beik, J. (2014). Health insurance today: A practical approach. New York, NY: Elsevier Health Sciences.
Benke, J., Lin, S., & Ishman, S. (2013). Directed educational training improves coding and billing skills for residents. International Journal of Pediatric Otorhinolaryngology, 77(3), 399–401.
Harrison, T., Doyle, D., McGowan, C., Cohen, L., Repass, E., Pfau, R., & Brown, T. (2010). Billing for Medical Genetics and Genetic Counseling Services: A National Survey. Journal of Genetic Counseling, 19(1), 38-43.
Mantzana, V., Themistocleous, M., & Morabito, V. (2010). Healthcare information systems and older employees’ training. Journal of Enterprise Information Management, 23(6), 680-693.
Moisio, M. (2013). A Guide to Health Insurance Billing. New York, NY: Cengage Learning.