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WCH News

February 27, 2014

 

WHAT MAKES A PROFESSIONAL BILLER?

 

Billing Department Supervisor
Zukhra Kasimova Billing Department Supervisor

Ask the first Certified Professional Biller (CPB®) from Brooklyn, N.Y.

By Olga Khabinskay, COO

Medical billing is the livelihood of healthcare practitioner revenue, and it has become more complex over the years. Submitting clean claims requires knowledge of coding guidelines, insurance requirements, and state and federal regulations. Additional expertise is necessary to ensure claims are properly paid. Qualified medical billing professionals who possess these skills are your best line of defense to proper reimbursement and a healthy revenue cycle.

This raises an important question: What defines a qualified professional capable of handling your medical billing needs?

Certify Proficiency

AAPC’s certification for medical billers—Certified Professional Biller (CPB®)—ensures personnel have the right tools and training to handle a full range of billing, coding, insurance, and collections procedures. It also provides a reliable measure of proficiency and expertise for medical billing staff who provide an important service on behalf of the practice.

When AAPC launched the CPB® certification, WCH (We Can Help) Service Bureau, Inc. nominated Zukhra Kasimova, CPC, to take the exam. With plenty of studying and support from her coworkers, she successfully passed the 200-question, five hour exam, adding a CPB® to go with the Certified Professional Coder (CPC®) credential she already earned.

 

CPB® Experience, from the Source

Kasimova was named the first CPB® in Brooklyn, N.Y. She shares her thoughts on earning the billing certification:

Q: Tell us about your experience when studying for the certification. What did you learn?

 A: Having five years of experience in medical billing prior to taking the nationally-recognized CPB® course, I found the training materials to be very well organized and structured. There are 16 chapters with a core focus on medical billing for the provider side of healthcare. The course provides some coding basics, including two chapters solely devoted to diagnosis coding in both ICD-9-CM and ICD-10-CM. Various aspects of revenue cycle management education material are also covered.

Although most of the information you need is provided in the education materials, AAPC recommends having prior knowledge of anatomy and medical terminology. I studied the materials at my own pace, covering one or two chapters per week. Each module contained links to additional study resources that allowed me to learn a lot on each topic. Chapters include post-study questions, so it’s possible to cross check the comprehension of the materials right away after you complete each chapter.

I took a web-based practice test containing 50 questions, which was very similar to the actual testing questions. The online practice test allowed me to self-evaluate my overall progress and material comprehension.

Q: What value does CPB® certification bring to your work in medical billing?

A: Healthcare business requires CPBs® who can handle all aspects of the revenue cycle. In my position, I am responsible for proper claims submission to the insurance company for reimbursement. The claims billing/submission process should include following all government regulations and insurance requirements. Improper billing may lead to audit reviews, reduced reimbursement, and insurance disputes, all of which negatively affect a practice’s revenue cycle. For these reasons, professional expertise is crucial to perform successful billing services.

Q: How does the training you received help you in your daily tasks in medical billing?

A: Training for the exam helped me to incorporate and enhance my knowledge in the different aspects of medical billing, such as billing regulations, HIPAA and compliance issues, case analysis, reimbursement procedures, etc. It continues to help me in navigating the complex process of medical billing and solving issues that I come across on a daily basis. It also serves as an additional source of materials to train new employees.

Q: Why do you think CPB® certification is important for the medical billing professional?

A: Because requirements and technologies of healthcare are constantly developing and updating, anyone working in the billing and coding field should continue education and training throughout his or her career. It’s important to advance your knowledge and skills, so you can continuously deliver high-quality service to healthcare providers and be confident in your work as a professional.

 

Understand Certification’s Impact on Business

WCH Service Bureau is a global service provider headquartered in Brooklyn, N.Y. It’s a multi-service company that specializes in medical billing and credentialing services, coding, chart auditing, and customized medical software solutions. Continuing education and certification adds value to the medical billing and coding services provided by WCH’s medical billing department. WCH staff consists of 80 full-time medical billers, reimbursement specialists, programmers, customer service representatives, sales, and administrative personnel who serve private clinics, hospitals, laboratories, imaging centers, pharmacies, and supply companies. Their staff holds a variety of AAPC credentials (CPC®, Certified Professional Medical Auditor (CPMA®), Certified Family Practice Coder (CFPC®), etc.), which help them in their everyday work in medical billing. AAPC certification provides WCH staff with the tools necessary to protect clients and take responsibility for the coding and billing process.

Following Kasimova’s success, WCH is promoting CPB® certification for many of its staff. This certification enhance staff knowledge to submit claims in accordance with government regulations and private payer policies, follow up on claims status, resolve claim denials, submit appeals, post payments and adjustments, and manage collections.

Bio:

Olga Khabinskay, COO, is chief operating officer of WCH Service Bureau, Inc., (www.wchsb.com) and Credentialing Department manager. She has experience in billing, coding, physician credentialing, marketing, HIPAA regulations, insurance networking, client relations, and legal practice issues. Khabinskay graduated with a Bachelor of Arts from Adelphi University and is working on her master’s degree in healthcare management. She is a member of the American Health Information Management Association (AHIMA); American Medical Billing Association (AMBA); Professional Association of Healthcare Office Management (PAHCOM); Health Care Compliance Association (HCCA); and the AAPC’s Jamaica, N.Y., local chapter.

Quote:

Healthcare business requires CPBs® who can handle all aspects of the revenue cycle.

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