WCH Service Bureau WCH Service Bureau
  • Services Services
    • Medical Billing
    • Provider Credentialing
    • Medical Auditing
    • Real-Time Eligibility
    • MIPS Support
    • Webinars
    • Practice Analysis
  • Products Products
    • Credentialing Application ©
    • iSmart EHR ©
    • PMBOS ©
    • Time Management Program
  • WCH Franchise
  • Company
    • About
    • Our Offices
    • Careers
  • News
    • WCH Insights
    • Healthcare News
    • WCH News
  • Contact Us
  1. Home
  2. > HealthcareNews
  3. > HealthcareNewsItem
Phone: 888-924-3973 Technical support Pay Now iSmart Login

Why certifications matter when looking for a medical biller

6/1/2022
Medical billers and coders are critical to revenue cycle management, thus having a skilled and high-performing workforce is critical to running your medical practice smoothly and successfully. Medical billers submit and follow up on claims with insurance companies in order to get paid for services provided by a healthcare provider, whereas medical coders translate medical reports such as diagnoses, medications, and procedures into codes that insurance companies use to reimburse for the performed services.

Medical billers and coders should have the necessary skills and knowledge in their fields, such as understanding how to read medical records and being familiar with the major code sets, among other things, in order to be more efficient with their responsibilities, which are critical to medical organizations' financial resources. Hiring billers and coders who are not only highly trained but also certified by specific reputable organizations is one approach to verify their credibility, such as the ones below.

American Medical Billing Association (AMBA)

The Certified Medical Reimbursement Specialist (CMRS) Certification, offered by the American Medical Billing Association (AMBA), is the longest-running and most comprehensive exam for professional medical billers. This is one of the best medical billing and coding certifications. Those who pass the exam and earn the certification are acknowledged as knowledgeable and skilled in the industry, and they are dedicated to promoting ethical and professional medical billing practices.

The Certified Medical Coding Specialist (CMCS) is a more modern certification demonstrating an identical set of skills & knowledge.
American Academy of Professional Coders

The American Academy of Professional Coders (AAPC) offers a certification for medical billers called Certified Professional Biller (CPB). This certification ensures that a biller has knowledge of various types of insurance plans and payment policies; Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs) for successful claim submissions; knowledge of CPT, ICD-10-CM, and HCPCS Level II coding guidelines; understanding of the life cycle of a medical billing claim.

Medical coder certificates from the American Academy of Professional Coders (AAPC) are nationally recognized and considered the gold standard in the healthcare business. They provide a variety of certificates for people of varying levels of expertise and specialties:

• Certified Professional Coder (CPC)

When it comes to recruiting medical coders, the Certified Professional Coder (CPC-A) qualification is highly regarded by physician offices around the country. This is a golden standard certification that demonstrates a biller’s ability to interpret medical records and superbills, while also his/her awareness of various combinations of procedure codes that cannot be reported together

• Certified Family Practice Coder (CFPC)

CFPC certification demonstrates expertise and experience in coding general medicine/family practice services and procedures, such as venipunctures, injections, EKGs, lesion excisions, foreign body removals, fracture care, etc.

American Health Information Management Association

The Certified Coding Associate (CCA) certification granted by the American Health Information Management Association (AHIMA) defines that the holder is competent across all coding settings, including hospitals and physician practices, and commitment to the profession. 

There are many certifications that you can use to measure the expertise of your outsourced medical biller, but the ones described above are the most popular. 

If you are still hesitant about whether to work with an experienced yet expensive professional or with a cheap amateur, below are the top-5 benefits of hiring a certified biller:

• Small claim denial rate. Since professional billers are familiar with CPT and ICD-10 combinations that cannot be reported together, they are more likely to identify “unclean” claims before submission

• Security. Certified billers and coders are more likely to comply with HIPAA requirements because knowing those is critical for passing the certification exams

• Rapidness. Expertise facilitates claim submission & collection processes

• Compliance with industry updates. Certified medical billing professionals always comply with the new payer reimbursement policies. Hence, they are always keen to adjust & facilitate the processes accordingly

• Specialty-specific support. Certified billing professionals understand the unique requirements of your specialty and work on denials in a unique matter

At WCH Service Bureau, we are proud to have gathered a team of professionals that can Help you facilitate all the above-mentioned indications. Here is a list of certifications our employees currently have:
• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Professional Compliance Officer (CPCO)
• Certified Professional Medical Auditor (CPMA)
• Certified Family Practice Coder (CFPC)
• Certified Medical Reimbursement Specialist (CMRS)
• Certified Medical Coding Specialist (CMCS)
• Certified Urology Coder (CUC)

Ready to boost your medical practice revenue? Contact us!

Liked the article? Share with friends:

WCH News

June 29, 2022
5 reasons to consider franchising
Ever wondered why some entrepreneurs are more successful than others? Yes, persistence, innovation, and a good investment capital are important, but acquiring a business from an established model ensu...
June 28, 2022
New service for home care agencies
The WCH credentialing team has gained so much recognition in the Home Care industry over the recent years. With growing experience and an extensive new list of clients in this area from New York State...
June 26, 2022
Why you need to check your insurance contracts
All participating providers should be aware of their contracted fee schedule with health insurance payers and ensure that their contracted rate is up-to-date. As credentialing experts, we often see th...
June 22, 2022
How WCH helps healthcare providers to succeed in their business
Managing a medical practice in this extraordinary is a challenge by itself. Not only do healthcare providers have to deal with maximizing their cash flow, but most of you constantly sacrifice your fin...

Healthcare News

June 28, 2022
Contractual obligations for out-of-network providers
WCH is committed to the success of our clients. For over 20 years, we have been resolving thousands of claim denials and underpayments directly with various insurance companies and other payers. At th...
June 26, 2022
How to work on denied claims
In recent months, our experts have witnessed a significant increase in claim denial rate of our prospective and existing clients. Insurance carriers have taken up a tendency of denying payment for ser...
June 22, 2022
5 simple steps to make your claims paid in full
At some point, many of us have wondered if there is "a secret formula" that eliminates all claim denials and instantly rises a reimbursement rate to 100%.The truth is – there is none. Ho...
June 19, 2022
The future of telemedicine: CMS prospective
Since the early days of the COVID-19 pandemic, telemedicine has become an essential way to render health care to everyone in need all over the world. By implementing various virtual care solutions, he...

Ready to start?

Contact Us
linkedin
⟶ let's start
WCH Service Bureau
Payment options
WCH Service Bureau WCH Service Bureau WCH Service Bureau WCH Service Bureau WCH Service Bureau
Pay Now
Services
  • Medical Billing
  • Provider Credentialing
  • Medical Auditing
  • Real-Time Eligibility
  • MIPS Support
  • Webinars
Products
  • Credentialing Software ©
  • iSmart EHR ©
  • PMBOS ©
  • Time Management Program
Company
  • About
  • Contact Us
  • Careers
News
  • WCH Insights
  • Healthcare News
  • WCH News
Support
  • Feedback
  • Technical Support
  • Privacy Policy
888-924-3973
3047 Avenue U, Brooklyn New York 11229
Fax: 347-371-9968
Follow us:
2022 WCH Service Bureau, Inc.® | Web Design and Programming by WCH Service Bureau, Inc.® | Privacy Notice
Can I help you?
Feruza
Zakhro
Administrative Assistant
Hi, what service does your question relate to?
Medical Billing
Provider Credentialing
Medical Audit
Franchising
PMBOS
iSmartEHR
Eligibility
MIPS Service
Other
What are you interested in?
Let me help you.
Please, leave your contact details and we will answer your question.
Thank you for your request, we will respond as soon as possible.
Let us Help You

Dear Provider,
WCH can help your practice in your credentialing needs! Using a credentialing specialist with the knowledge, expertise and connections that can help position your practice ahead of time. Let us help you today! During credentialing process WCH becomes your external credentialing department for all communications, submissions, follow up and any other questions that will come up during the process.

WCH Specializes in:

  • All individual Medical specialties
  • Mobile IDTF
  • Single & Multispecialty Groups
  • Urgent Care, Labs, DME, Pharmacy
  • Article 28, 32, 31
  • Revalidation, Reinstatement &
  • Exclusion
We help Providers in All States! WCH provides Clarity, Comfort and Security in your Practice.
Let us Help You
Wch SErvice Bureau

Medical billing services offered by WCH Service Bureau go far beyond the usual understanding of billing.

 

What we offer is not just excellent professional billing and collection services. We also stand as guardians of your reimbursement and compliance with federal, state laws and regulations as well as private insurance policies and procedures.

 

Do it right! Do it with WCH!

Let us Help You
Wch SErvice Bureau

Periodic medical chart auditing is vital for any healthcare provider and medical practice. Let the professionals evaluate your coding, billing, and documentation practices! Our auditors are AAPC-qualified CPMAs (Certified Professional Auditors) and CPCs (Certified Professional Coders). We perform comprehensive Chart Auditing. We can do the following services for you:

  • Identify areas of risk leading to upcoding or downcoding and medical coding accuracy;
  • Ensure that coding practices are compliant with the regulations set forth by private and government payers;
  • Evaluate Incident to guidelines and services performed on collaborative premises;
  • Perform Analysis of Denials/Duplicate billing /Appeal process/Modifier usage;
  • Review Front Desk work including but not limited to: Eligibility verification/Benefit maximums verification/Excluded services verification/Authorization process/Patient responsibility (deductibles, copays, coinsurance)/Coordination of benefits;
  • Evaluate Insurance plans participation and consistency of contracted rates;

Do it right! Do it with WCH!

Try WCH PMBOS
Request information
Perfect! Please fill in the form

What service does your question relate to?

Perfect! Please fill in the form

What service does your question relate to?

Let us Help You
Wch SErvice Bureau

Do it right! Do it with WCH!

REQUEST FREE DEMO
Planned number of Providers : *
Specialty : *
Job Role : *
Perfect! Please fill in the form
Perfect! Please fill in the form
Have any questions? Please contact us practiceanalysis@wchsb.com
Leave us a feedback
 
Thank you
for your feedback!
Wch SErvice Bureau

Thank you for your interest in our company!
Our team will process your request and will respond as soon as possible during regular working hours.

Subcribe
Subcribe Subcribe
 
Our site uses cookie.

This site uses cookies for analytics, personalization and advertising. By continuing to browse it, you agree that we use of cookies. To find out more or change your cookie settings click here.