How to Shift to the Healthcare Information Management Industry through Medical Coding

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By: George Ramos, AVP for Learning and Development | May 30, 2016

It is a common misconception that a degree in the health profession is required as a prerequisite for joining the HIM industry; although it is an advantage, it is never a real requirement. A lot of questions are raised as medical coding in the Philippines is a relatively new but promising industry.

Related: Why Healthcare Professionals Are Making the Big Shift

So what encompasses the field of medical coding? To understand Medical Coding and how it contributes to the provision of health services, let’s take a look at the basic structure of the US Healthcare System.

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Medicare

Federal health insurance program that pays for hospital and medical care for elderly and certain disabled Americans.

Medicard

Health and medical services program for certain individuals and families with low incomes and few resources.

Children’s Health Insurance Program

Also known as Children’s Medicaid, provides health coverage to eligible children.

Veteran’s Aid

Provides benefits that reduce the cost of care for veterans and surviving spouses who require assisted living.

Prior to Obamacare, in 2004, President George W. Bush launched an initiative to make electronic health records available to most Americans by 2014. This put more focus on health information management, creating demand for medical transcriptionists, medical coders, and billing specialists.

 

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What is Medical Coding?

Every service (test, office visit, injection, surgical procedure, etc.) in the provision of medical care has a numeric code associated with it designed to provide some commonality of terms.

Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The diagnoses and procedure codes are taken from medical record documentation, such as transcription of physician’s notes, laboratory and radiologic results, etc.

Medical coding professionals help ensure the codes are applied correctly during the medical billing process, which includes abstracting the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.

Why is Medical Coding Important?

Medical coding specialists are a vital link among patients, doctors, and insurance carriers. They are responsible for ensuring insurance companies have the right information and patients know their billing and payment options. They keep track of bills, payments. Test results, and medications to assist healthcare professionals with making diagnoses and treatment plans.

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 Let’s take a look at a day in the life of Sam, a Medical Coding Specialist

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Related: A Day in the Life of a Medical Coder

 

Health Information Management in the US

Health care in America is an explosive industry accounting for the top three producers in gross national product (and income), and still outpaces all but a few industrial sectors in growth. According to Tom Barry of the Atlanta Business Chronicle, “Health services typically are viewed as necessities, which consumers are very reluctant to forgo or even postpone, even during hard times,” therefore, jobs in healthcare are for the most stable even during economic recessions.

Four million jobs will open up in the next ten years in the U.S health care industry. Medical Coding professionals will continue to be high in demand. Coding drives the billing process, and gathers all the statistics for patient care. More and more codes are needed to comply and with greater accuracy than ever before. The technical skill and knowledge creates great job opportunities and income. Since the demand far exceeds the supply of competent coders, more and more of the business is outsourced to countries like India and the Philippines.

A Golden Opportunity for the Philippines

Healthcare Education

The Philippines healthcare system was institutionalized by the Americans during their rule over the country at the turn of the 20th century, naturally, the healthcare system was patterned after the American model – and this has changed very little since its inception. The impact of American rule on Philippine society is evident in the country’s educational systems. Schools and universities generally utilize American textbooks and educational materials. In the health sciences, Filipino graduates generally aspire to gain employment overseas, particularly in the USA.

A Surplus of Nurses

Throughout the Philippines there are approximately 50-60,000 new registered nurses who pass the Nursing Licensure Exam annually (25-30,000 pass the exam which is given twice a year). Unfortunately for the nurses and nursing students, there has been a retrogression in the demand for foreign nurses in the first world countries since the global recession began in 2008. This has resulted in a majority of Filipino nurses being either unemployed or underemployed. New nursing graduates have resorted to taking jobs that are way below their knowledge and skill levels, most of which do not pay as much as they would like.

A Wealth of Non-Healthcare Graduates

In the U.S., medical records and health information technician jobs do not require healthcare degrees. Usually, employees in this category are high school graduates who took training courses that teach the relevant skills for the job. This educational profile may pose quality risks for medical coding and billing positions, given the lack of higher education among new entrants. In the Philippine setting, where college graduates from different disciplines abound, this risk may be significantly reduced by having career shifters with no healthcare background, enroll in medical terminology and anatomy courses.

The acceptability of non-healthcare graduates participating in medical records and health information technician jobs is further validated by the fact that professional certification organizations such as AAPC (American Academy of Professional Coders) and AHIMA (American Health Information Management Association) themselves offer these preparatory or bridging courses online.

 

Current State of the Industry

The Philippine Medical Coding industry began to gain momentum in the second half of 2011 and early 2012. From a few hundred coders in

2010, the medical coder headcount in the Philippines has risen to a current number of approximately 2,000 heads. This is made up of a mixture of certified and non-certified coders. Certified coders are mostly CPCs, with a few hundred CCS-certified coders.

The Future is Bright!

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The Healthcare Information Management Association of the Philippines (HIMAP) paints a very positive picture for this budding industry, conservatively forecasting a whopping 303% increase in FTEs from

109,000 in 2015 to 331,000 in 2020. Conservative growth in revenue forecasted is at 343% from USD1.737B in 2015 to USD5.965B in 2020.

Is Medical Coding right for you?

The Certification and Coaching Organization lists the top skills needed to be successful as a Medical Coder:

  • Top-notch attention to detail
  • Analytical and evaluation skills
  • Drive and determination
  • Open to change
  • Computer skills and navigation

Unlike most BPO accounts, medical coding is a back office post, and requires no direct interaction with the patients or clients. This allows for greater flexibility in work shifts. Medical coders require training in medical terminology as well as to get certification.

 

Quick Return of Training Investment

The training investment for bridging (i.e., medical terminology and anatomy) and certification courses for non-healthcare graduates can be quite substantial.

However, the potential wages in medical records and medical information technician jobs in the Philippines makes the learning investment worthwhile.

Even with the lowest pay of certified coders, the training and certification investment for bridging and certification courses can be recouped within the first four months on the job. When newly-trained medical coders usually get paid a basic salary of PhP25,000 per month, experienced certified coders will usually ask for twice that price to move to a new startup company. Coders with CCS certification will ask for an even higher rate, asking for as high as PhP60,000 per month

Training and Certification

Success rates for the CPC exam in the Philippines have been very high, with a certification rate of >95%. This can be attributed to the high intake standards of medical coder training companies.

Time for a Career Shift?  We CAN help!

It starts with a decision to start a career in an industry that possesses unlimited potential fo growth. Healthcare and non-healthcare graduates can take part in this revolution by learning the rudiments of the trade and seeking US certification.

The Philippine Medical Coding Academy of TeleDevelopment Services (TDS) offers a medical terminology and anatomy course for career shifters who want to position themselves in the healthcare BPO industry. They also offer medical coding courses that culminate in the certification exams for the AAPC.

Related: Top Caliber Coding Instructor Accredited

The Philippine Medical Coding Academy (TDS) is the best place to obtain healthcare BPO training.

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Why choose The Philippine Medical Coding Academy (TDS)?

  • TDS trainers are experienced medical coders and medical coding instructors, aside from being licensed medical professionals (MDs, RNs, USRNs)
  • TDS trainers possess certification from the

AAPC (CPC, CPC-I) and AHIMA (CCS)

  • TDS is the ONLY training institution in the Philippines that has an in-house CPC-I with an active instructor license.
  • TDS trainers have more than 20 years of experience in the healthcare BPO industry, having participated in production and management of medical coding, indexing, abstracting, writing, content creation, and healthcare data management projects.
  • TDS trainers have more than 40 years of experience in clinical and academic health sciences.

 

Let us help you get started on your exciting, new career today!

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