How to Become a Medical Billing Advocate

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If you would enjoy a medical billing career but wish to work more on the side of the patients and insurance companies getting billed for medical care, a medical billing advocate position may be ideal for you. Becoming a medical billing advocate is not very difficult and can contain the same education you would receive for a medical billing career within a medical facility. The major difference in your duties is that you won’t be billing patients and filing insurance claims, but acting as a billing consultant that looks over medical bills to ensure there aren’t any unnecessary or mistaken charges or upcoding present. Upcoding is an act that has been found to be fraudulent and consists of patients being billed for a higher level service than was actually received. This is illegal and as a medical billing advocate, you would be pointing out these errors.

Getting a Higher Education

Just like you would attend a medical coding program or related program in order to enter the medical billing specialist position, you would do the same to become a medical billing advocate. You will be responsible for learning appropriate medical terminology and appropriate codes for billing procedures. You will also be trained on the appropriate procedures for pinpointing billing errors and addressing them properly. It is a federal law that all errors must be reported by the physician to the federal regulating agencies, and you will act as the consultant that checks for these errors.

Entering Into the Position

There are many medical coding consulting agencies that offer the position to those that wish to investigate medical bills and billing procedures. Your main role will be inspection of patient bills and decoding to identify any improper charges or upcoding that have occurred. Once the issue is found, the patient as well as the physician is notified and given appropriate details for making the appropriate reporting measures to the correct agency.

Why Become a Medical Coding Advocate

In a world where health care costs are always on the rise, it is important that there are medical coding advocates to ensure that patients are only billed for the services and resources they receive and no more. You will serve as the voice for the patients, and the insurance for the insurance companies that the payments due are necessary and should have been charged. In the event that you are able to identify any type of fraud, you will be able to ensure that the issue is resolved and the patient only charged what should have been from services.

A medical billing advocate holds a key role in the health care industry with a strong influence over the future of this industry. There are organizations that go further to ensure that policies are enacted to provide security to patients from medical billing fraud. Patients may not be able to decipher medical code, so it is up to you to ensure that there haven’t been any mischarged items on a patient’s bill or insurance claim.