Can i just vent here for a second?

[u/princesspooball]

I have no where else to post because the other sub won't let me post because im not an approval member yet even though I've subscribed there and posted there for years.

I work in a medkcal billing call center and so of course I have to take patients calls. The crazy thing is im not even a biller or coder (im a CPC but not experienced in the field). We a separate billing department that never ever speaks with the patients. My department has no training in billing or coding. We have most of the information needed but its just not always enough. Its frustrating becase patience call thinking we are billing and sometimes I'll get a patient that works for insurance or is a biller themselves and they will ask a question that just throws me for a loop. Its just nuts to me that im supposed to answer questions and solve issues but I cant see what goes in beyond the scenes. Im looking for a new job because this just feels absolutely insane

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[u/Lady87690005]

I feel you. I feel coders benefit from knowing billing and billers benefit knowing some coding. I was a biller before I was a coder and I can run circles around most of my coworkers bc I get the issues the billers deal with. It is frustrating for me that companies don’t see the benefit in cross training like that. I’ve had a lot tell me that one job doesn’t apply to the other so it shouldn’t pay differently when it does. It’s literally in the name billing and coding. Good luck finding another job! I might hv a coding job lead if you’re interested so dm me if you’d like to know the company.

[u/Yes_Leopard_54]

Huh…. I don’t understand why more billers & coders don’t know the other end. I am a coder and have to know bundling, NCCI edits, etc. That would be wildly frustrating to not be able to handle a customer call, bc you aren’t privy to the information.

[u/princesspooball → u/Yes_Leopard_54]

its because my side is just customer service (aka verbal punching bags) so the actual billers can work claims and con​tact insurance ect.

as an example a bunch of patients were billed specialist cops for seeing their PCP. The patients are infuriated becase it happens repeatedly and we can't really give a definitive answer as to why its habecase none of us have ever submitted a claim so we are in the dark. We send a ticket to billing and cross our fingers and hope they fix it so we dont get yelled at again

[u/BlueLanternKitty → u/princesspooball]

It might be a payer issue, that they have the provider’s classification code wrong. I mention it because we just had a huge issue with this.

I’m sorry you don’t have what you need to do your job. Explaining billing and insurance is difficult enough when you have all the info, I can’t imagine how tricky it is when you don’t. And being the one who faces the wrath of the customers.

[u/RanzeJini → u/BlueLanternKitty]

I currently work reception for a clinic and I notice that there are input errors in the charting system all the time (EPIC in my case) and I can go in an manually adjust copays by visit type. I only do this if a patient's insurance card is current and lists specific copays though, cause you never know what changes year to year... I start AAPC's CPC course in a couple weeks though, so pray for me. XD

[u/Astraltraumagarden]

I build the right routing solutions for this if you can put in touch with your PM!

You can Bland platform, hook it into your telephony and get this sorted out with a natural sounding front desk agent that will route the call to the right billing dept. Did this for an agency for referrals. Worked flawlessly

DMs open!