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5 Reasons Why Certification Is Important


The size and shape of the companies that handle billing are many! There are big and small companies that handle billing. There are individuals that handle billing. There are garden variety billers and billers with a niche. How then, would certification make any difference between the individual who bills out of their home and a large company? There are some significant advantages to outsourcing your billing to someone who has pursued certification over someone who has not.

Here are 5 reasons why certification is important:

1. A Certified Biller Keeps Your Practice Informed

There are stacks and stacks of rules and regulations for the healthcare industry. This is especially true for those who operate a healthcare business. Most people did not study these things in school. As a counselor or therapist, your passion is providing treatment to patients, not focusing on compliance.

A Certified Biller will keep you informed on the latest rules and regulations that are applicable to your practice. This can help avoid fines, keep your license, and in some cases avoid other legal consequences. Billers that are not certified may or may not be up to date with regulations, and this is a large risk. 2. A Certified Biller Has Demonstrated Competency In Billing

Billing is time consuming, and can be a difficult exercise. One of the main reasons counselors outsource billing is to save time. If your biller is someone who is unfamiliar with billing, but they read that they can make some extra money by billing at home, they may not be a good fit for you.

A certification demonstrates that a biller has spent significant time learning and being trained in billing. They can navigate the billing process and understand the A/R principles that keep your business afloat. Without certification, a biller may not fully understand what is involved in the billing process.

3. A Certified Biller Knows Every Kind of Insurance

Without the federal and state laws, a biller needs to understand the different kinds of insurance that exist. An uncertified biller might not understand how to bill an EAP program, workers compensation, or even government carriers. This can lead to not getting paid and a lot of frustration.

A certified biller has demonstrated a basic level of knowledge of the different kinds of payers and plans. Understanding every kind of insurance and plan should be fundamental knowledge that a biller can use to save you time and money. 4. A Certified Biller Wants to Keep Learning

To become certified, the biller must have a desire to keep learning. Certifications can range from 80-120 hours of a time commitment. If your biller has decided to make the leap into certification, they clearly want to keep learning and growing in the knowledge of their field. In addition to the time that is put in for the initial certification, many certifying bodies will require that you do a pre-determined number of continuing education hours.

This is an incredibly valuable asset to you, since the rules and regulations of the healthcare industry are ever changing and very fluid. You want to have someone who is committed to continually learning.

5. A Certified Biller Demonstrates Commitment to Their Field

Becoming certified is not a small decision, nor is it an inexpensive decision. One must join an organization, get certified, and submit a certain amount of continuing education units every year or every three years. Therefore, when a biller is certified they have invested time and money to demonstrate to you that they can do the job you are asking them to do.

To give you an idea of the different certification bodies that are reputable, you can trust people certified through the AAPC, AMBA, or MGMA. Those billers are going to be a valuable asset to you.

Overall, certification is incredibly important. There are billers out there who are not certified who have been billing successfully for years. However, if you want the confidence that your biller is competent and committed, you will want to make sure they are certified. This is especially important when it comes to any changes that are on the horizon in the insurance industry. A certified biller is more likely to catch these changes while doing their continuing education hours.

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