Above Ground Pools – Essential Care Tips Soon spring will be here and it will be time to undergo the task of opening your above ground swimming pool. Planning will make your job a whole lot easier. There is nothing worse than realizing you’re short one bag of shock when you are in the middle of prepping the pool. So first, you need to make a list of chemicals that are needed.

The needs will vary depending upon the type of pool you own. Therefore, this article will talk about it in general. You should always refer to your pool and pump instructions for additional information. Things you will likely need are liquid or powder shock, bromine, chlorine powder or tablets, sanitizing cartridge for the cartridge filters, pH increase or decrease and a test kit to test the chemical levels.

Do not take off just yet and run to the local pool supply store for chemicals. Stop and take a few minutes to check out all of your hoses, skimmer baskets, clamps, gaskets and o-rings. If any of the parts look like they might need replaced, take them with you to the pool supply store. It is a lot easier to match replacement parts if you have the old part with you.

Now that you have the easy part finished, it is time to begin the fun. The first thing required taking the cover off. You will want to enlist help for this, because you want to avoid getting any top water into the pool water. In an above ground pool, you should siphon the water off with a hose.

To get a good siphon started, hook up the hose to the spigot and put the other end of the hose into the top water. Turn the hose on for a minute to fill it. Next crimp the hose a foot or two away from the faucet, and with your other hand, disconnect the hose from the spigot. Position the hose at a downspout drain to discharge then let go of the crimp. The water will reverse and start to drain.
Once you have the water cleared, use a leaf rake to remove as many leaves and twigs as possible. Next, remove your cover weights or springs. At this time a few people positioned around the pool will help to keep the cover out of the water. Try to fold your cover like a blanket keeping the crud in the middle then remove the cover. You need to scrub the cover thoroughly so it is dry for summer storage.

Now it is time to attach all the pump hoses. Remember to lube plugs, fittings, valves, and o-rings with petroleum jelly. Also, be sure to remove any freeze plugs that were used to cover the hose openings. You will most likely need to add water to the pool. It needs to be filled to the skimmer halfway point.

At this point you should start re-circulating the water and check for any leaks around the pump and hoses. Once your pool is leak and drip free, skim off as much floating debris as you can with your skimmer net. Open all your valves to flood the hoses and prime the pool pump. Most manufacturers recommend constant recirculation of the pool water for at least three days. Any crud and debris on the sides and bottom of the pool will need to be scrubbed off. Use the broom attachment of your pool vacuum for this.

After all debris has been removed and the pool has been scrubbed, check your filter for cleaning. Some pumps have removable filters; others are back-flushed, so clean as directed. Once the filter is cleaned, you can now super shock the water as per your manufacturer’s instructions. If you start with green water, you will need a lot more shock. It may take a few days of recirculation to clear the water. Once the water has cleared, test your water or take a sample to your pool supply store and have it analyzed. Adjust the water as required and keep the recirculation going. All that is now left to do now is to wait for the water to warm up so you can start enjoying your pool.

Ethan K. Roberts writes on a variety of topics not limited to . Also available are more articles about and .

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Doing Internet Business to Succeed and Not Fail These days, doing internet business is getting more and more competitive. Many individuals are looking to capitalize on the internet through various products and services from the comfort of their own homes. Most people who get involved are looking to find a way to make a very healthy income while working whenever and wherever they choose.

However, doing internet business isn’t always an easy path for many who give it a try. Statistics show that over 90% of those who try doing internet business end up failing. Why is the failure rate so high? There are several factors that may contribute to the high failure rate. The good news is that there are ways to beat the odds and profit massively online.

To have any success from your early days doing business online it’s very important to learn from others mistakes and not repeat them! Understanding the vital components for doing internet business successfully will put you ahead of most of the others out there. Let’s call it the getting started checklist.

First, make sure you’re marketing real products or services backed by a reputable company. Next, seek out advice from a few different sources already involved in that particular business or one that is similar to the one you are interested in. All successful people doing internet business seek advice and build relationships with others in the industry. It’s also a very good idea to find a mentor who is excited about helping you create the same success that he or she has.

Keep in mind that doing internet business is about continually learning new trends online and building your knowledge on what works and what to avoid. Make sure you can get your hands on training and tools that will help you along the way.

The most important component to success is to NEVER give up. With every adversity comes an opportunity, doing internet business for the first time is about having a positive attitude and the determination to keep trying until you get it right!

Sean Weaver is a professional internet marketer who coaches aspiring entrepreneuers on the skills and techniques needed to profit from the internet at:
Global Resorts Network

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Before you sign the dotted line for a Banfield Wellness Plan, make sure you’ve educated yourself about what the plans offer, and what they do not.

When a Banfield employee pitches a Wellness Plan, one of the first things they will state is that the Wellness Plan is a binding contract that lasts for one year. If you’re in a rush, or if your mind is focused on your ailing pet, it’s to zone out while someone recites the Wellness Plan’s details. But this particular detail bears repeating: When you sign up for a Wellness Plan, you are responsible for a year of payments, even if your pet becomes lost, is stolen, is given away, or dies. In the event that you sell or give your pet to someone else, the Wellness Plan payments are non-transferable.

Banfield employees will also inform you that Wellness Plans are not pet insurance. This is true, though many customers mistake them for such. Wellness Plans are a pre-paid bundle of services. You will pay a sign-up fee, plus your monthly charges, and your pet will receive the pre-paid veterinary services throughout the year-long contract period. You end up paying less than you would if you paid for all of the services individually throughout the year.

Puppy and kitten Wellness Plans include all the vaccines that young pets require, as well as a spay or neuter. The spay or neuter option is a real selling point, but keep in mind that you are responsible for the price of medications associated with these procedures. Pain management and antibiotics are common.

The financial value of the vaccines is less clear. Certainly, there are some very necessary vaccines that your pet should have. But Banfield’s vaccination policy is somewhat controversial. Most veterinarians combine vaccines in order to spare pets the pain of multiple injections, and to spare clients the cost of paying for each shot individually. Banfield does not; your pet can be injected up to seven times in one sitting, depending on their size and species. Private veterinarians also contend that Banfield uses vaccines that aren’t necessary for certain animals. While Lyme’s Disease and Leptospirosis are real diseases, it is unlikely that they would be contracted by city-dwelling pets that seldom leave their homes. Do some research with local veterinarians who use fewer vaccines, and who combine many of the ones they do administer. You may find that you would pay a significantly lower amount of money at a private practice.

Some levels of Wellness Plans offer one free dental cleaning per year. This does not include extractions; if the veterinarian discovers loose or broken teeth that need removal, you will be responsible for the charge of extraction, plus necessary medications.

The Wellness Plans for young pets might be the value of all, but all Wellness Plans cover the cost of office visits, which is significant. They also give a small discount on medicines and services that are not covered outright. In addition, they promote vaccination, dental care, spaying and neutering to clients who might not otherwise acknowledge the value of these procedures. Finally, Wellness Plans can be used at any Banfield location, so they are convenient for those who relocate or travel with their pets.

The choice to put your pet on a Wellness Plan is yours to make. Show your pets the love they deserve by making an informed decision that is right for their needs.

Use corners. Buy or build a corner storage unit that stretches from floor to ceiling.

Build shelves. If there’s not much room on the floor but you’ve got some blank wall space, consider installing a set of shelves there.

Hang pegs. Hanging a row of pegs or hooks on the inside of your bathroom door can give you much needed space to store towels, bathrobes, or even hanging baskets.

Hang some baskets. Those wire baskets you hang from the ceiling in the kitchen aren’t just good for produce. They’re also great for shampoos, soaps, and bath toys.

Get rid of bulky items. Don’t keep every roll of toilet paper or towel you own in your bathroom.

Clean out your bathroom. Throw away empty bottles, expired medicine, expired makeup, and shampoo and soap. Combine bottles that are partially full.

Even if you have a tiny bathroom, it doesn’t have to be cluttered. Follow these tips, and your bathroom is sure to look spacious and well-planned—even if it’s barely bigger than a closet.

R Dobson is director of the online ECommerce business WD Bathrooms – for a wide range of bathroom and shower related products visit http://www.wdbathrooms.co.uk/acatalog/Shower_Cubicles.html

Businessman and philanthropist Peter Thiel offers young people fellowships to their own businesses instead of going to college; one of the first recipients is Dale Stephens, founder of the website uncollege.org.

Even Madeline Follin and Brian Oblivion, two 22-year-old indie-pop musicians, take a shot at the institution this week in New York magazine, summing up many of their peers’ frustrations: “A lot of my friends who are college graduates are not doing so hot right now. We had an opportunity to start our own business, and we had to take it.” (For author Daniel Pink’s more traditional take on the college question, see How to Create a Career in the New Economy.)

Michael Ellsberg, author of the new book The Education of Millionaires, also argues that for many people, self-employment in lieu of college is the ticket to success today. US News spoke with Ellsberg, who attended Brown, about why he thinks college is such a waste of time. Excerpts:

Why did you feel like you needed to write this book?

I had two reasons. One was personal. When I was 32, two years ago, I was taking stock of my life. Everything I liked about my life came from me having learned it in the real world. I was in a wonderful relationship, my health was in good shape, my career and money were coming together. All of this happened because I learned to bring those things into my life. I started to think, “Why do we place so much emphasis on young people learning abstract academic stuff, and then don’t give them any way to learn real world things?”

The second reason is that my wife did not complete college. She dropped out her junior year and became a successful entrepreneur. She feels a lot of guilt and shame about her educational status, and I thought that was crazy. I wanted to tell the story of people like her so that people like her, including her, would not feel shame.

Do you want to discourage people from going to college?

It’s not my place to tell people whether they should or shouldn’t go to college. They have to make that decision themselves. Young people get exposed to no substitute view other than to go to college, and I want to open up the dialogue. There are so many other ways to educate yourself, and to have this be the single option that we give kids is crazy. If you want to go into law, medicine, or become an engineer, accountant, or dentist, it makes sense. But for the typical kid like I was, who isn’t really sure what they want to do and is trying to figure it out, and just wants a general introduction to becoming an adult, $50,000 a year is a very expensive price to pay for that.

Did Brown really do nothing for you?

Zippo. Zero. I had a great time there, but we should be asking more of our than did they have a great time. Brown actually me as a writer. It thought me to write in a very academic way.

Didn’t it instruct you skills such as critical thought?

I was a very passionate reader starting at age 16. College forced me to do reading I didn’t want to do. My message applies more to kids who are highly motivated. Being in such an extremely structured environment can actually hold you back. There are kids who don’t have a lot of motivation, and they should probably be in a more structured environment. The people who are going to found major companies and make major innovations in business, technology, and art—those are the kind of people who will probably do that no matter what, and college could be holding them back from making those contributions earlier, especially if they have to pay off a lot of debt to go there.

What about all the research that suggests the unemployment rate is lower among college grads, and they earn higher salaries?

There is a huge problem with those statistics. Correlation is different from causation. The fact that people who do superior tend to also have college degrees doesn’t necessarily mean that [the degrees] caused their success, it just means that smarter and more ambitious people tend to go to college. So if one of those people, you should question whether you need to spend $200,000…What if instead, you begin a business? Then you could have a whole portfolio to show potential employees.

Are you saying that having a college degree doesn’t help you get a job?

It does in specific areas. Obviously if you want to be a doctor, lawyer, or engineer. The question is, can [a college degree] help you as much as going out and getting work experience, instead of spending four years racking up debt and writing papers on Shakespeare. About 80 percent of the job market happens informally…. through networking. You don’t need to go to college to build up a great network.

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New York, new York  (Profitable.com)  October is National Dental Hygiene Month and Celebrity Dentist and author Dr. Catrise Austin of VIP Smiles in new York City is launching a local consumer awareness campaign to alert residents of the new York/Tri-State community about the potential risks of postponing dental appointments and neglecting their oral health.

Dr. Austin’s Oral Healthcare Can’t Wait™ Campaign is a local component of a national awareness initiative sponsored by The Dental Trade Alliance (DTA), a nonprofit trade association representing leading dental manufacturers, distributors, and laboratories.

According to Dr. Catrise Austin, “There’s no denying that the last 3 years have been tough financially for many Americans across the nation including new York residents. The current economic climate is causing many people to either postpone the dental treatment plans recommended by their dentists, or to put off dental visits altogether. unfortunately, there are long-term health risks associated with postponing oral care.”

Some of the health risks that Dr. Austin is referring to include the following:

• Tooth decay is a progressive disease. Postponing treatment can lead to more complex, more invasive, and more high-priced treatment, such as root canals or extractions.

• According to everydayhealth.com, one study in the Australian Dental Journal pegged tooth decay as one of the most common infectious oral diseases. these bacterial infections can be contagious     and passed along.

• The National Institute of Dental and Craniofacial Research (NIDCR) warns that the mouth is the gateway to the body and is challenged by invasions by bacteria, viruses, parasites, and fungi. There are 120 diseases, including early signs of HIV infection, oral herpes virus, and oral cancer that can be detected while sitting in the dental chair. some of these diseases can be asymptomatic. Postponing your dental checkup could prevent the opportunity for early detection and treatment that could prolong or even save your life.

• Recent studies that have been reviewed by The American Academy of Periodontology (AAP) have linked undiagnosed and untreated gum disease with a negative impact on patients’ heart health, diabetes, pregnancy, and other systemic health conditions.

• Chronic bad breath is usually due to conditions that may be easily prevented by regular oral hygiene appointments and consultation.

“With so many people looking for jobs or worried about their job security, it must be noted that having bad breath and discolored, damaged, or missing teeth are the kiss of death in today’s competitive job market,” explains Dr. Catrise Austin. “Your smile is the first thing employers, managers, and co-workers notice.”

Is the Oral Healthcare Can’t Wait Campaign just a way for dentists to make during tough times? Absolutely not, states Dr. Austin. “If more people truly comprehended the connection between oral health with the rest of the body and its overall health, I believe they would prioritize their discretionary spending accordingly. Choosing between undergoing gum disease or cavity treatment versus buying a new cell phone, wireless personal pad, weekly professional hair and nail grooming, or taking costly vacations would become a no-brainer.”

Here are some options to consider during your next dental visit:

• Dental professionals are primarily focused on prevention when their patients allow them to do so. In addition, many patients are not taking full advantage of the scope of services covered by their dental insurance. Ask your dentist what can be done to prevent cavities such as dental sealants for permanent molars as well as fluoride treatment for adults.

• Most dentists are very flexible when it comes to paying out-of-pocket expenses. Ask about alternative payment options like 0% interest financing, using a credit card, or working out an in-office payment plan.

• Talk to your dentist about prioritizing your treatment plan. Ask what needs to be done immediately and what can wait until you have more discretionary income.

Dr. Austin shares 5 tips that can give consumers a healthy white smile at home throughout the year:

1.  Follow this smile workout at least twice daily:Brush, Floss, Rinse, and Scrape (or Brush) your tongue to keep your gums and teeth healthy and your breath fresh.

2.  Drink fluoridated tap water or use a fluoride mouthwash to fight cavities

3.  Read the nutritional facts on packaged food/beverage labels:Pay special attention to the hidden sugar in your food and drinks to avoid cavities.

4.  Need to rejuvenate your dull smile? try teeth whitening!consider refreshing your look using the Crest 3D White Collection (less than $100)! Brush for 2 minutes daily with the Oral B 3D Pulsar Toothbrush and Crest 3D White Vivid Toothpaste, then rinse daily with the Crest 3D White Multicare Whitening Mouthrinse, then add that dazzle and by using the Crest 3D White Professional Effects Whitestrips (the most effective of all Crest Whitestrips) once daily for 30 minutes (for 3-7 days). if you want to quickly whiten your smile try Crest 3D White 2 Hour Express Whitestrips ($54.99, 4 whitening strips) deliver a noticeably whiter smile in just 2 hours. Apply once for 2 hours and get noticeable results that last for three months. Each kit contains 4 treatments so you can keep your smile bright for a whole year.

5.  Never say to yourself, “My teeth don’t hurt. I don’t need to see a dentist.”You can’t have a great smile without the help of your dental team. although there are many tools available to maintain your smile in the comforts of your own home, nothing replaces visiting your dental team every 6 months for your gum evaluation, professional cleaning, and cavity check.

“Oral Healthcare Can’t Wait is a very important national initiative with the ultimate goal of sustaining and improving oral health in America,” explained Dr. Catrise Austin. “I’m very proud to do my part and spread the message with my new York City local community.” Dr. Austin will be kicking off her local Oral Healthcare Can’t Wait campaign in honor of October’s National Dental Hygiene Month with a series of free dental health lectures for the public (all ages welcome) where Dr. Austin will be discussing some of the top dental issues that our community should be concerned with such as the importance of prevention, free and low cost access to dental care, what dental products are safe and work best, and do-it yourself tips to maintain optimum oral health at home between dental visits.

Dr. Catrise Austin will lecturing for free, providing Q & A’s, giving away valuable prizes, and signing copies of her book 5 Steps to the Hollywood A-List Smile in new York City on the following dates:

Monday October 10th, 2011 6-8 PM (Columbus Day): Hue Man Bookstore, HarlemSaturday October 22nd, 2011 1PM: new York Public Library 96th Street Branch

About Dr. Catrise Austin

As the first private practice dentist in the nation certified to offer HIV testing to patients while in the dental chair, Dr. Catrise Lynette Austin is a trailblazing expert in the field of dentistry. she is an author, professional speaker, entrepreneur, and founder of VIP Smiles-a modern dental practice in new York City. Notable celebrities such as X-Factor Judge Paula Abdul; Dancing With The Stars dancers Karina Smirnoff and Maksim Chmerkovskiy; Apprentice Diva Omarosa; HBO’s Entourage Actor Rex Lee; Songstress Toni Braxton; show host Wendy Williams; Food Network Chef Sunny Anderson; Dallas Cowboy tight end Martellus Bennett, 2010 Olympic gold medalist Ashleigh McIvor, and Grammy Award-winning rapper/actor/author Common (to name a few) have all placed their teeth in her capable hands. Austin is an award-winning dentist and columnist who has solidified her reputation in her field with national radio as well as national television appearances on The Discovery Health Channel, Today show, and good Morning America, among others. Dr. Austin is available for local and national interviews, as well as speaking engagements on dental health, HIV testing in the dental office, entrepreneurship, careers in dentistry, and improving your image with your smile. for more information about dental health or for booking information contact Dr. Catrise Austin at 212-262-6054 or visit vipsmiles.com

About the Dental Trade Alliance

The Dental Trade Alliance is an association of companies that provide dental equipment, supplies, materials, and services to dentists and other oral care professionals. Its member companies are distributors, dental laboratories, and manufacturers located in the United States, Canada, and Mexico. by providing the best equipment, materials, and services to dentists and oral care professionals, they are partners in improving the oral health of everyone. for more information, visit dentaltradealliance.org

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October is National Dental Hygiene Month: New York City Celebrity Dentist and Author Dr. Catrise Austin Says, Despite the Economy, ‘Oral Healthcare Can’t Wait’

The US Senate may be close to inking a “compromise” bill on healthcare reform according to Michael D. Tanner of the Cato Institute. Tanner – a senior fellow at the Cato Institute – states this “compromise” bill keeps what he calls “the worst elements” of the current bill. He says the new bill will still mandate that Americans will have to health insurance that meets government standards – even if those standards will cost consumers more, and contains provisions that consumers have no desire to purchase. It still mandates high-priced regulations, and Tanner states that it will still contain provisions that will grant government to mandate care provided by doctors.

Tanner states the bill contains two new compromises that are really the same things with just different names.

First, Tanner says that instead of a national public option the bill introduces what it calls a “co-op” option. Of course, Tanner states that the name is a misnomer. He says instead of being run by its members – who would elect the officers – the officers would be appointed by the president, which according to Tanner would make it a de facto public plan. “A ‘co-op’ run by the federal government, under rules imposed by the federal government and with federal funding is simply government-run health insurance by another name”, says Tanner. In fact Senate Majority Leader Harry Reid put it, “We’re going to have some type of public option, call it ‘co-op,’ call it what you want”, according to Tanner.

The second “compromise” in the bill is just another misnomer according to Tanner. He that the new bill will drop a stipulation for employers to provide healthcare, but Tanner says the new language requires employers to pay for subsidies spent by the government to cover their uninsured employees if they don’t provide insurance for them.

In recent days the administration’s efforts to reform health care have met with a backlash from the public. An August 3, 2009 Rasmussen poll found that 47% of Americans support healthcare reform while 49% oppose the plan. It should be noted that according to the survey those who oppose the plan show more passion: just 25% of supporters support it strongly while those who strongly oppose the plan rank at 41% of those surveyed. There’s a three percent (+/-) margin of error in the poll.

Fox News states that Democrats are being dismissive of opponents of reform appearing at their town hall meetings are exercising “mob rule”. “The Republicans and their allied groups desperate after losing two consecutive elections and every major policy fight on Capitol Hill … are inciting angry mobs of a small number of rabid right wing extremists funded by K Street Lobbyists to disrupt thoughtful discussions about the future of health care in America taking place in Congressional Districts across the country,” DNC spokesman Brad Woodhouse stated in a statement according to Fox. Beirbart.tv posted a video of White House Press Secretary Robert Gibbs saying that any anger expressed by citizens is “manufactured”.

The White House is also fighting back against a charge leveled by the Drudge Report that the president is seeking to institute a single payer system. In a video link from the Drudge site to a youtube.com video of the president speaking to an AFL-CIO group, President Obama (in 2003) clearly says that he is a “proponent of a single payer system”. In response the White House posted a three minute video rebuttal according to politico.com.

Sources
1. Michael D. Tanner of the Cato Institute.
2.Rasmussen poll
3. video of White House Press Secretary Robert Gibbs
4.Fox News
5.video link to youtube.com
6.three minute video on politico.com

Medical billers and coders know this and feel good about the support they provide to physicians, clinics, hospitals, and patients. They know they play an important role in the business office where they are employed. Their work consists of submitting the proper documentation to a number of insurance companies and federal agencies for reimbursement in order for their employer to financially succeed and avoid fraud charges. Their specialized training and expertise lets them find work any place, any time. Numerous opportunities for trained individuals exist in medical offices, clinics, hospitals, insurance companies, and in form of freelance home-based businesses. Advancement opportunities are unlimited!

The U.S. Department of Labor states that continued employment growth for medical coders and billers is spurred by the increased medical needs of an aging population and the number of health practitioners. The Occupational Outlook Handbook reports that earnings vary widely and pay levels are governed chiefly by experience and qualifications.

Healthcare Careers Offer Job Security, Personal Satisfaction, Challenges, and Rewarding Experiences

Many interested in a career in the healthcare field decide to specialize in the medical billing and coding profession. Medical billers and coders are no longer restricted to only the doctor’s or dentist’s office but are now working in hospitals, pharmacies, nursing homes, mental healthcare facilities, rehabilitation centers, insurance companies, health maintenance organizations (HMOs), consulting firms, and health data organizations, or even from home.

These highly skilled professionals are earning impressive wages everywhere they are. Typical duties of medical billers and coders include:

• Explaining insurance benefits to patients and clients
• Office bookkeeping and other administrative duties
• Accurately completing claim forms
• Explaining insurance benefits to patients
• Handling day to day medical billing procedures
• Adhering to each insurance carrier’s policies and procedures
• Prompt billing of insurance companies
• Documenting all activities using correct medical terminology
• Scheduling appointments

Other job opportunities for medical billers and coders include:

• Billing Specialist
• Patient Account Representative
• Electronic Claims Processor
• Billing Coordinator
• Coding Specialist
• Claims Analyst
• Reimbursement Specialist
• Claims Assistant Professional
• Medical Collector
• Claims Processor
• Claims Reviewer

What is Medical Billing?

Medical billing is better described as medical practice management and a doctor’s key to getting paid. Although most doctor’s offices request that payment be made at the time a medical service is provided in order to minimize billing, every medical office has a need to maintain patient financial accounts and for collecting money.

In a small family practice or suburban clinic this task may be simple and assigned to the medical assistant or nurse but in bigger practices and clinics this is the medical biller’s job!

Medical billers and coders usually work forty regular office hours from Monday through Friday on a desk in the billing office or billing department of the professional healthcare office. They must know the different methods of billing patients, understand various collection methods, ethical and legal implications, have a good working knowledge of medical terminology, anatomy, medical billing and claims form completion, and coding. They also must understand database management, spreadsheets, electronic mail, and possess state-of-the-art word processing and accounting skills, be proficient in bookkeeping, and be able to type at a speed of at least 45 words-per-minute.

The work area of medical billers and coders usually is in a separate area away from the patients and public eye. However, even though they are not involved in the actual process of doctors and healthcare professionals providing medical care they need to possess excellent customer service skills when it comes to making contact with clients, insurance companies, and often patients. Medical billers must know how to explain charges, deal with criticism, give and receive feedback, be assertive, and communicate effectively without becoming confused as the person is asking questions. Patients can quickly become frustrated when trying to deal with healthcare providers and bills over the phone.

While an increasing amount of patient care is being funded through HMO related insurance, where the patient makes a small copayment at the time of service and the doctor bills the managed care company for the balance, a number of patients still need to make arrangements to pay for their medical services over a period of time. Part of the medical biller and coder’s job is to contact some of these patients from time to time regarding a past due bill. Incoming calls from patients who have questions regarding a bill are also directed to the medical biller’s office. The way s/he communicates over the phone can make or break business relationships.

Other specialties closely related to the medical billing and coding profession are:

• Medical Coders/Coding Specialists
• Patient Account Representatives
• Electronic Claims Processors
• Billing Coordinators
• Reimbursement Specialists
• Claims Assistant Professionals
• Medical Claims Analysts
• Medical Claims Processors
• Medical Claims Reviewers
• Medical Collectors

What is Medical Coding?

Every healthcare provider that delivers a service receives money for these services by filing a claim with the patient’s health insurance provider or managed care organization. This is also referred to as an encounter. An encounter is defined as “a face-to-face contact between a healthcare professional and an eligible beneficiary.”

Codes exist for all types of encounters, services, tests, treatments, and procedures provided in a medical office, clinic, or hospital. Even patient complaints such as headache, upset stomach, etc. have codes which consist of a set of numbers and combinations of sets of numbers. The combination of these codes tells the payer (health insurance companies or government entities) what was wrong with the patient and what services were performed. This makes it easier to handle these claims and to identify the provider on a predetermined basis. In addition, the services rendered (CPT) codes have to match the diagnosis (ICD) codes to justify medical necessity.

To do this correctly for each third party payer choices have to be made from a combination of 3 coding systems totaling over 10000 codes, and which change annually. In addition, a completely new coding system, ICD-10, is proposed for reimbursement purposes in the near future.

Tools of the Trade

CPT books provide all the procedural terminology and ICD-9-CM code books have the most up-to-date information on medical diagnosis coding. The medical coder must stay current on any new ICD-9 code changes that would impact code accuracy and claims submission. HCPCS books contain the complete lists of HCPCS Level II codes with descriptions. They will guide the medical coder through current modifiers, code changes, additions and deletions. HIPAA books help to develop an effective HIPAA compliance plan and DRG books are needed for Medicare’s classification of inpatient hospital services based on principal diagnosis, secondary diagnosis, surgical procedures, age, sex, and presence of complications.

Training

Training of the medical billers and coders can range from two to four years of college, a technical school diploma, certificates from correspondence courses, to simple home study programs. Upon completion of such training many coders may seek professional certification.

Though not necessary, it is recommended and national associations are available for the certification processes.

Vocational Training

Professional medical billers and coders are in very high demand. Billing for services in healthcare is more complicated than in other industries. Government and private payers vary in payment for the same services and healthcare providers and organizations provide services to beneficiaries of several insurance companies at any one time.

Therefore, to reach proficiency in this business, basic training, clinical supervision and continued professional development is essential!

Typical Course Requirements are:

• Medical Office Procedures
• Medical Keyboarding
• Medical Terminology
• Health Structure and Function
• Health Care Records Management
• Medical Insurance
• Survey of Pathology
• CPT-4 HCPCS II, III
• Healthcare Laws and Ethics
• Basic Coding ICD-9-CM
• Basic Pharmacology
• Medical Transcription
• Externship
• National Exam
• General Education Requirements

Professional Advancement Opportunities

A recent American Hospital Association survey showed that about 18% of billing and coding positions remain unfilled due to a lack of qualified candidates. Most companies and practices are looking for schooling and experience mostly because of the legal ramifications of incorrect billing practices.

However, medical billers and coders are also able to work independently out of their homes where they established a home based billing office. There are plenty of electronic billing programs available that can be set up through home office computers. Also, there is the possibility to become an independent insurance specialist or consultant who helps patients understand their insurance bills and what they should be paying.

Opportunities also exist as patient account managers, physician office supervisors and management, various types of personnel managers in the healthcare industry, health claims examiners, and medial billing and coding instructors. The more education the individual has, the more employment options are available and advancement opportunities become virtually unlimited!

Professional Certification

As in so many healthcare professions certification in the medical billing and coding field is not required but highly recommended. The days of the single family practice medical assistant or nurse typing out an invoice after office hours are history. Even the smallest offices and clinics have changed to computer billing because it offers greater coding accuracy, saves time, and can be used by administrators and auditors to ensure that visits are being coded to the appropriate levels which increases revenues.

Understandably, these offices and companies are looking for individuals who are certified in their field to ensure the employer that the individual whom they hire is competent and proficient.

There are numerous well known and well respected organizations sponsoring these types of examinations. Intersted candidates should research each one and find the one that most suits your needs: American Association of Medical Billers (AAMB) offers Certified Medical Biller (CMB) and Certified Medical Billing Specialist (CMBS) examinations. The National Association of Claims Assistant Professionals (NACAP) offer Certified Claims Assistance Professional (CCAP) and Certified Electronic Claims Professional (CECP). The examinations for Certified Procedural Coder (CPC), Certified Coding Specialist (CPS), Accredited Record Technician (ART), and Registered Record Administrator (RRA), are administered through the American Health Information Management Association (AHIMA). The National Healthcareer Assosciation (NHA) is offering their Medical Billing and Coding (CBCS) credential.

If your objective is to work for a medical office, group practice, healthcare provision network, or hospital as the medical billing and coding specialist keep in mind that most private practices, organizations and hospitals throughout the country not only prefer but often require national certification as a competency standard.

To learn more about this very rewarding career visit the Medical Billing and Coding Net web site at

© 2003 Danni R. of the Medical Billing & Coding Net. Reprint permission available by request.

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