If you do all coding for insurance in the clinic in which youare employed, but...

If you do all coding for insurance in the clinic in which you are employed, but you are not a professional coder, is it possible you could be held to the same standard as a professional coder? Explain your answer.

Expert Solution

Absolutely. A professional coder for insurance is responsible for applying the right procedures for billing medical services. If the coder for insurance in the clinic is not a professional, then documentation and coding would be incorrect which eventually lead to denial or lessening of the reimbursements for the patients. This is also a professional negligence which the health care provider (clinic) failed to adhere to. Every health care provider should be ethical in their practices and follow the professional code of conduct to provide the best of services to the patients. If the professional coders are not hired, then it is also a violation of the professional code of conduct. Hence, it is important that the coders are professionally certified by AAPC (American Association of Professional Coders) and AIHMA (American Health Information Management Association).

keosha answered 2 years ago

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