r/CodingandBilling

I keep seeing people talk about medical coding like it’s some quick, easy path to working from home, and honestly… that’s a huge misconception.

Yes, it can be remote. Yes, it can be a great career. But “easy”? Not even close.

You’re dealing with complex guidelines, constantly changing rules, and a level of detail where small mistakes can have big consequences. It’s not just typing codes you actually have to understand medical terminology, anatomy, and how documentation translates into billing. There’s a real learning curve, and even after you get certified, you’re still learning every day.

I’m not saying this to discourage anyone just to set realistic expectations. If you’re only getting into it because you think it’s a laid-back remote job, you’ll probably be frustrated pretty quickly.

But if you’re someone who likes structure, problem-solving, and continuous learning, it can be really rewarding. There’s a sense of satisfaction in getting things right and knowing your work actually matters in the healthcare system.

Hi all, I’m trying to see if this is a common experience for people in coding and billing and how others deal with providers who push back on coding advice.

I work for a small private practice, and I constantly feel dismissed by our main provider/boss when it comes to coding and billing questions. I went to school for this, and I know how to research guidelines and payer policies. But whenever I answer a question or bring something up, it feels like my input gets ignored or treated like I must be wrong.

I’ve even overheard him telling a coworker to contact a billing specialist at another office for her opinion instead of trusting mine, and she ended up giving the exact same answer I already gave.

One of the biggest issues is that when I explain why something may not be billable for a certain payer or why a denial happened, his response is usually, “Well Medicare pays for it, and they’re the strictest, so I don’t know why this insurance is denying it.” Then he keeps wanting to do it the same way anyway.

Lately he’s also been questioning me a lot about reimbursements being down and asking if I’m missing claims or doing something wrong. I’ve explained that our patient volume has dropped a lot over the last few years, so reimbursements are obviously going to be lower too. But it feels like he keeps bringing it up like he’s waiting for me to admit I messed something up.

For those who work in coding and billing, especially in smaller practices, how do you deal with providers who push back or don’t seem to trust your knowledge? Have you found good ways to explain things without it turning into an argument?

I received a bill for the entire visit amount 16 months after my visit with a participating provider. Apparently they filed the claim very wrong, because my insurance has no record of them filing a claim at all. I provided correct information so they could re-file. I see no evidence of this new claim on the insurance website/app. Regardless, they didn’t re-file until after a year had passed, so they failed to file in a timely manner, thus it’s rejected. As far as I’m concerned, that’s their fault, and I’m am not responsible for those charges. If they had contacted me earlier, I could’ve given them more information so they could get paid, or they could’ve asked me to pay and I could’ve filed for reimbursement. But it’s too late unless the insurance company grants an appeal. These are for charges from September 2024! I’ve spoken to someone in the provider’s billing department twice now. How much time are they going to expend for $200? 🙄

Hi there!

I had an ER visit for a dog attack. During the visit, they cleaned my wounds, touched/bent my arm (where the wounds were) and administered a rabies shot. I'm wondering if this would actually qualify as a level 4, since I didn't have any testing or imaging done.

Good morning. I realized after doing more research it makes more sense for me to get a CCS through AHIMA rather than CPC based on my goal of wanting to learn everything about profee and facility coding. Are there any programs that you recommend that focus on preparing for the CCS and inpatient coding? I don't have much a background in medical terminology aside from reading charts and encounters, just admin healthcare work.

Is there any training courses or guides for A/R escalation specialists? I am looking to understand denials better and know how to work them

Hello, Would anyone be willing to help me understand what they charge when taking over a legacy account?

Right now this account has about 400k in AR and it looks like about $130k of that is collectable. This provider wants a line by line audit, audit of specific procedures, helping switch over to a new EMR/Clearing house, etc.

What would you charge for something like this? My goal would be to charge the same contingency percent for any payments coming in regardless of DOS; which then makes me think that I need to collect more heavily on the up front. I dont want to be over the top, but also need to make sure my work and my assistants work are compensated fairly.

Thank you!

If any provider or practice wants a reliable and reasonable virtual help for RCM cycle or Virtual assistance, let's discuss and see if we could help each other.