To certify or not to certify?

Medical billing and coding certifications are highly coveted. The entities such as AAPC and AHIMA and the certifications they offer are considered the gold standard in the industry and are highly recognized by employers such as hospitals, payers and physician practices, among others.

There is no doubt that certifications give you a certain prestige and place you above the non-certified individual working in the same space. After all, studying and then taking these certification exams is not an easy task as it requires tremendous focus and discipline.

When I finished my billing and coding course back in 2005, I was not given any guidance on which certification to pursue. I somehow did my own research and stumbled upon CCS-P certification offered by AHIMA. I purchased the study guides, and gave myself two months to prepare for the exam. The exam was four hours long, and probably one of the hardest in my life. Fortunately I passed and went on to acquire more certifications in billing, auditing and compliance through AAPC . Having that first certification earned me a few letters behind my name but it didn't really help me in securing employment. I was not interested in working in a hospital and physician practices did not not care about the certification as long as I could do the job. I noticed that medical practices were so busy that they just wanted someone to file claims and get them paid as fast as they could so that the physician can pay his bills and keep the practice afloat. Most people who work in billing in small medical practices have learned it "on the job". Many of them started as medical assistants or front desk receptionists and were promoted or just shifted to the business office with little to no training.

In my business, I work with small to medium size medical practices anywhere from one to five providers and between 10-20 staff. A majority of practices that have hired us for their billing either started from the ground up or have been in business for many years with a single individual doing their billing who had little to no training and definitely no certification. Doctors who are running these practices could care less that their biller is certified, all they want is someone who is experienced in billing and specifically experienced in their specialty. Most of them don't even ask us if we are certified, even though we have all CPCs working at CodeRite. There is certainly a downside to this because an untrained biller with no access or knowledge in the rapidly changing regulations and guidelines, will leave money on the table. A very dangerous trend that is also leading to employee dissatisfaction and physician burnout. Physician owners of small practices must invest in their billers and coders and aid them in acquiring relevant certifications for higher job satisfaction and to save the practice's bottom line.

Now let's come back to the title "To certify or not to certify?" My answer is that acquiring certification definitely opens the door for you when looking for employment. Certifications also prove that you understand the basic concepts and know where to look for answers, not to mention you become a part of a community that promotes knowledge sharing and collaboration among peers. But certifications alone don't hold any water unless there is also experience behind it. There is no substitution to getting your hands in there and work on real-time claims and documentation analysis. So, get certified but also look for opportunities that will help you learn real world patient cases whether it is through volunteering or externships.