#Medical Coding Massachusetts

[outsource-medical-billing]

What is Medical Coding? Why is Coding Important?

Did you realize that more than 80% of medical claims in the United States have errors, most resulting from improper coding? These errors cost the U.S. healthcare system around $935 million weekly. In fact, 42% of doctors count coding errors as the number one reason for claim denials.

In a system where financial viability and quality patient care are not mutually exclusive, proper medical coding forms the foundation of a hospital's revenue cycle. It directly impacts claim acceptance rates, reimbursement cycles, and overall operational efficiency.

Medical coding is all about how healthcare services are documented consistently and effectively communicated to insurance companies for reimbursement. Through the translation of complex medical information into a structured coding framework, medical coders bridge the health delivery-financial accountability gap.

This blog will explore what medical coding involves and why it is essential for every healthcare facility.

Overview of Medical Coding

The AAPC defines medical coding as converting diagnoses, treatments, services, and equipment to standardized alpha-numeric codes that are drawn from a patient's clinical documentation, such as physician notes, lab tests, and radiology results.

Medical coders review such documents, assign the correct codes, and ensure these accurately reflect the patient's condition and provided treatment. This allows medical practitioners to communicate effectively with insurance companies for billing and reimbursement.

What are the Different Types of Medical Codes Used?

The healthcare industry relies on various coding systems, whereby each code is designed to serve a unique role in clinical documentation and billing:

Current Procedural Terminology:

CPT codes define the medical, surgical, and diagnostic care delivered by health practitioners to ensure that providers report consistently.

International Classification of Diseases:

ICD codes are utilized to record and classify the diagnoses, symptoms, and related health conditions of a patient, mostly in hospital settings.

Diagnosis-Related Groups:

DRG codes categorize hospital cases with comparable diagnoses and treatment to assist in determining the rate of reimbursement for inpatient hospital stays.

Healthcare Common Procedure Coding System:

HCPCS codes provide for services and items not addressed by CPT codes, including ambulance transportation, medical equipment, and supplies. These are mainly applied for billing Medicare and Medicaid.

Why is There a Need for Medical Coding?

Medical coding is the foundation of a smoothly working healthcare system, driving correct billing, minimizing claim denials, and maintaining financial health. The following are the key reasons for proper medical coding:

Minimizing Claim Rejections

Over the past decade, insurance providers have witnessed lower reimbursement levels and tighter claim scrutiny. Most denials are caused by errors or omissions in codes. Professional medical coders minimize such mistakes by accurately coding each claim. This results in quicker reimbursements, fewer rejections, and better cash flow for healthcare facilities.

Aging Population

As the population's life expectancy is increasing, particularly among the Baby Boomers, there is an increased need for medical services. With the increased need for healthcare services, the volume of medical records also increases. Therefore, proper coding is required to keep up with the increase, ensuring that healthcare providers can track medical services, maintain efficiency, and receive reasonable compensation for their care.

Evolving Care Delivery Models

Today’s health care is not just confined to the traditional hospital settings. There are ambulatory centers, outpatient clinics, and home care as part of the healthcare system. Coders must be in sync with these changes and use the proper codes according to the updated guidelines for accuracy and compliance.

Improving Care Quality

Medical coding plays a vital role in value-based care, wherein reimbursements will be quality-based on the healthcare services. Coders can assist healthcare providers and hospitals to measure outcomes, become performance-based incentive eligible, and provide better patient care by offering accurate code reporting.

Ensuring Proper Reimbursement

Precise and accurate medical coding has a direct influence on the financial well-being of a medical facility. Each procedure or diagnosis needs to be coded correctly in order to secure proper payment from payers. Inaccurate coding or incomplete coding will result in lower payments or even denials, having an adverse effect on total revenue. Accurate coding ensures providers receive maximum and adequate payment for all services provided.

Frequent Coding Updates

Medical coding systems are updated on a regular basis to keep pace with changes in care delivery. To illustrate, new codes were introduced for telehealth services during the COVID-19 pandemic. Keeping up with these updates allows the healthcare facilities to become eligible for performance-based incentives and comply with federal reporting requirements.

Maintaining Regulatory Compliance

Accurate coding also protects hospitals and healthcare providers from compliance issues. Mistakes or fraudulent entries can lead to penalties under regulations like HIPAA or the False Claims Act. With up-to-date and compliant coding practices, providers reduce their risk of audits, legal consequences, and financial penalties from Medicare or private insurers.

Handling Diverse Care Settings

Healthcare is provided across different settings, ranging from hospitals to ambulatory centers and home health. Consequently, coders need to know the rules of documentation and billing for each setting so that proper coding is ensured, compliance is facilitated, and optimum reimbursement is realized.

Improving Patient Records

Coding is crucial for ensuring comprehensive and unambiguous patient documentation. When codes reflect the true scope of treatment and diagnoses, care continuity improves, especially when multiple providers are involved. Proper documentation ensures correct treatment choices, reduces errors, and improves communication within care teams.

Why Outsource Medical Coding Services?

Though modern Practice Management Software (PMS) and other technologies have automated many aspects of billing and coding, they still cannot replace the expertise and oversight of certified medical coders. Inaccurate or incomplete documentation, unreported procedures, or incorrect code application can still slip through automated systems. All this can lead to claim denials, revenue loss, and compliance risks. That’s why having skilled coders to manually audit, review, and correct code before submission is essential.

Outsourcing medical coding services to 24/7 Medical Billing Services gives healthcare providers access to experienced, AAPC-certified professionals who stay updated with the latest ICD, CPT, and HCPCS updates. These experts understand code sequencing, proper use of modifiers, and the critical compliance requirements that impact your reimbursements and audit preparedness. Therefore, outsourcing medical coding services means you can reduce operational overhead, eliminate costly errors, and improve both the accuracy and speed of claim submissions.

FAQs

Q1. What does upcoding mean in medical billing?

Upcoding refers to the illegal process of assigning codes for more severe diagnoses or services than were provided.

Q2. What is the difference between ICD-10 and CPT codes?

ICD-10 codes identify diagnoses, whereas CPT codes describe procedures and services.

Q3. What is the CPT code for an echocardiogram?

Use 93306 for a complete transthoracic echocardiogram with spectral and color flow Doppler.

Q4. What is the difference between inpatient and outpatient coding?

Inpatient coding uses ICD-10-PCS and DRGs, whereas outpatient coding uses CPT and ICD-10-CM codes.

Q5. What ICD-10 code is used for a rotator cuff tear?

Use M75.1X series based on location and whether it’s partial or complete.

Q6. How do I code for a migraine diagnosis?

Use G43.909 for unspecified migraine, not intractable, without status migrainosus.

Q7. What is the CPT code for a well-child visit?

Use 99381–99385 (new patients) and 99391–99395 (established patients), based on age.

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[dysthymia-wet-specimen]

re: being "groomed" into radical feminism

i was raised by a (non-radical but shares some beliefs) feminist mom who was super anti-porn (irl porn due to exploitation) and always taught me to stand up to misogyny. throughout my life she's been the biggest advocate and protector of me through medical misogyny, ableism in the school system, and helping fight for justice against poorly handled sexual harassment reports i made against classmates who'd been inappropriate to me.

i went through puberty during gamergate, an era of "feminist cringe comps" and buzzfeed manspreading videos. i was in comp-sci and stem spaces, surrounded by these sweaty hentai addict nerds, some even grown men breathing down my neck for being a "female who plays real video games" *pushes up nerd glasses* no matter what community it was, coding, anime, furry fandom, my local gsa spaces, there was always a permeating stench of male supremacy, sexualization of women/female people, and a blatant disregard of respect for the "walking fleshlights" in the room. "what's better, tits or ass?" "oh this anime is so peak, wdym you don't like it cause there's also panty shots of underage girls in it?" "keep furry weird! the horse fursuit with styrofoam G cup breast padding is such an icon!" "terfs* can suck my girlcock" (*which i later found out meant anything from hating trans people to respecting but not wanting to sleep with them, and sometimes conservatives are labeled under this branch of "radical.... feminist?")

seeing time and time again the way women and female people are pushed aside, unconsensually sexualized, or even had rape jokes/threats made abt them, is what made me radical.

I used to think my mom was crazy. "Everyone says bitch? what do you mean it's sexist when guys call women that?" "telling a stranger to choke on a dick isn't rapey its just an insult to someone" "every male watches porn, don't they?" Sexism had stained my life to the point that there was no "safe space" for me. I could no longer keep my eyes closed to the horror that is the female experience. "Radfems won't just respect cause you have a vagina" Well talking about my breasts certainly didn't stop being misogynistic once I told you my pronouns were he/they? i don't believe what others tell me to believe out of wanting to be accepted.

when the mainstream liberal men speak over human trafficking survivors to justify upholding the porn/prostitution industry. when fandom spaces welcome child erotica with open arms under the guise of "anti-censorship for queer media", all while adults pushed the limits of "family friendly convention hours" further and further, being called a "fascist puriteen" for not wanting to see a guy in a thong and a dog mask being walked on all fours during the public pride parade at 1pm in fucking massachusetts...

i'm tired of stepping on eggshells to be the "good feminist". FOR ANYONE. i'm gonna be the most obnoxious they/he nonbinary transmasc radical feminist there ever was. i don't care i'm too "TRA" or too "radfem" to fit into your boxes. fuck your boxes dude!

Let adults make decisions about their own bodies. Call people what name/pronouns they want to be called. Trans people are oppressed and at risk of violence. Children don't need to transition to be respected. Not all trans people can/will have certain surgical procedures but are still valid. The only scenario in which asking trans ppl about their procedures is when its in a (consensually) sexual or medical context, otherwise asking ppl invasive questions abt their privates without consent for your "entertainment" is sexual harassment. Trans people aren't here to satisfy your fetish for our bodies. Making fun of trans people who aren't doing anything wrong is cringe behavior. You can't be a feminist and a conservative/trump-supporter. trans women when perceived as women face misogyny even if they weren't born/raised female and aren't effected by certain issues of reproductive rights or medical misogyny. gnc-phobia is bad even when it's against men, being gnc doesn't make someone trans

are all statements that can coexist with: Respect single-sex spaces (female only housing, gyms, DV shelters, etc. You deserve safe spaces too, but so do we. trans men and nonbinary female people benefit from female-only spaces too!). Some people are only attracted to people who were born male or female, no matter how much you transition, some people are same-SEX attracted, not just same-gender. if you are trans you need to disclose that before sex. being lgbt doesn't make you a predator, but that doesn't mean you should excuse predatory behavior from other ppl in that community (happened to me multiple times sadly, also see ava kris tyson situation/response). in US politics, abortion and reproductive rights needs to be centered more in bodily autonomy conversations, women bleeding out over a pregnancy they're forced to have is not the same as choosing to kys over surgery bans. (though suicide is bad and trans ppl should be aloud to decide what to do with their adult body) intersex people shouldn't be used as an argument point by radfems or trans people, using someones medical condition to win arguments is weirdo behavior... criticizing misogyny/rape culture/anti-female behavior in lgbt spaces isn't the same as hating trans people. misandry isn't real (at least in the USA/western culture) (men can be oppressed differently based on minority status, but men/males are not inherently/systemically oppressed the way someone is for being female. there's not a male hate movement killing and raping men like there is for incels. "misandry" is just as real as "reverse racism/racism to white people", aka bullshit)

i'm not going to go through every single post someone makes to see if they're "agreeable enough" to reblog. my opinions are my own. and i'm happy to clarify that, but does porn and rape culture stop being bad the woman speaking out against it has a wrong opinion? are you fucking kidding me?

not every radfem takes me seriously, not every trans person takes me seriously. i just left the radfem community i really enjoyed due to personal conflict (sadly, but hoping to keep in touch still on tumblr). i'm not a poor victim of the evil radfems. i'm female in a male supremacist world and i woke the fuck up.

[melancholicstation]

JOHN F. KENNEDY AND NURSE!READER HEADCANON'S!

putting this in memoriam for the jackuno instagram account... my number one boy come back home soon

tags: @obsessedwithjohnjr @candyneckl6ce @rocker-chick-7 @ultr4v1ol3nt @violetharmonsfavgf @strip-weather-forecast @darcyspirits @fortheloveofjos @h-l-v-kennedy-blog @h-l-vlovesvintage @bluelancergirl @snowsgames @salvatoresablondie @dulcegal @kennedyism @bloxholden35 @kimcrystal123 @absurdlyvintage @jackiesgirl @chemicalw0rld @remotewatch @starsprangledgirl @strryhaze @beloved-angel

you two definitely meet when jack, or rather joe senior, is trying to bribe jack's way into the naval academy despite his various medical ailments...

you're the only nurse that actually is able to convince the head doctor at the massachusetts hospital you work at to give jack the go-ahead, so naturally you and jack become fast friends... though the term in this case is used VERY fast and loose

in between feeling very sorry for himself jack would definitely beg, and be successful, in having you to sneak out with him to go to high society parties on the cape saying that they're "for the betterment of his health"

after a few times of this happening during his medical stay, you now have made it routine to always bring an overnight doctor's bag to your shift fit with: a tipping coat, oxford shirt, cummerbund, and a wool pique bow tie.

you'd also bring a change of clothes to change out of your normal nursing uniform... which in my personal mind palace looks like that one flashback scene of miss alison dilaurentis in the hospital but more elevated

think a nice candy striped dress shirt in a starched cotton with a silk vest on top or a nice white, 100% cotton midi dress

would soooo bitch and moan for you to get him real bedding instead of those nasty polyester hospital sheets

he feels at home wrapped up in baby cashmere who can blame him? not i... not i

in the early days you're not taking him, or your "relationship" seriously as it appeared that he didn't either

but... that all changes once he finally starts to open up slowly but surely, starting with his feelings around his own health, and moving onto his family and their less than psychologically beneficial dynamics...

makes you feed him pomegranate seeds like a baby deer in bed and not a twenty-something man

when his family comes to visit him (which is less often than you think he secretly would like) you indulge in his request for you to apply a bit of rouge to his cheeks just so his family doesn't worry that he's approaching death's door

you take daily walks to your local bibliothéque and browse the history sections for books to take back to the hospital, knowing that he gets through them suspiciously fast...

does he skim or is he just a very, very fast reader? the world, and you for that matter, may never know...

once he's in a more stable condition and thereby is let out for visitations on the weekend he stays with his family for the day, no doubt sailing on cape as instructed by his medical team, yet then he books a local boutique cape hotel for the two of you to stay the night.

he doesn't tell his family about whom and where he spends those weekend evenings and you definitely don't tell your boss that you just stayed at the hyannis travel inn with a certain trust fund patient of theirs

he gets sick of the hospital food real fast so you brave your way into the hospital kitchen and cook him steak and potatoes like you've got a high school crush...

how you and him are moving on days you're not working once he's out of the hospital:

these photos are very you and him coded. the first is so him carrying you bridal style to his private (cause we know that's one thing joe sr. doesn't play about) hospital room despite him being in the hospital for an AILING SPINE. the second is you two absolutely tearing it up at hyannis port, having fun meanwhile his family is confused like didn't we see this girl at hospital check-in... curious, curious indeed

[covid-safer-hotties]

Also preserved in our archive (Updated daily!)

Researchers report that a new AI tool enhances the diagnostic process, potentially identifying more individuals who need care. Previous diagnostic studies estimated that 7 percent of the population suffers from long COVID. However, a new study using an AI tool developed by Mass General Brigham indicates a significantly higher rate of 22.8 percent.

The AI-based tool can sift through electronic health records to help clinicians identify cases of long COVID. The often-mysterious condition can encompass a litany of enduring symptoms, including fatigue, chronic cough, and brain fog after infection from SARS-CoV-2.

The algorithm used was developed by drawing de-identified patient data from the clinical records of nearly 300,000 patients across 14 hospitals and 20 community health centers in the Mass General Brigham system. The results, published in the journal Med, could identify more people who should be receiving care for this potentially debilitating condition.

“Our AI tool could turn a foggy diagnostic process into something sharp and focused, giving clinicians the power to make sense of a challenging condition,” said senior author Hossein Estiri, head of AI Research at the Center for AI and Biomedical Informatics of the Learning Healthcare System (CAIBILS) at MGB and an associate professor of medicine at Harvard Medical School. “With this work, we may finally be able to see long COVID for what it truly is — and more importantly, how to treat it.”

For the purposes of their study, Estiri and colleagues defined long COVID as a diagnosis of exclusion that is also infection-associated. That means the diagnosis could not be explained in the patient’s unique medical record but was associated with a COVID infection. In addition, the diagnosis needed to have persisted for two months or longer in a 12-month follow-up window.

Precision Phenotyping: A Novel Approach The novel method developed by Estiri and colleagues, called “precision phenotyping,” sifts through individual records to identify symptoms and conditions linked to COVID-19 to track symptoms over time in order to differentiate them from other illnesses. For example, the algorithm can detect if shortness of breath results from pre-existing conditions like heart failure or asthma rather than long COVID. Only when every other possibility was exhausted would the tool flag the patient as having long COVID.

“Physicians are often faced with having to wade through a tangled web of symptoms and medical histories, unsure of which threads to pull, while balancing busy caseloads. Having a tool powered by AI that can methodically do it for them could be a game-changer,” said Alaleh Azhir, co-lead author and an internal medicine resident at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system.

The new tool’s patient-centered diagnoses may also help alleviate biases built into current diagnostics for long COVID, said researchers, who noted diagnoses with the official ICD-10 diagnostic code for long COVID trend toward those with easier access to healthcare.

The researchers said their tool is about 3 percent more accurate than the data ICD-10 codes capture, while being less biased. Specifically, their study demonstrated that the individuals they identified as having long COVID mirror the broader demographic makeup of Massachusetts, unlike long COVID algorithms that rely on a single diagnostic code or individual clinical encounters, skewing results toward certain populations such as those with more access to care.

“This broader scope ensures that marginalized communities, often sidelined in clinical studies, are no longer invisible,” said Estiri.

Limitations and Future Directions Limitations of the study and AI tool include the fact that health record data the algorithm uses to account for long COVID symptoms may be less complete than the data physicians capture in post-visit clinical notes. Another limitation was the algorithm did not capture the possible worsening of a prior condition that may have been a long COVID symptom. For example, if a patient had COPD that worsened before they developed COVID-19, the algorithm might have removed the episodes even if they were long COVID indicators. Declines in COVID-19 testing in recent years also makes it difficult to identify when a patient may have first gotten COVID-19.

The study was limited to patients in Massachusetts.

Future studies may explore the algorithm in cohorts of patients with specific conditions, like COPD or diabetes. The researchers also plan to release this algorithm publicly on open access so physicians and healthcare systems globally can use it in their patient populations.

In addition to opening the door to better clinical care, this work may lay the foundation for future research into the genetic and biochemical factors behind long COVID’s various subtypes. “Questions about the true burden of long COVID — questions that have thus far remained elusive — now seem more within reach,” said Estiri.

Reference: “Precision phenotyping for curating research cohorts of patients with unexplained post-acute sequelae of COVID-19” by Alaleh Azhir, Jonas Hügel, Jiazi Tian, Jingya Cheng, Ingrid V. Bassett, Douglas S. Bell, Elmer V. Bernstam, Maha R. Farhat, Darren W. Henderson, Emily S. Lau, Michele Morris, Yevgeniy R. Semenov, Virginia A. Triant, Shyam Visweswaran, Zachary H. Strasser, Jeffrey G. Klann, Shawn N. Murphy and Hossein Estiri, 8 November 2024, Med. DOI: 10.1016/j.medj.2024.10.009 www.cell.com/med/fulltext/S2666-6340(24)00407-0?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2666634024004070%3Fshowall%3Dtrue

[technofeudalism]

From 1945-70s, Scientists working under the Manhattan Project and the US atomic energy commission injected hundreds of US citizens with plutonium, including children and pregnant women.

In Nashville, pregnant women were given radioactive mixtures. In Cincinnati, some 200 patients were irradiated over a period of 15 years. In Chicago, 102 people received injections of strontium and caesium solutions. In Massachusetts, 57 developmentally disabled children were fed oatmeal laced with radioactive tracers in an experiment sponsored by MIT and the Quaker Oats Company.

In none of these cases were the subjects informed about the nature of the procedures, and thus could not have provided informed consent. During atomic testing, US soldiers and families who lived downwind from the blast were deliberately exposed to nuclear bomb blasts and radiation.

The experiments began in 1945, when Manhattan Project scientists were preparing to detonate the first atomic bomb. Radiation was known to be dangerous and the experiments were designed to ascertain the detailed effect of radiation on human health. Most of the subjects, Welsome says, were poor, powerless, and sick.

In pursuit of this goal, many American doctors violated not only the Hippocratic Oath but the Nuremberg Code, American Medical Association guidelines, and U.S. government regulations. Crimes were committed and, in the end, damages paid, mostly to survivors.

As late as 1985, body parts were being severed from cadavers, usually without the knowledge of the next of kin, for shipment to Los Alamos where they were analyzed for plutonium content. More than 15,000 human bodies were raided for this project, which was called Operation Sunshine.

At a 1954 conference in Washington D.C., Willard Libby, winner of the Nobel Prize, lamented the shortage of bodies of persons, especially children, who had been exposed to radioactivity. “If anybody knows how to do a good job of body snatching,” Libby said, “they will really be serving their country.”

[fantasies-fairytales-n-fics]

Code Blue Ch. 61- Foreshadows

Summary: Lee receives an infuriating gift and unleashes his wrath upon the givers. A sinister sign is interpreted that Josie can't deny. Two informative stories are revealed with two doctors. Josie wants to finish another's failed attempt. Lee has a most bittersweet dream.

*Chapter Warnings* Strong language, angst, mentions of suicide

Stories Stories Stories Masterlist:

Mach 24, 2022

Salem, Massachusetts

After crashing at his farm all morning with his dogs and cat, Lee tidied himself up, knocked back a Red Bull and headed down the stone road to his neighbor's home to thank her for taking care of his farm and animals while he was away. After some small talk over a quick cup of coffee, he then made his way to the home he once shared with Jacob to resume the neglected remodeling and feel close to his son, hoping Jacob would visit him again. He knew if he didn't keep himself busy, his thoughts of Josie would consume him and drive him in to a drunken stupor yet once again. As much as he craved the wicked whiskey's mind numbing properties and the burn of it rolling down his throat, he had to stay sober for his evening shift at the hospital and then he planned to medicate himself to his heart's content for his pre-planned birthday vacation that he now knew he would be spending alone.

With a Red Bull infused coffee with no lid in one hand, he fumbled for the house key as he blindly walked up the porch steps only to find himself stumbling over a small object near the front door and spilling the piping hot drink all over his hand and down his pants where it conveniently had appeared he had pissed himself.

Cursing like a sailor under his breath, he chucked the empty cup into the yard and scooped up the booby trap beneath his feet which was a small wicker basket filled with fresh baked cookies, for he could smell the warm aroma, and on top was a scribbled note attached. "My mom and I worked hard this morning when she got home to bake these for your berthday tomarrow and asked me to give them to you so you would have sumthing to eat and she said you like sweets and that you never eat at work and you are getting too skinny and she also wants to know if you can come over sumtime and she will make you a berthday diner.

Love your frend and nayber,

Dash.

Pee-ess,

She said she has wissky to and sorry I drank all the milk we had for the cookies. I hope you have sum."

Normally, Lee would have smiled and invited his favorite kid on the block to come join him because he did in fact have some milk but after the last few days he had, especially the early morning blow up and break up with Josie that Dash's mother's lies were partially to blame for, every little thing was getting under his skin and the unwelcomed gift and cocksure invite from Angel and using her son to deliver it had just triggered the time bomb inside of him that had been waiting to explode.

Lee marched inside and emptied the basket into the trash and then with the basket in hand, he marched right back out the front door, bee-lining straight for Angel's house next door where she was conveniently sitting on her front porch.

"Hey Lee, I saw you pull up and....oh," she paused with an aroused brow lift as she looked down at his wet crotch and giggled, "Did you have an...accident? I could help clean those up for you except my water is a bit rusty for some reason. Can you do plumbing?"

He tossed the basket at her feet and with hands in his pockets, he stood firm with a frown. "Look, I appreciate that you helped me out the other night but what I don't appreciate is you spreading rumors and lies through the hospital about you and me and what happened here that night, which was absolutely fucking nothing and I also don't want your damn cookies or whiskey or dinner that you would probably drug. As if I would ever put anything of yours in my mouth and I'm not fucking with your damn pipes either."

Lee instantly sighed, closing his eyes and mentally poured scalding hot coffee down his throat as he realized what he had just unintentionally and stupidly set himself up for in his fit of blinding rage.

Angel smirked. "Yeah, well I certainly recall you liked putting things of mine in your mouth and fucking with my pipes once upon a time."

"That's ancient fucking history and one sorry ass mistake because if you ALSO recall, it never happened again. I was drunk out of my damn mind from booze and grieving over the death of my son and I couldn't wash my dick enough times to feel clean after that. Speaking of son's, I also don't appreciate you using your kid to do your dirty work. You're a shitty ass mother just like Liz was. No wonder you two cunts instantly clicked. I truly hope Dash don't pay the price like Jake did. Crazy thing is, Dash is old enough to know better and he knows I have a girlfriend....well, HAD I should say...no thanks to your twisted lies that played a part in firing her up. I'd steer clear of her if I were you. She's pretty pissed, rightfully so and she's got a mean right hook and if you're ever on the receiving end like I've been, I hope I am there to witness it. I fucked up thinking you could actually be a decent human being by helping me out when I was in a jam without expecting anything from it but apparently all I did was unintentionally lead you on. That's my fault. I own it but I promise you, that will never happen again. Stay the fuck away from me. Got it??"

Before Angel could respond, Lee noticed Dash was eavesdropping from inside the open front door. With slitted eyes, he glared and pointed at the frightened boy who gasped and swiftly slammed the door shut and then placing his hands back in his pockets, Lee marched back home, leaving Angel with a scowl on her face.

As Gerry and Josie's mom spent the afternoon visiting with comatose Victor and making their amends, Josie continued to bond with her sister, washing and styling her unruly hair and doing her makeup to make her feel better after lying in a hospital bed for three days, unable to fully shower due to her leg cast but Josie knew the act of endearment was only delaying the inevitable meltdown that was coming.

Taking in a deep breath, Josie began informing Megan of Gerry's generous offer that would provide her and their mother a temporary safe haven at the Kiriakis mansion and that he would soon be coming to speak with her about the suppressed memories of her attacker that she had recently recovered and as predicted, she took the news just as Josie had presumed she would, ranting and raving in a bout of paranoia that the psychotic Scotsman, as the terrified and tearful redhead called him, was playing a trick and would surely strangle her in her sleep.

"You broke your promise!" Megan sobbed. "You still hate me. I knew it!"

"Megan, I do not hate you and I did not break my promise. I promised you I would do my best to keep you safe and that's what I'm doing. You need to trust me ok? I know Gerry better than anyone, better than you and if I thought he wasn't sincere, I would have never asked him to do it."

Megan's eyes bulged in anger. "YOU ASKED him to do it??? Oh my god. This is your secret way of making me pay for what I did isn't it!?! I'd rather face the shadow man than the doolally detective. Do you know what he said to me the day he was here with crazy eyes and veins popping out of his forehead??? He told me he hopes the Bean Nighe comes for me. I googled it and it's some malevolent Scottish fairy, some say Banshee, that screams and if you hear her, someone close to you will die!!! And I told you I heard a woman in my dreams screaming in the tunnels!!"

Josie choked down the overwhelming urge to laugh, only because Gerry's mom used to tell him many of the Gaelic fearsome fables when he was being a mischievous child to try and set him straight and he had definitely succeeded with his intent of putting the fear of god into Megan. "Ok look Megs, the Bean Nighe is just scary Scottish folklore just like we have scary legends here. It's not real and I think that what you read triggered the dream, so...in a way, it was a good thing because it helped you to remember that Elizabeth was probably the woman you heard, although I don't condone Gerry's stunt of scaring you to death."

"A good thing??!" she snapped and cried harder. "It's an omen. A sign, just like you yourself believe in so much! You know what else it said?? The Bean Nighe means washer woman. She would wash the blood out of clothes of those about to die! Did you not just tell me only hours ago about the red water that you and others you care about are all seeing???? And I told you I did too before I was attacked so tell me again how it's NOT real!! Bad things are going to happen Joey!"

Josie embraced her sobbing sister, her eyes now wide and wary. "You didn't die though and you're not going to because...because someone is helping us."

Megan sniffled and leaned back, gazing at her sister with befuddled eyes soaked in smeared mascara. Grabbing a tissue, Josie handed it to her. "You're ruining your makeup. Now, stop crying and listen to what I am about to tell you. Since you believe in all of this, then I know you'll believe this too but this stays between us. Dave wasn't too happy when I outed him to Landy about his...secret ability."

Megan tilted her head, brow arched. "Huh?"

Josie then proceeded to tell Megan about David's gift of seeing and speaking to the dead and how Lee's late son was the one who guided him to find her in the tunnels.

"Oh my god so...he's like a real life ghost whisperer?? Bitchin!"

Josie chuckled. "Yeah but he hates that term. Makes him feel like he's a freak. Anyways...Megan, Lee has seen Jacob too. He shares the same gift. I don't know how or why but he does. I can't see or hear him but I've been in that house when Jake has made his presence known. It's quite the phenomenon, let me tell ya."

"Awww, that poor sweet little boy. No wonder he hasn't crossed over yet. It's the unfinished business thing. I wish I could thank him for helping me. I owe him so much."

Josie desperately wanted to tell her that like her, she was that sweet little boy's aunt but it would all be too much at the moment and it would also reveal that Jason was alive considering he was the one who told her and Josie knew that a secret like that, Megan would not be able to keep.

"Well, thank him in private. Keep your lips sealed ok? Anyways, speaking of Dave and Landy, I'm going to go see if they're working today. The guard's right outside and mom will be back soon, probably with Gerry so he can question you. Don't worry about him and his spooky stories. You can bet your ass she'll keep him in line and so will I."

"Ok...I guess." she softly peeped, forcing a light smile. "Oh and Dave and Orlando are here. They come to check on me and mom from time to time and they were here early this morning."

As she headed out, Josie's heart smiled knowing the good doctors were taking time out of their hectic schedules to look out for her family and now she wanted to make sure her loyal friends were doing alright since she seemed to have lost her childhood friend Emily for not being around much.

After shooting a quick text to both physicians during a bathroom break, Landy was the first to respond.

"Hey beautiful. In the cafeteria on break. Can't wait to see you."

"Be there in a few :)"

Orlando's lunch buddy and fellow colleague lifted a curious brow. "What's got you so chipper with that cheeky smile? You never smile when you're here."

"Because this place sucks the life out of me."

"I hear ya on that bro. I'm working a double. So do tell, who's the one that breathed the life back into you just now? Would it happen to be a woman? I'd be careful there. They'll suck the life out of you too and I don't mean from your lollipop with the surprise cream center."

"And I hear ya on that bro." Orlando agreed with a chuckle and a mouth full of what appeared to be meatloaf, then he promptly stood when he saw the woman he was agreeing about. "Gotta go. There she is now."

"How goes it girl??" he raved as he snapped his food tray onto a table and scooped her up, giving the squealing blonde a quick spin around, then a sweet kiss on the cheek.

Giggling, Josie sat down. "Well, not as good as you seem to be, but it's going."

Orlando sat down and gave a cheesy grin as he popped a few grapes in his mouth. "Well, that's what you do, light up a dark room when you walk in. Let me guess. Lee?"

Josie's smile faded. "He left me."

Orlando's chomping chews halted and he forced a hard swallow. "What?"

Her eyes burned of tears but she held them in. "7 A.M. this morning. I guess he's still not talking to you since you didn't know?"

"I haven't heard from him since he sent me that unwarranted text saying she's all yours."

"He was drunk, as if that's any consolation but I didn't come here to talk about Lee. How are you doing? Like really doing. Any problems from your dad errr sorry...I mean Luke Sr?"

"Not a peep from him or anyone related to me. Mum, Sam and Jimmy went back home and my brother Luke, as usual and as if I really care, is MIA and I, as usual, am all alone."

Josie smiled and slid her hand across the table, clutching his. "You got me. I know I've been stuck in my own little world lately but I'm still here if you need me. You've certainly been here for me."

"Well I certainly owe you after you stuck your neck out for me the night Ethan attacked me AND the night I stupidly went after my fath...Luke...with that hammer, oh and how could I ever forget you saved my life when the other asshole Luke almost killed me."

"You owe me nothing. That's what friends are for Landy. You tried to protect me from Ethan too and you took one hell of a sucker punch for me from Lee as well. It's just that, Britt and Jason are gone, god knows where, Lee gave up on me, Craig probably too which is my fault but I'm sure it makes you happy and then there's Em who hates me right now. I just don't want to lose you too."

His hand squeezed hers and his other hand reached up to stroke her cheek. "Never. I'm not going anywhere Jo. As far as Cujo Craig, yeah there's no love loss there. Can't stand the dude but it does not make me happy to see you hurting. I'm sorry for whatever happened between you both and I'm here if you want to talk about it or Lee or anything else. Always. So who's this Em you mentioned?"

"My friend from Ireland. She was at Jason's funeral reception at mom's remember?"

His lips puckered in thought. "Oh yeah, the cute little brunette with the accent."

"That would be the one but don't let the cuteness fool you. She can be quite the conniving cunt."

The British doc chuckled. "Bloody hell. May I ask why you are friends with her then?"

"Because I forgave her for something really bad that wasn't entirely her fault. God, I haven't spoken about this in years."

Noticing Josie's disconcerting spirit, Orlando backed off. "Hey, whatever it is, you don't have to talk about it. We can talk about something el..."

"No, no. It's ok. I don't mind telling you because I know you won't say anything to anyone. It's a secret between me, Em and...my dad that I've kept because it just would have done more harm than good if you know what I mean? Actually, no good at all."

Orlando shifted in his seat during a delayed reply, his eyes breaking contact as he thought of what his dad had done to him in his adolescent years. "Absolutely I do."

Josie stiffened up, eyes wide with instant regret. "Oh god, Landy, of course you do. How insensitive of me. I'm so sorry. I wasn't thinking."

"No no no Jo, it's alright. I'm ok. Promise." he claimed with a smile. "Please...go on. I'm all ears and my lips will remain forever sealed. Fire away love."

She released a deep, remorseful sigh and then submitted to his polite demand in hopes of distracting his thoughts away from the personal hell she had just unintentionally sent him whirling back to. "Ok well...it was Christmas time, 10 years ago. Her dad had recently passed by taking his own life because her mother left him for another man. Em don't have any siblings either so she was left all alone for the holidays. I invited her to come spend Christmas with us, all expenses paid to help her out. I missed her and felt so bad for her so I thought it would do us both some good since we hadn't seen each other since our early teens, well except through video chat but anyways. It wasn't exactly a festive time for our family either. My mom and dad were having marital troubles and were discreetly avoiding each other due to my father finding out about her affair and that my brother Bo wasn't his son. Mom stayed mostly in the kitchen with Megan and my aunt Olivia, mom's youngest sister, cooking and sipping her Irish whiskey. Jason had just been sucked into Sonny's underground lair of crime so he wasn't there and since Bo was a cop, he used the excuse of short staffing to not be present but we all knew he was avoiding the drama. I understood though. His entire world had just been turned upside down, SO, it was just me, Em and my dad hanging out.

After a silent and awkward dinner and a small gift exchange, mom went to lay down. The rest of us were playing games and going pretty heavy on the wine. Em decided to play the piano for awhile while me, Megan and Olivia were engrossed in a game of UNO and that's when I first noticed something with my dad when I watched him walk away. He went over to her, glancing into the hall as if he were making sure no one was there and then he propped his arm on top of the piano to listen to the song. The way he smiled and blushed, it just felt off to me, especially when I then saw the way he looked at her. First her face, then his eyes traveled down her body.

I told myself I was surely mistaken in what I was witnessing, that dad was just flushed because of all the wine and he was so smiley because he was tipsy and that he was just enjoying the music because Em played so well. He must have been looking at her fingers dance along the keys and not her body right?? That's what I convinced myself of, I mean, he was in his late 50's and Em was my age, early 20's but deep down I knew that age has never stopped attraction.

UGH so...as the night went on, we must have went through at least a dozen bottles of wine between all five of us. Needless to say, we were all quite inebriated and began dancing and singing on Megan's Karaoke machine. At some point, Em had to use the bathroom and a few moments later, I noticed Dad was missing. That off feeling came rushing back so I snuck off to see where he went. That's when I saw her in his arms, crying her eyes out.

Normally, I would have thought he was just comforting her because of her loss until I saw him turn his mouth to her ear and kiss it. Then he said "I'm here for you Emily." Their hug was body pressing and longer than it should have been and my dad's hand was stroking her back in a seductive way and THEN...she told him he smelled and felt so good and he said the same fucking thing back to her. I don't know what happened next because Megan was shouting my name and I panicked and ran back. I was shaking and furious and decided I was just going to keep drinking and keep quiet because I didn't want to start something and wake mom up.

Anyways, the reason Megan was calling for me was because we were out of wine and at that point, I was desperate to find more. Megan was too so she spilled a secret and told me she forgot that she had stashed a few bottles in her closet to drink when she would sneak a guy in. She got up to go get it and fell right back on her butt and broke her wine glass, cutting her finger. After some time of me and Olivia cleaning her up in the kitchen, I went to get the wine so I could spy on my own father once more. He and Em were still not in the living room where we had been and they weren't where I had last seen them. That's when I noticed the bathroom light on under the closed door. When I crept up to it, I....I heard soft moans and panting and then, the toilet flushed to drown out the sound of their...you know...but I was close enough to hear.

I panicked again and bolted up the stairs and hid in Megan's room until I could pull myself out of my state of absolute and utter shock."

Orlando's chocolate eyes were wide and his mouth wider as he sat in momentary silence before relaying his thoughts. "I can imagine that right now, I look just as you did? This girl, your friend of all those years...actually slept with your married father???"

"Yep...and right under our noses and mom's to boot. And the fact that he even did it...I still can't fathom it. Nothing like a drunken quickie in the bathroom! I get that mom betrayed him but what he did was so extreme. I'm sure he felt he was justified but not me."

"So, what did you do? You said you kept it a secret so I assume your mom or anyone else found out?"

"Well, when I came down the stairs with the wine, dad, with his jacket now off and a sweaty face, was coming through the hall with more wine glasses. He asked me if mom was awake and I was just so mad that I said nothing. I just shrugged my shoulders and rushed past him to avoid conversation and having to look him in the eyes or he would have known that I knew.

So no, I never told anyone...but I sure as shit told Emily the next morning that I knew and told her to get the fuck out. She flew back to Ireland and it was a couple years before we reconnected. Forget and forgive right? Wrong. I'll never forget it. Honestly, I'm not sure if I've even forgiven her because I still feel so angry about it. How could she do that to my mother?? or to me??"

"I completely understand that. What about your dad though? Did you forgive him?"

"In time, yes. I mean, he's my dad and I could tell he regretted it the next day when he was sober where is, I don't feel Em did. When I had confronted her about it, she got pissy and defensive as if she had done nothing wrong, claiming she and my dad were both consenting adults and could do as they pleased. She even had the audacity to admit she had been fucking him the entire week she had been there before Christmas and that's when I socked her hard and good. She left with a split, fat lip and that was that."

"Damn, she really IS a bloody cunt. So...you eventually made up years later and you said that she hates you now? What happened this time, if...I may ask?"

"She's pissed that I haven't been to skating class for the kids, leaving her to do it and she needed a break, which that part is true but then she asked me to cover for her tomorrow so she could go shopping all day for some party later that night. Tomorrow's the 25th. It's Lee's birthday. My mind just isn't there to be on the ice right now so I told her no and to just cancel the class. She then proceeded to tell me who the guy was that she was going out with which I know she told me on purpose to piss me off. It's a guy named Johnny and he's mob. I know him and he's only using her to get under my skin. He's not a good guy and I made my thoughts about it known to her more than once about him. To paraphrase the rest, she called me a hypocrite because of Jason and Craig, oh and also a jealous bitch, then she hung up."

"With all due respect Josie, mob is mob. None of them are good."

"Well, respectfully to you also, we will just have to agree to disagree. I know your feelings towards Craig but he and my brother are different. Alright, I have rambled long enough and probably wasted your entire lunch break. One last thing though. I wanted to also thank you for looking in on my mom and sister. It means a lot."

Orlando took her hand once more, his fingers softly fondling hers as he smiled. "You are very welcome and never a waste of my time...you know I said what I said because I care about you right? I just don't want to see you get hurt or I feel I'm going to have to dig my hammer back out."

"No you're not." she ordered with narrowed eyes and pulled her hand away. "I don't want you involved AT ALL ok? I care for you too and don't want you to get hurt either Landy."

"Well I kind of am involved Jo. Look who my brothers are. Alright I'll drop this. So, I hear you and Megan have reconciled? She was quite happy to tell me that."

"It's a work in progress but yeah, I think we're getting there. At least she's genuinely remorseful. Crazy how bad shit brings people closer together. She's having some memories too, of what happened. Nothing too concrete but could you maybe keep an extra eye out for who goes around her room? She swears she saw a man in the hall that she believes was her attacker the same night I was here in the ER. He was wearing a suit, shiny shoes and strong cologne, had a strong accent too but not foreign. She just couldn't see his face. It was too dark."

"Sure will but you do know you just described half the men I see on a daily basis."

Josie scoffed. "Ugh not you too."

"Huh?"

"Nothing, it's just that Gerry and Craig already told me the same thing and..."

"You know...the night you were here...that's what your Kiwi K9 was wearing and he wasn't with you the entire ti...."

"Stop." Josie huffed, lips pursed as she thought to herself once again...not you too. Her gnawing guilt over accusing Craig of being the shadow man had her bound and determined to defend him. "I know you're hell bent on finding some kind of fault in Craig because you don't like him but it wasn't him. He has no reason to hurt Megan and I just said the man's accent wasn't foreign. It is most likely someone in or from the Boston area and Gerry, who is a cop remember? He agrees with me."

"Sorry but it's not hard to find fault in someone like him. It amazes me how he has you wrapped around his dirty little finger. Just why is that?"

"I'm not sure if what you're implying but I'm not going to argue with you about this. I can't. I have no fight left in me right now after the morning I had. You said you would stop, so please stop Landy."

Noticing a slight whimper in her voice and trembling of her body as she softly pleaded in defeat, Orlando was overcome with self-reproach. "If it will make you feel better, just slap me because I deserve it for being an asshole yet once again. I'm sorry, truly. What can I do to make you feel better?"

"You can tell me you haven't seen any red water lately?"

Orlando's brows furrowed at the peculiar question. "Umm Red....water? Is that..some new movie?"

"I really wish it was but no. Like, actual red water Landy. Out of the tap or shower?"

"Oh you mean like rusty water. Not that I can recall. Why?"

"Because..." she began but then her phone beeped. "Sorry, let me check this. It might be mom or Megan." Or Lee, she silently hoped, but it wasn't. It was Dave.

"Hey, where are you? I need to see you ASAP!"

"Weird. I was actually looking for u too. I'm here at the hospital. Where are u? I'll come now."

"Doctor lounge. Hurry."

"So sorry Landy. I need to go."

As Josie stood, Orlando stood too and she kissed his cheek before rushing off. "Let's meet up sometime soon ok? Lunch or something. Text me, especially if you see red water. See ya later!"

His brow arched and his cheeks puffed out as he released a hard sigh and dumped the rest of his food in the trash. "Alrighty then. Back to work Landy."

After racing up two flights of stairs, she came to the small and private lounge where staff could take a break in some peace and quiet. Upon peeking inside, there sat her tall, dark and handsome blue-eyed bff in his white doctor coat with a coffee and muffin before him.

"Hey you. " she panted as she wriggled out of her jacket, then sat down with a smile, offering a sweet touch of endearment by laying her hand upon his flawless face. "You ok? What's so urgent?"

Smitten by her touch, Dave gave a shy smile and complimented her in his soft voice. "Hey beautiful. "I'm ok but...I don't know if you will be when I tell you something."

She slowly lowered her hand, her smile fading. "W..what is it?"

"Josie...Peter was just brought in to the ER and has been admitted."

"You...you mean he's still alive?? Again???"

"Unfortunately, yeah. That was my exact thoughts too. The wastrel certainly appears to have nine lives. Let's hope he used them all up this time."

"So what happened to him? Shanked?" she asked with a sarcastic giggle.

"No actually. They're doing tests and labs but my guess is he was poisoned based on his condition. He's been intubated and has lapsed into a coma."

"The strangler." she whispered as her eyes drifted off.

"The what?"

"It's an appellation for a common poison in the underworld inspired by Game of Thrones when that little prick King Joffrey was poisoned. Jason told me about it before. It causes the neck muscles to clench so tightly that the person asphyxiates. I'm actually surprised the louse made it this long. Peter has as many haters as Nickelback does. If only he had died the day you pushed him down the stairs and put him in that ice chest."

Dave's eyes bulged as he rushed to shut the door. "Shhhhh!!! Don't say that out loud around here...or anywhere for that matter! Anyone could have been walking by. No one can ever know about that Josie. It's our secret that we take to the grave remember??"

"Relax David jeesh. I didn't say it that loud. No one knows. Not even Peter. He don't remember or he surely would have mentioned it when I went to visit him."

"Unless he was just toying with you and plotting some of his sick and twisted reven....wait, you what??? You went to visit him??? WHEN?"

"A few days ago." she squeaked with worry because Dave was such a reserved guy and hen he got angry, people knew it.

"And NOW he ends up here??? Possibly poisoned by this strangler potion that you know ALL about because of your connections with the fucking mob!! And why would you even go visit him?? It only leads his demented mind on for one thing and..."

"You know, it's a good thing you shut the door! Calm down already before you have a fucking stroke."

"Oh this IS fucking calm miss condescending. Stop dismissing me and my questions."

"You're swearing at me! That's not calm and that's not you!"

"What, because I dropped the F bomb that your pretty little mouth spews like a fucking sailor?"

"Oh my god Dave, are we really fighting over Peter???"

"We ARE. What if your presence after all this time would have triggered his memory, if he don't already know that is? Megan told me she's remembering things. It happens Josie. Memory loss isn't always permanent. Sights, sounds, smells, anything can trigger it! What if he miraculously lives and rats us out? You were there too ya know? Aiding and abetting me."

"I kind of had no choice when I found you at the top of the stairs and him in a pool of blood at the bottom with no pulse! Why did you have to follow him up to the roof of the hospital??"

"I kind of had no choice either! You know all of this Josie! It was the day you were finally being released after he had shot you, which he got away with since the bullet was meant for his father to save you, and I came to your room to take you home and you were gone. The nurse told me you already left. I called you and I heard your phone ringing on the night table so when I went looking for you, I saw Peter sneaking into the stairwell that led up to the roof so of COURSE I followed him, thinking he had you."

"Well he didn't. The nurse was mistaken because I went to Britt's office to say goodbye but you should have called the cops if that's what you believed! I came back to get my phone and then you never showed up so I called you and got no answer! I asked around and finally a nurse told me she saw you take the stairs only moments ago and when I neared the floor where your office was, I heard the commotion above me and THAT'S when I came up and found you both!!"

In a brief silence from exhaustion, the memory of Peter's tumble flashed before both of their eyes as they stared at each other.

Dave's voice softened as he resumed the conversation. "If I hadn't followed him and if he DID have you with him, you'd be gone right now, lost on some other continent in one of his many hideaways. He had a helicopter circling far above to land at his command. You were supposed to be with him. Going to see my sister who's unfortunately his too is most likely what saved you because he didn't know where you were. I was just so angry Josie. That's why I confronted him and we briefly argued on the roof. When he realized he was busted, he took off so I followed him to the stairs and grabbed him. We scuffled and that's when it happened. I just couldn't let him hurt you again but he did when he kidnapped you a few months later and locked you in that morgue drawer. Clearly, he wasn't dead. His pulse was too weak for you to feel but he should have died from lack of air in that old freezer chest we put him inside in the abandoned area of the hospital basement. The thing had cobwebs on it. He wouldn't have been found for possibly years but he must have became conscious shortly after we left him. I'm sorry for losing my shit. I really am. You know how I feel about you Josie and I would do it all over again to keep you safe."

With a single sniffle, he stood and walked to the window, his blue hues icy from the tear glaze they basted in as he watched Josie's reflection in the window appear behind him. "Hey, come here."

She took his arm, turned him around and embraced him. "I'm sorry too. We're both just worked up over the fact he cheated death once more and now all we can do is hope that the grim reaper makes an appearance. You risked everything for me and I love you for it."

Dave closed his eyes, pained by knowing her love wasn't the kind he had always longed for from her.

She released him with a smile. "Let's not fight ok? If he lives and if he remembers, I highly doubt he could prove it. There's no witnesses for one thing and for another thing, Gerry would have my back if he did. I should have told him in the first place but it wasn't just my life at stake, it was yours too. Either way, we can't let him win. Not anymore. Thank you for telling me he was here. I'm going to go see if Gerry knows yet."

As she put her jacket back on, Dave gently clasped her wrist. "Promise me you won't go near Peter."

"How could I? There's surely a guard outside of his room."

"That's not an answer Josie."

"Ok fine, fine jeesh. I won't go near him."

As she left, Dave sat back down and swigged back his cold brew, then leered back at the door. "Like hell you won't."

Walking through the halls, Josie appeared calm on the outside but inside she was raging like she never had before which even she knew caused her to make poor decisions.

As her irrational thoughts came to a devious conclusion, she briefly paused her steps and then walked right past the hall that led to Gerry's location.

After Lee had completed some small carpentry projects, he took a shower and used the next 4 hours before his shift to sleep. It only took seconds for him to drift off and soon, he found himself in a dreamworld he didn't want to wake from.

Muffled music played.

"The first time ever I saw your face, thought the sun rose in your eyes and the moon and the stars were the gifts you gave to the dark and the endless skies, my love."

A crowd of nameless faces circled about the large tent adorned with crystal chandeliers and strings of glowing globes as they watched Lee take his new bride in his arms for for their first dance as husband and wife. He held his Jo so close, kissing her forehead as they slowly swayed to the song that they had first danced to while falling in love.

It was a picture perfect moment. All was finally as it was written in the stars when Jacob appeared, dressed like his father. "Hi Daddy. Hi Mommy."

Lee scooped him up in one arm and wrapped his other around Jo and the happily united family continued to dance as Mr. Pace kissed Mrs. Pace.

"And the first time ever I kissed your mouth, I felt the earth move in my hand like the trembling heart of a captive bird that was there at my command, my love."

As Jacob dozed off on his daddy's shoulder, he smiled.

"Daddy?" Jacob mumbled.

"What is it monkey?"

"Did you her that?"

Lee's brows furrowed as he looked around. "Hear what Jake?"

"Don't push the red button Daddy."

A powerful pop startled Lee from his sleep. "Jake??"

When his eyes began to focus, Lee noticed that 2 hours had passed, yet the dream seemed like only seconds. He also noticed his almost full can of watermelon Red Bull laid in a puddle of red liquid on the wooden floor beside his bed. Assuming he had knocked it off in his sleep and that that was the noise he had heard, Lee sat up and as he played the very lucid dream back in his mind, he slid from the bed to his knees and sobbed.

@redeemer46

[whencyclopedia]

Discovery of X-Rays

The discovery of X-rays – a form of invisible radiation that can pass through objects, including human tissue – revolutionised science and medicine in the late 19th century. Wilhelm Conrad Röntgen (1845-1923), a German scientist, discovered X-rays or Röntgen rays in November 1895. He was awarded the first Nobel Prize for Physics for this discovery in 1901.

The thrill of the discovery became caught up in the late Victorian obsession with ghosts and photography. X-rays could 'photograph' the invisible, penetrating flesh, exposing bones and the human skeleton. 'Bone portraits' became popular, and photographers opened studios for a public fascinated by otherworldly images of skeletons.

Wilhelm Conrad Röntgen

Wellcome Collection (CC BY)

One of the first medical uses of X-rays occurred in 1896 when John Francis Hall-Edwards (1858-1926), a British doctor, located a needle embedded in a colleague's hand. X-ray technology soon moved from being seen as a new form of photography to a modern diagnostic tool used by hospitals and medical practitioners.

Wilhelm Conrad Röntgen was a meticulous scientist, but the discovery of X-rays may have been an unintentional result of his work with cathode rays in his Würzburg laboratory in Bavaria, Germany.

Early Years

Wilhelm Conrad Röntgen was born in Lennep, Prussia (Remscheid-Lennep, Germany) on 27 March 1845, to a German textile merchant father and a Dutch mother. He was an only child and spent his early years in Apeldoorn in the Netherlands. His father, Friedrich Conrad Röntgen (1801-1884), managed a cloth manufacturing business in Apeldoorn. The family had also moved due to political unrest in Prussia.

Röntgen attended the Utrecht Technical School from 1861 to 1863 but was expelled when a fellow student drew a caricature of a teacher. Röntgen was implicated but refused to name the student responsible. Despite excellent marks, he did not graduate with a technical diploma and could not obtain a degree in the Netherlands. He was accepted by the Mechanical Technical Division of the Federal Polytechnic School in Switzerland in 1865, where he gained a diploma in mechanical engineering and, in 1869, a PhD in physics with his thesis Studies on Gases.

The German experimental physicist August Kundt (1839-1894) was Röntgen's supervisor. In 1866, Kundt designed the Kundt Tube, a glass apparatus that measured the speed of sound in gases. Kundt significantly influenced Röntgen and his research career.

Röntgen followed Kundt to the University of Würzburg in 1870, where he worked as an unpaid assistant during a time of rapid advancements in experimental physics. Scottish mathematician James Clerk Maxwell (1831-1879) was researching electromagnetic radiation and established the connection between light and electromagnetic radiation. Maxwell also took the first colour photograph in 1861, based on his three-colour theory that the human eye sees colour through a combination of blue, red, and green light. Massachusetts-born Samuel Morse (1791-1872) developed the electric telegraph, which transmitted messages over long distances, and Morse code to encode messages, while Alexander Graham Bell (1847-1922) invented the telephone.

Of particular interest to Röntgen was the work of German physicist Heinrich Hertz (1857-1894) and British chemist William Crookes (1832-1919). Both scientists studied cathode rays – invisible streams of electrons whose behaviour can be observed when an electrical current is passed between the two electrodes (cathode and anode) in a glass vacuum tube. It is called a cathode ray because the electrons are emitted from the cathode (or negative electrode) when an electrical current heats it, and the electron stream glows. Johann Wilhelm Hittorf (1824-1914) was the first to detect cathode rays glowing green in the glass wall of a vacuum tube in 1869 but did not realise that X-rays had been produced during his experiments.

Röntgen became fascinated with the fluorescence caused by cathode rays hitting certain materials, such as salts like barium platinocyanide, which glow a greenish-yellow colour when exposed to cathode rays. It was this fascination that led to the discovery of X-rays.

Continue reading...

[azurlaneincorrectquotes]

The girl in question is Clemenceau

Cleveland: there, right there! Look at that tan, well tended skin, look at the killer shape she's in, look at that slightly stubbly chin, oh please she's gay! Totally gay!

Belfast: I'm not about to celebrate, every trait could indicate a totally straight expatriate, this girl's not gay, I say not gay

Ensemble: that is the elephant in the room, well is it relevant to assume, that a girl who wears a suit is automatically radically fae?

Formidable: look at her coiffed and crispy locks

Cleveland: look at her silk translucent socks

Belfast: there's the eternal paradox, look what we're seeing

Atago: what are we seeing?

Belfast: is she gay?

Cleveland: of course she's gay!

Belfast: or European?

…

Ensemble: oh…

…

Ensemble: gay, or European? It's hard to guarantee. If she's gay, or European…

Tallinn: well, hey, don't look at me!

Formidable: well, they bring their girls up different in those charming foreign ports. They play peculiar sports

Ensemble: in shiny shirts and tiny shorts! Gay or foreign fella, the answer could take weeks! They both say things like "Ciao, Bella" when they kiss you on both cheeks!

Cleveland: oh, please.

Ensemble: gay or European? So many shades of grey!

Eugen: depending on the time of day, the French go either way

Ensemble: is he gay or European, or-

Massachusetts: there, right there! Look at that condescending smirk, seen it on every ship at work! That is a metro hetro jerk, that girl's not gay, I say no way!

Ensemble: that is the elephant in the room! Well, is it relevant to assume that a hottie in that costume

Formidable: is automatically radically

Belfast: ironically, chronically

Massachusetts: certainly, curtainly

Eugen: genetically, medically

Ensemble: gay! Officially gay! Swishily gay gay gay gay

Interrupted by Clemenceau arranging a meeting with the commander

Ensemble: damn it! Gay or European?

Belfast: so stylish and relaxed

Ensemble: gay or European?

Belfast: I think her legs are waxed.

Formidable: but they bring their girls up different there, it's culturally diverse. It's not a fashion curse

Ensemble: if she wears a suit or bears a staff! Gay or just exotic, I still can't crack the code!

Brooklyn: yeah, her accent is hypnotic, but her shoes are pointy toed…

Ensemble: huh. Gay or European? So many shades of grey!

Commander: but, if she turns out straight, I'm free at eight on Saturday!

Ensemble: is she Gay or European? Gay or European? Gay or Euro-

Marco Polo: wait a minute! Gimme a chance to crack this girl, I've got an idea I'd like to try

Belfast: the floor is yours.

Marco Polo: so, Minister, this alleged affair with the commander has been going on for…

Clemenceau: two years.

Marco Polo: and your first name is?

Clemenceau: Clemenceau

Marco Polo: and your girlfriend's name is?

Clemenceau: Littorio.

Gasps

Clemenceau: I'm sorry, I misunderstand! You say girlfriend, I thought you mean good friend!

Littorio: you bastard! You lying bastard! That's it, I no cover for you no more. Peoples, I have a big announcement! This man is gay AND European!

Ensemble: whoa!

Littorio: and neither is disgrace!

Ensemble: oh!

Littorio: you've gotta stop your being a completely closet case!

Ensemble: D'oh!

Littorio: it's me, not him she's seeing, no matter what she say. I swear she never, ever, ever swing the other way. You are so gay, you big parfait, you flaming one man cabaret-

Clemenceau: I'm straight!

Littorio: you were not yesterday. So, if I may, I'm proud to say, she's gay!

Ensemble: and European!

Littorio: she's gay!

Ensemble: and European!

Littorio: she's gay!

Ensemble: and European, and gay!

Clemenceau: fine, okay, I'm gay!

Ensemble: hooray!

[june-gdprototyping]

CNC development history and processing principles

CNC machine tools are also called Computerized Numerical Control (CNC for short). They are mechatronics products that use digital information to control machine tools. They record the relative position between the tool and the workpiece, the start and stop of the machine tool, the spindle speed change, the workpiece loosening and clamping, the tool selection, the start and stop of the cooling pump and other operations and sequence actions on the control medium with digital codes, and then send the digital information to the CNC device or computer, which will decode and calculate, issue instructions to control the machine tool servo system or other actuators, so that the machine tool can process the required workpiece.

‌1. The evolution of CNC technology: from mechanical gears to digital codes

The Beginning of Mechanical Control (late 19th century - 1940s)

The prototype of CNC technology can be traced back to the invention of mechanical automatic machine tools in the 19th century. In 1887, the cam-controlled lathe invented by American engineer Herman realized "programmed" processing for the first time by rotating cams to drive tool movement. Although this mechanical programming method is inefficient, it provides a key idea for subsequent CNC technology. During World War II, the surge in demand for military equipment accelerated the innovation of processing technology, but the processing capacity of traditional machine tools for complex parts had reached a bottleneck.

The electronic revolution (1950s-1970s)

After World War II, manufacturing industries mostly relied on manual operations. After workers understood the drawings, they manually operated machine tools to process parts. This way of producing products was costly, inefficient, and the quality was not guaranteed. In 1952, John Parsons' team at the Massachusetts Institute of Technology (MIT) developed the world's first CNC milling machine, which input instructions through punched paper tape, marking the official birth of CNC technology. The core breakthrough of this stage was "digital signals replacing mechanical transmission" - servo motors replaced gears and connecting rods, and code instructions replaced manual adjustments. In the 1960s, the popularity of integrated circuits reduced the size and cost of CNC systems. Japanese companies such as Fanuc launched commercial CNC equipment, and the automotive and aviation industries took the lead in introducing CNC production lines. 

Integration of computer technology (1980s-2000s)

With the maturity of microprocessor and graphical interface technology, CNC entered the PC control era. In 1982, Siemens of Germany launched the first microprocessor-based CNC system Sinumerik 800, whose programming efficiency was 100 times higher than that of paper tape. The integration of CAD (computer-aided design) and CAM (computer-aided manufacturing) software allows engineers to directly convert 3D models into machining codes, and the machining accuracy of complex surfaces reaches the micron level. During this period, equipment such as five-axis linkage machining centers came into being, promoting the rapid development of mold manufacturing and medical device industries.

Intelligence and networking (21st century to present)

The Internet of Things and artificial intelligence technologies have given CNC machine tools new vitality. Modern CNC systems use sensors to monitor parameters such as cutting force and temperature in real time, and use machine learning to optimize processing paths. For example, the iSMART Factory solution of Japan's Mazak Company achieves intelligent scheduling of hundreds of machine tools through cloud collaboration. In 2023, the global CNC machine tool market size has exceeded US$80 billion, and China has become the largest manufacturing country with a production share of 31%.

2. CNC machining principles: How code drives steel

The essence of CNC technology is to convert the physical machining process into a control closed loop of digital signals. Its operation logic can be divided into three stages:

Geometric Modeling and Programming

After building a 3D model using CAD software such as UG and SolidWorks, CAM software “deconstructs” the model: automatically calculating parameters such as tool path, feed rate, spindle speed, and generating G code (such as G01 X100 Y200 F500 for linear interpolation to coordinates (100,200) and feed rate 500mm/min). Modern software can even simulate the material removal process and predict machining errors.

Numerical control system analysis and implementation

The "brain" of CNC machine tools - the numerical control system (such as Fanuc 30i, Siemens 840D) converts G codes into electrical pulse signals. Taking a three-axis milling machine as an example, the servo motors of the X/Y/Z axes receive pulse commands and convert rotary motion into linear displacement through ball screws, with a positioning accuracy of up to ±0.002mm. The closed-loop control system uses a grating ruler to feedback position errors in real time, forming a dynamic correction mechanism.

Multi-physics collaborative control

During the machining process, the machine tool needs to coordinate multiple parameters synchronously: the spindle motor drives the tool to rotate at a high speed of 20,000 rpm, the cooling system sprays atomized cutting fluid to reduce the temperature, and the tool changing robot completes the tool change within 0.5 seconds. For example, when machining titanium alloy blades, the system needs to dynamically adjust the cutting depth according to the hardness of the material to avoid tool chipping.

‌3. The future of CNC technology: cross-dimensional breakthroughs and industrial transformation

Currently, CNC technology is facing three major trends:

‌Combined‌: Turning and milling machine tools can complete turning, milling, grinding and other processes on one device, reducing clamping time by 90%;

Additive-subtractive integration: Germany's DMG MORI's LASERTEC series machine tools combine 3D printing and CNC finishing to directly manufacture aerospace engine combustion chambers;

‌Digital Twin‌: By using a virtual machine tool to simulate the actual machining process, China's Shenyang Machine Tool's i5 system has increased debugging efficiency by 70%.

From the meshing of mechanical gears to the flow of digital signals, CNC technology has rewritten the underlying logic of the manufacturing industry in 70 years. It is not only an upgrade of machine tools, but also a leap in the ability of humans to transform abstract thinking into physical entities. In the new track of intelligent manufacturing, CNC technology will continue to break through the limits of materials, precision and efficiency, and write a new chapter for industrial civilization.

[expatiating]

Like what you do for work or school…. Dreams…. Aspirations…. Relationship status,… favorite color… just fun facts :)

Haha well I’m a dog walker and pet sitter, I just graduated from my medical billing and coding program, and I’m trying to find a medical coding job.

My dreams and aspirations hmmm, I wanna find a job where I can support myself… and I wanna move out of florida… I would love to move back to Massachusetts. That’s as far as I can think right now lmao.

I am single

My favorite color is probably purple… It changes between purple and green usually

And a fun fact, when I was a baby I was supposed to be in a commercial like I got the part… but when it came down to film, I wouldn’t cry on command for the camera so they went with a different baby…. I’ve been crying ever since

[brookemedbil]

2024 Certified Medical Billing & Coding Salary Insights: Earnings, Factors, and Career Potential

2024 ​Certified ⁣Medical Billing & Coding Salary Insights: Earnings, Factors, and‌ Career Potential

If you’re considering a career in medical billing and coding, or you’re already certified‍ and looking ⁢to gauge your‌ earning potential in 2024, you’ve ⁣come to‍ the right​ place.‍ The healthcare industry is rapidly evolving, and so​ are ⁢the opportunities for certified professionals. In this thorough guide, we ​delve into the ⁢latest ⁤salary insights,⁤ key factors influencing earnings, career growth prospects, and practical tips⁣ to maximize⁢ your earning ​potential.

Introduction

Medical billing and coding are vital components of the healthcare ​system, ensuring accurate documentation, billing, and ‍reimbursement processes. Certification in these fields not only enhances employability but also significantly impacts earning potential.As ⁣2024 unfolds,understanding salary trends and career⁣ factors is crucial for both newcomers and seasoned professionals aiming to maximize ‍their income and⁢ career satisfaction.

2024 ​Certified Medical Billing &‍ Coding Salary Overview

According to ⁣recent ‌industry reports and salary surveys, the average annual⁣ salary for certified‍ medical billing and coding specialists in ‌2024 is approximately $45,000 to $55,000. However,⁣ these ⁤figures vary based on several factors such as experience,​ geographic location, ‍certification level, and work ⁣setting. Here’s ‍a speedy snapshot:

Experience Level

Average Salary (USD)

Entry-Level ‍(0-2 ​years)

$35,000 – ⁣$45,000

Mid-Level (3-5 years)

$45,000 ​-‌ $55,000

Experienced (>5 years)

$55,000 – $65,000+

Key Factors Influencing Medical Billing & Coding Salaries in 2024

Understanding what impacts ⁢your​ salary can ⁤help you strategize your career ​and maximize your earnings. Several key factors influence ‍medical billing and coding salaries​ in 2024:

1. ​Certification and Specialization

certified Professional Coder (CPC): Most widely recognized; frequently enough commands higher ⁤salaries.

Certified Medical Reimbursement Specialist (CMRS): Focus on reimbursement processes can⁢ boost earning ⁢potential.

Specializations: Coding⁤ for specific fields (e.g., radiology, ⁢cardiology) can attract higher pay.

2. Geographic ⁣Location

Salaries vary significantly​ across regions. Such ⁤as:

High-paying states: California,New York,Massachusetts

Lower-paying regions: parts of ⁤the⁣ Midwest ⁤and South

3. Work Surroundings

Hospitals ‍and health systems: Typically offer higher‌ salaries.

Physician offices ‌and outpatient ⁣clinics: Moderate pay.

Remote work: Increasingly popular and may offer competitive wages depending on employer.

4. Experience and Skills

More‍ experience leads ‍to higher salaries. Also, proficiency in advanced coding software, knowledge of ‍Electronic Health Records (EHR), and familiarity with‌ ICD-10, CPT, and⁣ HCPCS coding enhance earning ‌potential.

5. Certification ⁢Level

Higher certifications and⁣ continuing education often lead to promotions and salary increases.

Career Growth and Potential in Medical Billing & Coding

The healthcare industry continues to grow, ‌and ‌so ‌does the demand for‌ certified medical billing and coding specialists.The U.S. Bureau of Labour Statistics projects​ a average job⁣ growth of 8% from 2022‌ to 2032, faster⁢ than the ⁣average for ⁣all occupations.⁤ This growth presents excellent career stability⁢ and ‍advancement opportunities.

Potential Career paths:

Senior Medical‌ coder

Billing Supervisor

Healthcare Compliance Officer

Coding Auditor

Revenue Cycle ⁣Manager

Benefits​ of ​Being a Certified Medical Billing & Coder in 2024

Stable employment: growing demand ensures job security.

Flexible work‌ options: Many ⁢roles offer remote and part-time⁤ opportunities.

Good earning potential: Competitive salaries with room for growth.

Continuous learning: Ongoing certifications and ⁤courses keep skills sharp and earnings high.

Practical Tips to maximize Earnings⁤ in 2024

Get certified: Obtain recognized ⁢credentials like CPC or⁤ CCS-P to increase marketability.

Specialize: ⁣ focus on high-demand ‌fields such as radiology or cardiology coding.

enhance technical skills: Master coding software, EHR systems, and‌ compliance regulations.

Negotiate salary: ⁤Don’t be‌ afraid to negotiate based on your ‍skills,⁢ experience, and certifications.

Consider geographic⁢ mobility: Be ‍open to relocating to high-paying regions.

Stay current: ​ Keep abreast of industry changes, ⁣new coding standards, and best practices.

Case Study: From Entry-Level to High Earner in Medical Coding

Samantha’s‍ Journey: Starting with an‌ entry-level ⁣certification, ​Samantha spent two years gaining‍ experience ⁣at a community clinic. ⁤She pursued advanced certification in cardiology coding, which opened⁤ doors to higher-paying roles. Moving to a metropolitan hospital, she increased her ⁣salary by 30%, now earning over $60,000 annually. Her dedication to continuous education​ and certification in​ specialized‍ coding ⁤helped her rapidly climb the career ladder.

Conclusion

As we⁣ look into 2024, the prospects⁢ for‍ certified medical ⁣billing and coding professionals remain promising. With strong earning potential,flexible work ⁤options,and a growing demand,this career path is ​an excellent choice for those interested in‍ healthcare and technology. By understanding ‌the​ key factors⁤ that influence salaries and actively investing in certifications and skills, ⁢you can⁣ significantly enhance your career trajectory and financial ‌rewards in ​the coming years.

Whether ⁢you’re just starting out or seeking to elevate your existing‍ career, now is an ideal time to​ explore the rewarding world of medical billing and coding. Stay ⁤informed, keep learning, and watch your earning potential grow⁤ in 2024!

https://medicalbillingcodingcourses.net/2024-certified-medical-billing-coding-salary-insights-earnings-factors-and-career-potential/

[outsource-medical-billing]

What is Medical Coding? Why is Coding Important?

Accurate medical coding boosts timely reimbursements, reduces claim denials, and strengthens your healthcare facility’s overall revenue cycle.

[sahraeyll]

Medical Coding & Billing Salary Insights 2024: How Much Can You Earn in This Rewarding Healthcare Career?

medical Coding & Billing Salary⁢ Insights 2024: How Much Can You Earn​ in This Rewarding Healthcare Career?

Are you considering a​ career in healthcare that combines technical skill, attention to detail, ⁣and solid earning potential? medical coding and billing are essential roles ⁣within the healthcare ⁢industry, responsible for translating ​medical procedures into universally‍ recognized codes and ensuring accurate billing. As we step⁢ into 2024, ‍understanding the salary landscape, job prospects,​ and growth opportunities in medical coding and billing can help‍ you make⁢ informed career‍ choices. Let’s explore the latest salary insights, benefits, practical tips, and real-world experiences ⁤in this rewarding healthcare field.

Understanding Medical Coding & Billing: An Overview

Medical ‍coding⁤ involves converting healthcare providers’ services, procedures, and⁤ diagnoses into standardized codes used for billing, insurance claims, and‌ record-keeping.Billing professionals ‌than ensure these​ codes are correctly processed to facilitate prompt reimbursement.‍ These roles demand knowledge of medical terminology,​ coding systems (such as ICD-10, CPT, HCPCS), and compliance standards.

Popular career ​paths in this field​ include:

Medical Coder

Medical Biller

Medical Coding Supervisor

Billing Specialist

Compliance Officer

Salary Expectations for ​Medical⁤ Coding & Billing⁣ in 2024

Average ‍Earnings Across the U.S.

The salary landscape for medical coding and⁢ billing⁢ professionals varies ⁣depending on experience, location, certification, and employer type. In 2024,the ⁣**average annual salary** for medical‍ coders and billers in the ⁢United States​ is approximately $50,000 to $65,000,with some experienced professionals earning beyond $75,000 annually.

Top Factors Influencing Salary

Experience: Entry-level⁣ coders typically earn less,⁤ while seasoned coders with years of experience or specialized certifications command higher salaries.

Location: Urban centers and​ states ​with higher living costs (like California,New ​York,and Massachusetts) tend to offer higher wages.

Certification: Certified Professional ‍Coder (CPC),⁤ Certified⁣ Coding Associate (CCA), and othre credentials can substantially boost earning potential.

employer Type: Hospitals, outpatient clinics, and large healthcare organizations frequently enough pay more than small private practices.

Salary‌ Comparison Table: ‌Entry-Level⁣ vs.Experienced Medical Coders &‍ Billers

Career Level

Average Annual Salary

Potential Range

Entry-Level

$35,000

$30,000 – $45,000

Mid-Level

$55,000

$50,000 – $65,000

Experienced/Specialized

$75,000+

$70,000 ​- $90,000+

Projected‍ Growth​ & Job ⁢Outlook for 2024

The U.S. Bureau of Labor Statistics projects an **employment⁣ growth rate of‍ 8% for medical records and health data technicians** ‌(which includes medical coders and billers) from 2022 ⁢to 2030. This growth is faster than the ⁤average ⁣for all occupations, driven⁤ by increased​ healthcare needs and the​ ongoing digitization of medical records.

As healthcare providers modernize their record-keeping systems, experienced and certified medical coders are in high ‍demand, ensuring job stability and opportunities for advancement.

Benefits of a Career in Medical⁢ Coding ​& Billing

Choosing​ a career‍ in medical coding and billing⁤ offers numerous advantages:

Flexible Work Arrangements: Remote work possibilities are expanding, allowing for work-from-home ⁢setups.

Low Barriers to Entry: Certification programs are affordable ‌and ⁣can be completed in a few‌ months.

High Job Stability: ⁣The healthcare industry remains resilient, ensuring consistent demand for skilled professionals.

growth ⁣Opportunities: With experience and further certifications,career advancement to managerial roles or specialized fields is achievable.

Competitive Compensation: As ‌highlighted earlier, earning potential is strong, especially with experience.

Practical Tips to Maximize Your Salary⁤ in Medical Coding & Billing

If you’re looking to increase ⁣your earning potential in this healthcare‌ career, consider the following tips:

Obtain Relevant Certifications: ⁤ Certifications like⁢ CPC, CCS, or⁣ COC can significantly boost your salary prospects.

gain⁤ Experience: Start with ⁣entry-level​ roles and seek ‍continuous⁣ learning⁤ opportunities.

specialize in a Niche: Focus on specific areas like ⁣oncology, cardiology, or outpatient coding to command higher‍ pay.

Stay ‌Updated: Keep abreast of new coding standards⁤ and healthcare regulations.

Negotiate⁤ Like‍ a Pro: Don’t shy away from salary discussions; ​leverage your certifications ‌and‍ experience.

Real-Life Case⁣ Studies & First-Hand experiences

Case‍ Study: From Beginner to Certified Coder

Jane,‌ a recent graduate, ⁣started as⁣ a medical billing clerk earning $40,000 annually. After​ earning her CPC certification within six months, her salary increased to $55,000.Over time, specializing in outpatient⁢ coding, she now⁤ earns $70,000 and works remotely, enjoying better work-life balance.

First-Hand Experience:​ Working‌ Remotely in‌ Medical Coding

Mark, a seasoned medical coder, transitioned to remote work during the pandemic. With five years of experience and ⁣a CCS ⁣certification, he earns over⁣ $80,000⁤ annually, highlights the importance of certifications ‌and experience for career versatility and‍ higher salaries.

Conclusion

Medical coding and billing continue ‌to be lucrative and rewarding ‌healthcare‍ careers ⁣in ‍2024. The evolving healthcare landscape, combined‌ with technological advancements, offers promising salary potential, job stability,⁤ and career growth‌ opportunities. Whether ‍you’re⁤ just starting or looking to advance ⁢your existing career, investing in certifications⁤ and gaining experience can lead to higher earnings and a⁤ more fulfilling professional life. If you’re passionate about ⁢healthcare and detail-oriented work,this field might be the perfect fit for your future.

Embrace ⁤the opportunities in ‌medical ​coding and billing, stay updated on industry trends, and leverage⁢ your‌ skills to maximize ‌your earning potential in 2024 and beyond.

https://medicalbillingcertificationprograms.org/medical-coding-billing-salary-insights-2024-how-much-can-you-earn-in-this-rewarding-healthcare-career/

[hayleymedbil]

Medical Billing Career Salary Insights: How Much Can You Earn in 2024?

medical Billing Career Salary Insights: How Much Can You Earn in ‍2024?

If you’re considering a career ‌in healthcare administration, specifically ⁣in medical billing, you’re‌ on the right track to a rewarding and⁤ stable profession. With the healthcare industry expanding⁤ rapidly, the demand for skilled medical billers continues to grow. ⁤But one‍ of ‍the most ‍common ‍questions prospective professionals ask is: how much can ‍I earn in ​2024 as a medical biller? In this comprehensive guide,we’ll explore salary ⁢insights,factors influencing earnings,benefits of a medical billing career,practical tips to maximize your income,and real-world case studies ⁣to help you plan your career⁤ path effectively.

Understanding the Medical Billing Profession

What ​is Medical Billing?

Medical billing involves processing billing claims between healthcare⁤ providers and insurance companies. It requires accuracy, knowledge of healthcare coding,‌ insurance policies, and interaction skills to ensure clinics and⁤ hospitals receive proper reimbursement for services rendered.

role and Responsibilities

Verifying patient insurance coverage

Submitting⁣ claims to insurance providers

Follow-up on unpaid or rejected claims

Ensuring compliance with healthcare regulations

Maintaining accurate⁢ billing records

Salary Overview for Medical‌ Billers in 2024

National Salary ‍Averages

In 2024, the salary​ for medical billing⁤ specialists varies based on⁣ experience,​ location, certification,⁣ and employer type.Here’s a ⁢fast overview of average annual salaries across different‍ career stages:

Experience Level

Average Salary (USD)

Entry-Level (0-1​ year)

$35,000 – $45,000

Mid-Level (2-5 years)

$45,000 – $60,000

Experienced/Certified (5+⁢ years)

$60,000 – $75,000

Salary by Region and State

Location plays a crucial role in ‌earning potential. For example, ​urban ‍centers and states with higher​ living costs tend‌ to offer higher salaries. Here’s a snapshot:

Region / State

Average Salary (USD)

California

$55,000 – $75,000

New York

$55,000 – $72,000

Texas

$45,000 – $60,000

Florida

$42,000 – $55,000

Factors Influencing Medical Billing Salaries

Experience and Certification

Certified ​medical billers or coders, such‌ as those holding a‌ Certified Professional Biller (CPB) or Certified Coding associate⁣ (CCA) credential, often command higher salaries. Gaining hands-on experience ​and certifications can significantly elevate your earning potential.

Location​ and Cost⁤ of Living

Salaries tend to be ‍higher in metropolitan areas with a higher cost ​of living.⁤ States ‍like California, New York, and Massachusetts often offer premium wages compared to rural regions.

Type of Employer

hospitals and large clinics usually‍ pay more than small practices or outpatient centers.

Medical billing companies might offer competitive wages along with flexible ‌work arrangements.

Technology Skills

Proficiency in healthcare management ‌software, Electronic Health Records (EHR), and billing platforms can give you an advantage, often leading⁣ to salary increases and promotions.

Benefits ‍and Practical Tips⁣ for Maximizing Your Income

Additional Benefits and Perks

Health insurance and retirement plans

Paid time off and sick leave

Opportunities for remote work

Professional growth and certification ‌reimbursement

Practical Tips⁢ to Boost Your⁤ Salary

Get certified: ‍Certifications like CPB or CPC can increase your marketability.

Gain experience: Entry-level roles build a foundation for⁣ higher-paying positions.

Specialize: Focus on niche areas like oncology or cardiology billing for higher pay.

Stay updated: ‌ Keep current with healthcare regulations and⁢ coding changes.

Explore remote opportunities: Remote medical billing jobs often offer competitive wages and flexible schedules.

First-Hand Experience: A Medical Biller’s ​Journey

jessica, a certified medical billing specialist ⁢from‍ Texas, shared her experience: “Starting with an entry-level position, I earned⁤ around $38,000 annually. After earning my ⁤certification and gaining two years ​of experience,my salary increased to $55,000. Working remotely helped me balance work ⁢and life better, ⁢and I was able to take on additional certifications to boost my ​income further.”

Future Outlook for Medical Billing ⁤Careers

The Bureau of ⁢Labour Statistics projects a steady growth rate of around 8% for⁢ medical records and health data technicians through 2030, indicating a robust demand for skilled medical billers. As healthcare technology advances and⁢ regulations evolve, the⁣ need for qualified professionals will continue to rise,‌ making medical billing a promising‍ career choice for 2024 and beyond.

Conclusion

Embarking on a medical billing career in 2024 offers promising earning potential, especially for those who invest in certifications and ⁢gain ⁢experience in high-demand ⁤areas. Whether working in hospitals, ⁢clinics, or remotely from home,​ your salary can grow significantly with ​the right skills, regional location, and dedication. Remember, ongoing education and staying current with industry changes are key to maximizing your income and advancing your career in the healthcare industry.

If you’re ready ​to start ⁤or enhance your medical billing career,‌ now is an excellent time to ​take the ‌next step.​ With the demand high and salary prospects strong, healthcare billing professionals are more valuable than ever!

https://medicalcodingandbillingclasses.net/medical-billing-career-salary-insights-how-much-can-you-earn-in-2024/

[covid-safer-hotties]

Also preserved in our archive (Daily updates!)

Researchers say new AI tool sharpens diagnostic process, may help identify more people needing care While earlier diagnostic studies have suggested that 7 percent of the population suffers from long COVID, a new AI tool developed by Mass General Brigham revealed a much higher 22.8 percent, according to the study.

The AI-based tool can sift through electronic health records to help clinicians identify cases of long COVID. The often-mysterious condition can encompass a litany of enduring symptoms, including fatigue, chronic cough, and brain fog after infection from SARS-CoV-2.

The algorithm used was developed by drawing de-identified patient data from the clinical records of nearly 300,000 patients across 14 hospitals and 20 community health centers in the Mass General Brigham system. The results, published in the journal Med, could identify more people who should be receiving care for this potentially debilitating condition.

“Our AI tool could turn a foggy diagnostic process into something sharp and focused, giving clinicians the power to make sense of a challenging condition,” said senior author Hossein Estiri, head of AI Research at the Center for AI and Biomedical Informatics of the Learning Healthcare System (CAIBILS) at MGB and an associate professor of medicine at Harvard Medical School. “With this work, we may finally be able to see long COVID for what it truly is — and more importantly, how to treat it.”

For the purposes of their study, Estiri and colleagues defined long COVID as a diagnosis of exclusion that is also infection-associated. That means the diagnosis could not be explained in the patient’s unique medical record but was associated with a COVID infection. In addition, the diagnosis needed to have persisted for two months or longer in a 12-month follow up window.

The novel method developed by Estiri and colleagues, called “precision phenotyping,” sifts through individual records to identify symptoms and conditions linked to COVID-19 to track symptoms over time in order to differentiate them from other illnesses. For example, the algorithm can detect if shortness of breath results from pre-existing conditions like heart failure or asthma rather than long COVID. Only when every other possibility was exhausted would the tool flag the patient as having long COVID.

“Physicians are often faced with having to wade through a tangled web of symptoms and medical histories, unsure of which threads to pull, while balancing busy caseloads. Having a tool powered by AI that can methodically do it for them could be a game-changer,” said Alaleh Azhir, co-lead author and an internal medicine resident at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system.

The new tool’s patient-centered diagnoses may also help alleviate biases built into current diagnostics for long COVID, said researchers, who noted diagnoses with the official ICD-10 diagnostic code for long COVID trend toward those with easier access to healthcare.

The researchers said their tool is about 3 percent more accurate than the data ICD-10 codes capture, while being less biased. Specifically, their study demonstrated that the individuals they identified as having long COVID mirror the broader demographic makeup of Massachusetts, unlike long COVID algorithms that rely on a single diagnostic code or individual clinical encounters, skewing results toward certain populations such as those with more access to care.

“This broader scope ensures that marginalized communities, often sidelined in clinical studies, are no longer invisible,” said Estiri.

Limitations of the study and AI tool include that health record data the algorithm uses to account for long COVID symptoms may be less complete than the data physicians capture in post-visit clinical notes. Another limitation was the algorithm did not capture possible worsening of a prior condition that may have been a long COVID symptom. For example, if a patient had COPD that worsened before they developed COVID-19, the algorithm might have removed the episodes even if they were long COVID indicators. Declines in COVID-19 testing in recent years also makes it difficult to identify when a patient may have first gotten COVID-19.

The study was limited to patients in Massachusetts.

Future studies may explore the algorithm in cohorts of patients with specific conditions, like COPD or diabetes. The researchers also plan to release this algorithm publicly on open access so physicians and healthcare systems globally can use it in their patient populations.

In addition to opening the door to better clinical care, this work may lay the foundation for future research into the genetic and biochemical factors behind long COVID’s various subtypes. “Questions about the true burden of long COVID — questions that have thus far remained elusive — now seem more within reach,” said Estiri.

Link to preprint: www.medrxiv.org/content/10.1101/2024.04.13.24305771v2

[pittchief]

people always asked her to choose: hands-on care or high-level reform.  systems thinking or human-centered healing.  M.D.  or D.O.  they wanted her to fit neatly  —  into labels,  into lanes. 

but isobel marecha was never built for that kind of medicine. 

raised in oakland by a mother who practiced osteopathic medicine in a community clinic,  she saw healing as relational,  deeply human,   &  often political.  her mother’s hands were strong  —  the kind that reset joints  &  soothed trauma  —  but the system didn’t see that kind of work as legitimate.  isobel saw how easily people could be brilliant  &  invisible at the same time. 

so when she got into johns hopkins university school of medicine,  she went with purpose.  there,  she pursued an m. d.  with a focus in emergency medicine  —  not just for the adrenaline of the trauma bay,  but because that’s where the fractures showed first.  the er,  to her,  was the frontline of every systemic failure: housing,  addiction,  race,  infrastructure.  she thrived in it.  published research.  stood her ground.  but she never stopped thinking about her mother’s way  —  whole-person care,  structural work,  touch as diagnosis. 

so she did something nearly no one else did.  while her peers chased prestigious specialties,  isobel quietly enrolled in a d. o.  program at philadelphia college of osteopathic medicine.  she completed both degrees  —  M.D.   &  D. O.   —  within five grueling years,  building a bridge between the clinical world she was mastering  &  the legacy she refused to leave behind.  she didn’t talk about it much.  she just did the work. 

her residency at massachusetts general hospital was in emergency medicine  —  fast,  chaotic,  exacting.  she led code blues like a conductor.  she was awarded resident of the year for her leadership  &  clinical precision,  but even then,  she felt the limits.  too many patients were dying not from what brought them in,  but from what sent them back out.  the problems were upstream. 

so she pivoted. 

she earned a fellowship in healthcare administration & systems reform at harvard’s t. h.  chan school of public health,  then a wharton executive mba in healthcare management,  completed part-time while still on call.  she followed it with a master of healthcare administration (mha) to formalize her shift. 

now,  as chief operating officer of pittsburgh trauma medical center,  dr.  marecha operates with surgeon’s clarity  &  strategist’s scope.  she’s the kind of leader who still answers the trauma pager if things go sideways.  who writes policies with a medic’s triage instinct.  who knows a hospital is a body  —   &  that it,  too,  can go into shock.