Medical billing is a payment practice within the United States healthcare system. The process involves a healthcare provider obtaining insurance information from a patient and filing, following up on and appealing claims with health insurance companies in order to receive payment for services rendered, such as testing, treatments, and procedures. The same process is used for most insurance companies, whether they are private companies or government sponsored programs. Medical coding reports what the diagnosis and treatment were and prices are applied accordingly. Medical billers are encouraged, but not required by law, to become certified by taking an exam such as the CMRS Exam, RHIA Exam, CPB Exam and others. Certification schools are intended to provide a theoretical grounding for students entering the medical billing field. Some community colleges in the United States offer certificates, or even associate degrees, in the field. Those seeking advancement may be cross-trained in medical coding or transcription or auditing, and may earn a bachelor's or graduate degree in medical information science and technology. It is not required to have a certification to learn billing, and billing practices vary from state to state. Certification does, however, help a person create demand for themselves as far as job openings are concerned. History For several decades, medical billing was done almost entirely on paper. However, with the advent of medical practice management software, also known as health information systems, it has become possible to efficiently manage large amounts of claims. Many software companies have arisen to provide medical billing software to this particularly lucrative segment of the market. Several companies also offer full portal solutions through their own web-interfaces, which negates the cost of individually licensed software packages. Due to the rapidly changing requirements by U.S. health insurance companies, several aspects of medical billing and medical office management have created the necessity for specialized training. Medical office personnel may obtain certification through various institutions who may provide a variety of specialized education and in some cases award a certification credential to reflect professional status. Billing process The medical billing process is a process that involves a third party payer, which can be an insurance company or the patient. Medical billing results in claims. The claims are billing invoices for medical services rendered to patients. The entire procedure involved in this is known as the billing cycle sometimes referred to as Revenue Cycle Management. Revenue cycle management is the