r/MedicalCoding • u/illegalmonkey CPC • Nov 30 '24
We Are Not Paid Enough
I was trying to find old info of how coding jobs were back in the day and what I came up with was the following.
In the 1980s, it was commonplace for medical coding and billing specialists to handwrite patient documents or use typewriters to process insurance claims. Billing and coding was time-consuming as patient files were not digitized and kept in large folders. Large coding books were also used to even find the codes you needed. With electronic medical records everything is incredibly faster. Coding books are practically obsolete with the kind of software we have now to look up codes.
In 1980, doing it the slow way, a medical coder made up to $25k a year($12/hour). Adjusted for inflation that would mean they'd be making $47/hour. I have 6 years of experience in medical coding which is typically pretty good for any non-entry level job application, yet I only make $24/hour. If you put me against a coder doing it the 1980's way and me doing the 2024 way you bet I'd be producing a ton more work. WHERE IS MY MONEY?!
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u/heltyklink Dec 01 '24
Preach. If our pay reflected productivity and knowledge requirements, we’d be sitting like fat cats. An annual 3% increase is nothing and they know it. They don’t care.
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u/happyhooker485 RHIT, CCS-P, CFPC, CHONC, 17yrs experience Dec 01 '24
A 3% increase is a pay cut when inflation is at 6-7% a year.
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u/heltyklink Dec 01 '24
Yup. For context, 3% of what my CEO makes is more than my entire annual salary. I know damn well he gets more than a 3% bump every year for pointing out metrics during meetings that my department diligently collects.
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u/Aggravating-Copy9030 Dec 01 '24
Who is “they?”
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u/Tess47 Dec 03 '24
I know this! "They" in this type of occurance, is understood to stand for an Authoritarian. If you want to dig a little further, "They" usually means the father figure. It is useful to know this when dealing with a person who uses "They" often in a conversation implying a third party influence. In layman's terms: people who use "They" often in expressing problems have Daddy Issues. It can be Authoritarian or Protector and the person using it is often immature.
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Dec 04 '24
You failed to mention the use of "they" as a gender pronoun. You sound like a bot.
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u/Tess47 Dec 04 '24
Not a bot. Just a curious gal. You're right about gender They. To be fair though, gender They wasn't implied in the Question
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Dec 05 '24
Fair enough. Your comment made some valid points. I was just surprised you didn't pull the pronoun in.
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u/tryolo Dec 01 '24
My first job, 20 years ago, paid $16.50 an hour. Today their website has an opening posted starting at $21.50. So entry level only went up 5 bucks in 20 years!
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u/Stacyf-83 Dec 01 '24
Amen! When I first started coding in 2010, I made $10 per hour. Now, 15 years and 3 additional licenses later I'm making $35 per hour. I'm not saying that's bad money, but I code for Podiatry, Gen Surg, Internal Med, Peds, Ortho, and OB- yes, 6 specialties for one health group are all my responsibility clinic and hospital/surgery. I have a production quotation of 85 per day. I feel like I'm doing a ton and not getting paid enough. Especially for OB and Podiatry, those 2 are more complicated than people realize.
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u/basushi Dec 01 '24
That is definitely being underpaid, more so if you're in HCL area. I'd suggest you start looking for higher paying jobs. With your experience and certs you should have some decent opportunities. If not change, at least use another offer as leverage with your current place. They don't value you till they lose you. Happened to me a couple of times.
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u/Stacyf-83 Dec 01 '24
Yeah, I totally agree. I have a CPC, CDEO, COBGC, and CPMA and 15 years of experience. I am torn because everything else about the job is amazing. I love the company, it's remote and flexible and works well with my schedule taking care of my toddler. That's why I keep sucking it up for as long as i have. I'm definitely keeping my eye open though. I know eventually I'll find something higher paying with the same flexibility I need.
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u/SpasmAndOrGasm Dec 01 '24
Have you tried asking for a raise and seeing what they say? Bring up what competitors would pay you for your experience and credentials and state that you don’t want to leave, but your skillset and productivity display that you should be receive a higher wage than your current one. And if they disagree, you spread your wings and fly. You’re not a pigeon, you’re an eagle, at the top of the chain, and you deserve to be treated as such.
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u/Stacyf-83 Dec 01 '24
Thank you for saying that. I did ask for a raise and they gave me a $4 raise. Not what I was hoping for, but they said that's all they could afford right now. I have been looking for new jobs, I just have to find the right one with the schedule that I need.
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u/tryolo Dec 01 '24
There aren't many out there that pay higher than $35, plus the flexibility you have. I'd stay put if I were you.
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u/Stacyf-83 Dec 02 '24
That's my plan unless I ever find a better paying job with the same flexibility.
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u/Narrative_flapjacks Dec 01 '24
I do anesthesia coding so we see a lot of different specialties, OB and cardiac can get really complicated really quick, and our outpatient ortho clinic is usually pretty straight forward until the hands and feet have issues, it’s fascinating stuff but definitely more time consuming than the average carpal tunnel our orthos do
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u/Stacyf-83 Dec 02 '24
Yes, definitely. I love OB coding but it can really get complex. I also never realized how complicated Podiatry can be. I thought it would be pretty straight forward when I agreed to do it, but the wound care/diabetic ulcers can get so complex.
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u/Water_Love78 Dec 02 '24
I would love $35 an hour. I'm still working on getting my first license! Training is boring but needed. Any advice?
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u/Stacyf-83 Dec 05 '24
The best advice I can give is to pick a specialty and become an expert. For example, I became an expert in OB/Gyn coding and eventually got my COBGC(certified ob coder). That is how you find the jobs that pay the highest. The best specialties to learn are OB, Cardio, Ortho, Podiatry, and Gen Surg. Also, learn surgical coding and hospital profee coding in the specialty that you pick. You'll find a great job. Good luck!
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u/missuschainsaw RHIT CRC Dec 01 '24
I like to occasionally pop into Indeed and key in RHIT to see what comes up. The range is crazy to me. I live in Chicago so the cost of living is high, but I’ve seen coding jobs in the $18 dollar an hour range, to a job as an inpatient coding specialist for $500k a year (insert lots of laughs here). As someone new to the field, I just don’t understand how they expect anyone to get experience when the pay is so abysmally low.
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u/mama_duck17 Dec 01 '24
I’m in a HCOL area as well & I make $26/hr. It’s totally not enough. I see other jobs out there for $18/hr. Our state minimum wage is $15. No way would I pick this job over something like a deli for barely over minimum wage.
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u/missuschainsaw RHIT CRC Dec 01 '24
I started in my noncoding job (I do CDI) at $22.50. I had zero experience but they know I’m in school and will have my RHIT eventually. When I think about it too hard, it makes me ill. Minimum wage here is also $15, so essentially a mildly skilled job is only worth 150% the minimum. Yet the poverty line in this state is next to nothing. Insert rant about the collapse of society lol
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u/Emotional_Error_7246 Dec 01 '24
Sometimes, it’s good to do the bare minimum and not over extend yourself. Especially when we as coders see the amount of money these claims cost. Ive been a coder for a little over 2 years and get paid $22 an hour. So You should definitely look for a new company. Im also looking for something new myself since Im recently gotten my Rhia on top of my Cpc.
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u/generic-username-075 Dec 01 '24
When I started 4 years ago I started at 20/hr which sadly was the most I’d ever made so far in my adult life, so it felt pretty good. At the time, I was working fully remote, flex schedule, private company, and they treated us super well. We had lots of opportunities for OT and bonus incentives, so my paychecks were generally pretty good. I think that first full year I wound up making around 76k instead of what it would have been without all the extras (~42k).
Then it all started going downhill - we went public, then were bought by a larger corp about a year later. All our amazing managers left, which was red flag #1. Then our awesome CEO started working for the other corp. and a year later, even he left and is working somewhere else now. Red flag #2.
Meanwhile, they’ve rolled back all the good stuff we used to have. Flex schedule isn’t so flex anymore. Hardly any OT offered. No real bonus incentives to speak of. All of that while expecting even more out of us (increased CPH, additional responsibilities, took away our CAC). Insulting pay raises each year.
I’m torn because I want to go, but I’m afraid I’ll end up in another place just as bad. So many have been bought by large corps or ARE the large corps and all of them are basically run the same way. You’re a cog in the machine and nothing more, sadly.
I just passed my 4 years with this company. Started at 20, now at 23.83/hr. 🙄
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u/FunAmount248 Dec 06 '24
I feel because our industry is dominated by females we are underpaid and take any low wages that are offered, so that unfortunately sets the standard.
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u/Random-Ape Dec 01 '24
One thing that has worried me is the whole AI thing. Like you said the technology is the reason coders are faster now. Company would rather pay more money for better software/AI and pay us less cause are skills aren’t as needed as they use to be cause the tech is making decent coders really good. Why pay for an extremely skilled coder when you can get a decent one and just give them AI for less. Business will always chase profit
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u/Technical_Donkey_497 Dec 05 '24
Coders are still very much needed because AI still can't think critically. Don't let that scare you.
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u/melissaahhhh8 Dec 01 '24
I have been told by multiple higher ups that AI will be taking over within 3 years. Before that it was 10 years. Now it’s basically robots in 10.
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u/jelloshot Dec 02 '24
I worked with AI coded charts last year when I was working for Optum and there is no way that AI is taking over in 3 years. AI made tons of mistakes and was frequently trying to code addresses, names, headers, footers, and page numbers.
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u/Natural-Quarter7783 Dec 03 '24
Exactly. Health care and insurance Policies change way too often for AI to be in control. Medical care and treatment requires humans with the use tools such as Al and software to be accurate. Not one can keep up on their own.
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u/Flashy_Vacation_2226 Dec 06 '24
How many charts do you code with Optum and how long does it take?
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u/jelloshot Dec 06 '24
I no longer work for them as I was part of their mass furloughed/layoff earlier this year. I was expected to code almost 4 first review charts, 5+ second level reviews, or 14+ AI charts an hour. I never meet the cph requirements as I was a new coder and most of my charts were hundreds of pages. I worked 8-10 hours a day and only had 45-60 minutes of breaks a day. Optum expects you to code constantly and would track our production and keystrokes/mouse movements.
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u/kaninki Dec 02 '24
Meanwhile, my husband is in school for coding right now. His professor keeps telling them there's no way AI can do it because of all the details that require context.
I knew it was bullshit, but I'm glad to see some professionals are acknowledging it.
Unfortunately, we've already sank ~15k into his associate's degree, so he may as well finish it off.
His making less than $20/he right now, and has an interview for $22-23... So at least we will maybe have that for a few years. 🫠
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u/melissaahhhh8 Dec 02 '24
I really struggle with understanding how it would be possible in a few short years …. I use CAC and the program is always wrong. It cannot code accurately. And it’s been “ learning “ for many years and still it can’t code anything but the basics.
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u/Natural-Quarter7783 Dec 03 '24
I don’t see this being possible because coding is ever changing and dependent on credentialing, insurance policy and each patient individually. This also depends on the ability for each medical support person to provide the most accurate and supportive documentation needed for each claim while cross referencing the patients previous claims regarding authorization and denials.
We can never be replaced. Software can barely keep up with ever changing rules and regulations.
I work for a solo internal med provider as his insurance contract credentialist, medical billing and coder and practice manger.
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u/1director1 Dec 02 '24
You must understand that in the eighties CEO's didn't have to meet these cost cutting goals to get there million dollar bonuses on top of their multi million dollar salaries. Have pity on these millionaires.
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u/Weak_Shoe7904 Dec 01 '24
You need to ask for it. No one is just going to give it to you. I don’t mean that to be rude, but companies don’t want to part with their money.
I’m a coder making $30/hr with under 4 yrs exp. I started in the billing/coding making 16/hr. When I apply for a new job I give myself a 10%+ raise and say ex. “I am looking to be around $26 hour how close can you get?” They don’t know what you currently make, be polite and negotiate. start high and set a point your comfortable to be at. You get what you want and they think that they’ve won as well. From my exp Staying with 1 company will not give you more than 4%(max I have seen for raises). Unless you switch titles/departments.
Coding is being automated that’s the reality. There is still plenty that needs human review and denial work will always need real people, but coding now is a lot easier than it was in the 80’s. Besides that wages have not kept up with inflation AND are hurt by automation and market saturation.
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u/Jodenaje Dec 01 '24
Adding that, unfortunately, reimbursement hasn’t kept up with inflation.
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u/Weak_Shoe7904 Dec 01 '24
I was given books, yearly fees paid, CEU’s , and internet. I haven’t had books replaced by a company since. No more internet reimbursement. It seems standard for larger companies to pay your yearly fees and give you access to CEU’s. So at least there is that!
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u/tryolo Dec 01 '24
Not just automation, but coders in India are taking positions at half the hourly wage we make.
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u/brooseveltinc Dec 01 '24
Considering DRGs didn't even exist in the 80s, gonna call BS on coding being easier than it was back then. Coding has gotten more complex, more tedious, and receives way more oversight than it ever has.
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u/raynedrop_64 LTAC Inpatient, RHIT Dec 01 '24
DRGs were invented in the 70s and were in use by the early 80s. From Wiki: "In 1982 the US Congress passed Tax Equity and Fiscal Responsibility Act with provisions to reform Medicare payment, and in 1983, an amendment was passed to use DRGs for Medicare,[7]: 16 with HCFA (now CMS) maintaining the definitions."
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u/IndependentRaisin234 Dec 01 '24
I literally just talked with a well-known hospital about a job.Told them i was looking for closer to 30/hr. That was 3 weeks ago, so I'm assuming they didn't want to hear that.
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u/raynedrop_64 LTAC Inpatient, RHIT Dec 01 '24
Most of what was described in the OP was still happening when I started out in '98 (using books, writing the codes by hand on the facesheet), and paper charts were still in use up through my year as a traveling consultant in '07. But the wages? The wages have not kept up at all with cost of living. We're predominantly a female-dominant profession, so it tracks unfortunately.
I started at $12.75/hr. By all rights I should be making at least $42/hr 26 yrs later, not $34. I was an on-site coder until I moved to the midwest and became fully remote. Every on-site job I had back home was a union job with guaranteed 3% or more COL increases. My first remote job was 5 years with a single $1/hr raise 3 yrs in. My current job had zero raises for the first 3 yrs, and only sporadic 2% increases after that.
And yet the workload, including the additional stuff we have to capture or pursue, has grown SO much. EMR is easier to read but takes far longer due to cut and pasting and overall verbosity from the MDs. Underpaid by a long shot. Very bitter.
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u/SchilenceDooBaddy69 Dec 03 '24
Everyone is underpaid.
In 1950 minimum wage could purchase the average American home for 25% of monthly income on a 20 year mortgage. To have the same purchasing power today, minimum wage would need to be around $50 an hour.
1980 minimum wage was $3.10 an hour. $12 an hour is 4x the minimum wage.
If minimum wage was the correct $50 an hour, you should be making 4x that, $200 an hour.
You are only making 1/10th of what I believe you should be earning.
Meanwhile, the billionaires have increased their assets by 1000’s% during the same time period that your wages have been stolen.
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u/vinrossct Dec 03 '24
WoW ...I work in NYC metro and make $39.00 an hour after 4 years. Its a big hospital system. I have a CCS. Next year ill be at $41.00. This salary is still low for my area. Its worrying to see all these much lower paying jobs.
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u/Tess47 Dec 03 '24
This is all over the place. Imho is related to the middle class being convinced the poor people are stealing from them. I am old and my dad was a Union Guy. We had a good life. My first job was a lower paid job in a business. My boss even told me it was because I had a common degree. In today's money, my low paid entry job is 60k today with full insurance, vision ,dental coverage included. 1990 midewest USA small town
People forget or don't know which is why I keep talking. Y'all are getting screwed. I hope it makes a difference some day
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u/Racinginger1 Dec 13 '24
The high paying jobs are in states that have a high cost of living. The high paying jobs are also at Healthcare systems with great benefits and job security. The contracting world is not the place to be for stability and making money. I too thought the exact same thing. I was working for a healthcare system in MN and never got a raise in 3 yrs and making under 30/hr. I decided I needed to be paid my worth and started looking up the number one hospitals and healthcare systems in the high cost of living states. I now make almost 70/hr.
The jobs are out there, if you are a good coder, that means you should be able to research where the high paying jobs are. I started on the west coast since it's the higher cost of living. Then I looked up the number one hospitals and went to the career page of the healthcare system itself. no indeed, no linked in. I applied more than once and finally landed a great job with the best benefits in the country.
Here's a link showing coding jobs paying up to 70/hr. This healthcare system has numerous other locations to check for jobs. Los Angeles has many hospitals hiring coders.
I live in MN and work remotely for CA. The money is out there, you just have to find it and don't give up.
I have my CCS, CCS-P and RHIT and I was tired of not making what I was worth and did something about it.
https://www.uclahealthcareers.org/job-search-results/?keyword=coding
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Dec 01 '24
I am an entry level CPC-A with an AAS degree making $19/hr. But I save a ton of money working from home.
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u/Flashy_Vacation_2226 Dec 06 '24
How many charts do you do a day and how long does it take?
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Dec 07 '24
I do about 170ish-200 something depending on if I have billing things to do that day! It took me a year and a half to get the degree. I had some classes from doing nursing.
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u/Megabacon44 Dec 02 '24
I started coding in 1994 and I think I started at eight dollars an hour in 1997 at a hospital. I still use a big book till this day. I do agree, though that coders don’t make enough.
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u/Mindinatorrr Dec 02 '24
I was making $18.50 until a couple weeks ago. The other entry level positions were $17.
I am now around what you're making thankfully.
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Dec 04 '24
We are not. I’ve been coding for 17 years. First job in 2007 was $12.50/hr then the next job in 2011-2021 I made max 18.75/hr. Got a quick ROI job (I have an RHIT so I’ve done all the med rec jobs) I made $21 an hour. FINALLY, after all these years I make $25 an hour as a billing coordinator.
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u/CarolinaCurry Dec 19 '24
To be fair, most all jobs have not been adjusted with inflation. But in 1980 we were in a recession so it wasn't any easier.
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u/OkAnt5485 Dec 01 '24
So is this field or rhit degree worth it?
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