Thursday, March 20, 2008

How easy is it to be a Medical Biller?

Any medical billing service who reads this will probably want to tar and feather me but the truth is Medical billing is quite easy. It's about the desire and willingness to learn the proper foundation to a good medical billing and collections process.

If you want to break medical billing processes down to simple steps:
1. Doctor treats a patient
2. Doctor complets a form (encounter, Charge Slip, Routing Slip)
3. The form makes it's way to the billing department
4. The billing department is responsible for many aspects at this point but to keep things simple lets just say they convert the form into a claim and bill the insurance carrier.
5. The claim gets paid out
6. Payment is posted to the software
7. Patient is billed
8. Patient pays the bill

Wow! That was simple however; lets add a few medical billing "problems" to this -

Eligibilty - Does the patient being treated actually have insurance even though they present a ins card
Mailing Address - Did the patient give us a legit mailing address and contact information
Insurance Cards - Did the correct insurance information get uploaded to the patient demographics?
eClaims - Is the proper connection setup between the billing service and the insurance carrier for payment?
Check vs. EFT - Is the insurance carrier mailing a hard check or performing Electronic Fund Transfers (this affects the different way of posting the payment)?
EOB vs ERA - Will the insurance carrier be mailing paper explanation of benefits (EOB) or sending Electronic Remittance Advice
ERA Translating issues - All software carriers including insurance carriers have problems with electronic remittance advice. From dropping interest payments, translation of denials, and codes included with global code and yet look like the patient is resp for payment etc.
Denial EOB's - Identifying time to work and process?
Overpayments - Processing these in a timely matter and refunding
Refund Patients - Processing these in a timely matter
Patient Phone Calls - Keeping it nice and professional with patients
Statements - Sending in a timely matter and crossing fingers patients will pay
Collection Letters - Keeping it nice Hi I want you to keep coming to my office however; I show you have this outstanding balance - PAY IT NOW OR GO TO COLLECTIONS
Collections - After several phone calls, statements, collection letters and maybe even personal letters it comes to this.
End of Month - Yes, every last day of the month for most doctors office is the end of month. You get everything as clean as possible and take a snapshot of the progress you made for the month.
Reports - Front office, Doctors, Billers and Managers all need varying reports to identify what's going on.

It takes desire to want to do this kind of work.

When I first started in the medical billing industry 13 years ago most everything was done by paper . Now things are becoming much more techy. Things have become increasingly streamlined and time saving software can really help the billing offices. I would also recommend visiting to learn Microsoft Excel and Word as this will help you in the Medical Industry.

I have had several jobs in the medical industry over my 13 years and what I find is that after 6 months of training just about anyone with desire can work in the medical industry. If you would like to learn more about how to become a medical biller you can leave a message or question.

I have been contemplating putting a course together on basic 101 Medical Billing for a low price. The medical billing training would include:
* live web-based training by phone and internet
* downloadable videos
* Access to a Demo Key to play as you learn the techniques in our online class

If you feel this would be valuable please leave comments and visit my site often to review any updates on?

Medical Billing and Codingquestions are answered here: Online Medical Coding and Billing Courses

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