Tools for Medical Billing

Sure you can make money at home being a Medical Biller. There are lots of courses, at your local community college or even online. Beware of scams. Be sure you are getting support as well as materials and that these are up to date. In the past 3 years there have been many changes in the HIPAA laws that affect Medical Billers. Most of the courses teach Coding, but you should have some Practice management info such as how to read insurance EOB's, basic patient accounting and claim rejection troubleshooting and possibly some work in one of the popular Medical Billing Software programs. Schools and Colleges can get the current Medisoft program for their computers for about $700.00. If you are learning Medisoft, be sure it is at least version 11. Anything older is not HIPAA compliant.

If you are well on your way to becoming a Medical Biller then you should begin to signup for some newsletters. Medicare (http://www.cms.gov/) has some great web training tools and you don't have to have a doctors sign-in for them. They give you small (15-20 question) tests for many specialties. These usually cover the most common billing mistakes and reasons for rejections. Their newsletters can sometimes be overwhelming but are definitely a good idea - be sure to get the newsletters for your state. MedicalCoding.net is another good place to browse and gather some good info. If you think you might have a job with a certain specialty look for websites devoted to those.

You may even want to join a medical billing community online. Remember all of these things are free. Don't join anything that has a cost associated with it until you are sure that is what you are going to need to work for the specific practice that hires you.

So now you've completed your course at a local school or online, you got current info coming in with newsletters and website access. Hopefully you've had access to some of the software you will be using. Put it all together in a Resume or post online to start getting some business. If you haven't had any Medical office experience, it may be a good idea to sign up with a temp agency and get some experience. But you won't want to go into an office and try to take over their Medical Billing all at once. Let some of the others there share their knowledge with you. No matter how current and accurate and thorough your training is, you will never know all that a Biller of 10 or more years knows. Experience is "hands down" the best teacher in the Medical Billing profession.

If you've got a practice to bill for from home, FANTASTIC! We are very proud of you, and sooooo excited! Do you have your software? Do you have a current coding manual? A good black and white printer? Here comes the next big commitment.

Are you going to send paper claims to the insurance carriers or send them electronically? Of course Auto and Worker's Comp are still going paper in every state, for the most part. Texas has some laws regarding Electronic Workers Comp Claims but I don't think they are pushing it too much. Medicare IS pushing Electronic Claims. There is free software to send claims to Medicare, but that means double entry into the claims system and into your patient accounting software so you can track patient balances and coinsurances. Most of the Medical Billing software out there has a way to create a file and send it to a clearinghouse. A clearinghouse takes all your claims and seperates them by insurance and sends them to the individual carriers. That way you send 1 file and can submit claims to dozens of insurances at 1 time.

Clearinghouses are really the only choice if you going to send claims to multiple insurances, but they are also a good choice for sending claims to a few insurances. For example, a doctor who specializes in geriatric medicine will more than likely have 85-95% of his patient's under Medicare. So you could send directly to them, but if you send through a clearinghouse your claims will be double checked for errors, missing fields and other problems even before they go to the insurance carrier. You get rejection notices the same day or next day and can correct these and resubmit. Greatly improving cash flow and lessening tracking of your claims.

Before you sign up with a clearinghouse, be sure they work with your Software. They should help you with the doctor's contracts, since you have to tell each insurance how you will be sending claims and authorizing the clearinghouse to do be an intermediary. Also be sure you will be able to get the support you need if you just can't get a claim to go through or there are software problems. Many clearinghouses charge a monthly fee, per claim fee or package deal. Some require you to pay a setup fee or buy additional software. Be sure that they are able to send claims to the insurances that you will be submitting to.

That covers the basic steps to get you going. Happy Billing!