How Communications Affects the Relationship Between a Provider and a Medical Billing Service

In order for the billing to be done effectively it is crucial that the relationship between the billing service and the provider's office is a good one. Frequent communications with your providers is key to a good relationship. It is important to keep them abreast of everything that is going on with their billing and all that you are doing. When we first started our business we didn't see the point in telling a provider that we were taking care of a denial or appealing a particularly difficult claim. We assumed he knew we were taking care of it. But experience showed us that this is not necessarily true and you need to find a way to keep your providers up to date on the status of their accounts without bothering them.

Some providers say they don't want to know about the issues, but someone in the office should be watching for what the issues are. You don't have to speak to the provider every time you communicate. You can have a weekly fax or email that just gives the highlights of the issues for the week. It is important that they know that any issues that come up are being taken care of and you are showing them this by your weekly communication.

When there is no communications between the provider and the biller, the provider may assume that the biller is not doing that much because the biller isn't telling the provider about all the things that he or she is doing. It is amazing how many things we do for providers that they never realize. If you don't let them know then they don't know you did it and they don't realize all the services they are getting.

We work for many small providers who don't keep track of their claims payments. Their whole perception of what is getting paid and what is not getting paid is based upon two things. Do they have any money in their checking account and the explanation of benefits they get from the insurance carriers. They rip open envelopes and tear off checks. If there is no check some only wonder what happened. They often do not understand the reason codes and have no idea why there isn't a check attached. While we may be resubmitting a claim with a corrected diagnosis or ID#, one eob comes through as a denial before the second one comes through paid. Some doctors never notice that they were for the same claim. They only notice that one didn't get paid.

To keep our providers updated of what we are doing, we send a simple fax or email when we complete the billing for the week letting them know what the issues were. It might read something like this.

Dorothy Winn-has incorrect ID# - do you have a copy of her ID card?

Melvin Black-appealed denial for timely filing with electronic reports

Mara Rosen-clearing house report states she no longer has that Blue Cross policy-so you have new info?

Much of the work you do is not just the data entry of the claims and payments but your providers may not have a clue as to the extent of this other work. If you are in the habit of letting the provider know, they will value you even more.

A lot of times billing services think that if they are not hearing from the provider then he/she must be happy. That is a really bad assumption. They may be thinking anything from "Wow my billing service is great!" to "Man, what are they doing over there? Sitting around playing solitaire?" If you want to be successful you really need to know what they are thinking. The best way is to ask. There is nothing wrong with getting in touch with a provider and saying "things appear to be going pretty smooth from our end. How do you feel they are going? Is there any areas you are concerned about?"

If they are worried about something they should tell you. Then you can either rectify it if it is something wrong, or clarify it if it's a misunderstanding. Many billing services have lost clients based on lack of communication. It's something that can be easily rectified.

Training a Medical Biller

Training to become a medical biller can be overwhelming. Whether you are an employer who needs to train employees or you are looking to become a medical biller, good training is crucial. When we have a new employee the training process is intense. It is important that the new employee learn how we do things, and become as self-sufficient as possible as quickly as possible.

Of course in the beginning mistakes are going to be made. We start out by having an experienced biller sit directly with the new employee and have the new employee watch what the experienced biller is doing while taking notes. The whole time, the experienced biller is explaining step by step what they are doing, why they are doing it, how they accomplish it, and every other detail that the new employee may need to know. They are also explaining our practice management system, our filing system, our system of receiving information, and how we communicate with our providers. There is so much to show them.

Once we feel that they have observed enough, the experienced biller switches places with the new person and gives them a chance to try things out for themselves. The amount of time that a new person watches before they are ready to try it varies greatly depending on their previous experience and how quick of a learner they are. Once they switch places the experienced worker watches every keystroke to make sure they truly understand. Many times they give verbal instructions the whole time until they are sure the new person has grasped the task.

Once they are able to observe without having to give verbal assistance they will allow the new worker to complete a task and then check it over after they are done. This is still time consuming as it's being done twice basically. But we feel it is necessary in order to be sure the new person is doing things correctly. The experienced worker will check over each item and bring any mistakes back to the new person and show them what they've done incorrectly. We find this is a great tool. Learning from visually looking at your mistakes is the best experience you can give someone.

As you can see the training process (at least in our office) is very intense and very disruptive to normal work flow. It takes two people to do the job of less than one really. The process is slow but if you want the person to be effective you need to take the time in the beginning to make sure they are trained properly. When we bring on a new person it is usually several months before they are up to speed and the person involved in their training can go back to their regular duties.

If you want your employees to be good quality employees then you need to take the time to train them. You can't expect them to give you excellent quality if you haven't taught them how to do that. We find that mistakes take a lot more time to correct on the back end than they do to avoid them up front. If you take the time to properly train the person, it will pay off in the end.

The Basics of UB04 Claim Forms

UB04 claim forms are use by facilities such as hospitals and clinics to submit medical insurance claims to insurance carriers as opposed to CMS1500 claim forms which are used by doctors and other medical providers to submit their claims. This includes drug and alcohol rehab facilities, eating order facilities and surgery centers. When a medical office is classified as a facility with an insurance carrier it is necessary to submit the claims on the UB04 which is much less familiar to most than the CMS1500 form. While most medical billers are very familiar with the CMS1500 form the UB04 form can seem very complicated.

The facility forms look similar to the CMS forms in that they are printed in red ink on white paper. They can be purchased where most CMS forms are available and they can also be submitted electronically as well as on paper.

The UBO4 requires a few fields which are totally different than fields required on the CMS form. Some of these fields include Rev Codes, type of bill, condition codes, and value codes which can make it terribly confusing to the biller only familiar with CMS forms. In order to get UB04 claims paid, the biller must learn what these fields are and how to complete them correctly for their situation. Many of the other fields on the UBO4 form are similar to the CMS form but these few different ones must be completed correctly.

Many of the boxes on this form are not required for other than hospital billing so the biller must know which boxes must be filled. In order to avoid time consuming resubmissions for denials of these claims you want to make sure they are completed correctly. Charges for claims files on UBO4 forms generally are higher than charges billed for many medical specialties so the amount of money tied up when claims are denied for incorrect information can be substantial.

It is not unusual for many of the clinics and facilities to be out of network with most insurance carriers and therefore not billing on the UB04 forms as they are not billing the insurance carriers, they are collecting the payment from the patients. But some of these patients are finding out that they have out of network benefits which means the insurance carrier would reimburse them for all or part of the expenses. The patients are then responsible for billing the insurance carriers. The insurance carriers may then demand that the claims be submitted on UB04 forms and it ends up the responsibility of the confused patient.

Stop the Bleeding! - Ways to Prevent Unnecessary Loss of Income During These Hard Times

For most Americans, whether or not the government has officially declared these times as a recession or a depression, things are a little tougher than they were 10 years ago. This includes doctors. Many patients think that all doctors are living good and aren't hurting like "the rest of us" but that isn't true. Doctors are feeling the pinch now too. After all there are a lot of expenses in running a medical office, especially with all of the changes going on with EMR and ICD 10.

They have the normal expenses of office space rent, taxes, receptionist(s), nurse(s), physician help (NP's or PA's), insurance, office supplies, utilities, computers, software, and the list goes on. In addition to that many are faced with needing to buy new software to be compliant with the EMR laws and training expenses to prepare their staff for the switch to ICD 10. Most patients really don't have any idea how much a doctor has to pay just to keep their office open.

Now more than ever medical providers need to "stop the bleeding" by plugging the holes in their office that are causing them to lose money. One of those holes for many providers are denials. I read a statistic a while back that said that 47% of denied claims are never appealed. To me, that number is staggering. Sure there are claims that are denied correctly, the services may not be covered, or the patient may have met a maximum and the patient is responsible for the charges. But I don't believe it can be that many. And unfortunately, I've been in enough medical offices to know that many have office staff that are just not dealing with the denials.

I have found there are a couple of different reasons why denials in an office can go neglected. One of them is due to lack of time. Many offices are chaotic. They not only have the regular patient load, which in and of itself is enough to keep them running all day, but they have the add on patients who just have to be seen immediately. In addition, they've got the phones ringing, someone has called in sick so they are short handed, and they've got pharmaceutical reps coming in. You get the picture. They barely have time to get the billing out, possibly record the payments that have come in, but handling denials? Maybe they will get to those tomorrow. Unfortunately tomorrow never (or at least not usually) comes.

The staff isn't purposely ignoring the denials. They truly think they will get to them. The problem is that many insurance carriers have time limits on when a claim can be appealed. Most allow 60 or 90 days from the date the claim was processed to file an appeal. Also, if the denial means that a different insurance needs to be billed the timely filing limits on that carrier may be reached if the denial isn't handled quickly. If the denial means that the patient needs to be billed, the odds of getting payment are greater the closer it is to the date the services were provided. The doctor usually isn't even aware there is a problem. Many times, neither the doctor nor the staff have any idea how much money the office is losing due to these denials not being handled.

Another reason that denials go unresolved is if the staff in the doctors office doesn't know how to handle them. It's not always that they don't have a good comprehension of medical billing, but they don't always know what needs to be done in the case of certain denials. It may be a denial they are unfamiliar with or haven't run across before. Or it may be an insurance carrier that they haven't dealt with much. If they don't know how to handle it then it may go unresolved.

In some cases, doctors hire people to do their billing that don't have a good comprehension of medical billing. In this case not only do the denials go untouched, but there are a larger number of denials than there are in an office with an experienced biller. It is unfortunate, but some providers don't understand the importance of the billing.

No matter the reason that the denials are not being handled, the important thing is that the doctor do something to change it. There are a couple of things that can be done. First, see if there is anything that can be done on the initial billing to prevent any of the denials that are being received. If a doctor is receiving a lot of denials for terminated insurance plans then the staff needs to do a better job of verifying the insurance with the patient at the time of their visit. Maybe they are not asking the patient when they come in if there are any changes in their insurance information. Many patients forget to inform their doctor when they change policies. Having the receptionist ask will cut down on these denials.

Another thing that can be done is to develop a system for handling each denial. Having a system will eliminate the need for the staff to determine what needs to be done each time a denial is received. For example, if the doctor receives a denials for timely filing the staff should know exactly what to do. First, check to see if the claim was originally submitted in a timely manner. If it was, a claim should be reprinted along with proof of the original submission. If the claim was submitted electronically that proof may be an electronic report verifying the first submission. If it was a paper claim, it may be a patient ledger printed out from the practice management system.

In addition to the claim and the proof, an appeal form should be attached. It's best to design a generic one for the insurance carriers that don't have their own adjustment forms. This will cut down on time since the staff can just simply grab the generic form and attach it to the claim and the proof instead of writing up new one each time one is needed. For the carriers that have required adjustment forms, they should be kept handy for quick and easy access.

Having a system in place for each denial will greatly reduce the amount of time needed to file the adjustment request or submit an appeal. It will also make the process easier for the staff so it won't be such a dreaded task. Reducing the number of denials received and having a system for handling those denials will help the staff be able to deal with them in a more timely fashion.

Handling Denials For No Coverage or Coverage Terminated

One of the most important parts of billing is handling denials. Many providers' offices don't handle denials and end up losing thousands of dollars a year as a result. In fact, I saw a statistic once that said that 47% of denied claims don't ever get appealed. That is outstanding! Obviously based on that statistic the insurance companies have a great incentive to deny claims.

There are three reasons that denials don't get appealed. The first is that the denial is correct and there is nothing to appeal. In that case, there is nothing to be done except bill the patient if that is appropriate. The second reason is because the person responsible for handling the denials doesn't have the time to handle them. This problem can be rectified. If the right systems for handling denials are put into place then they can be handled in less time. Most time spent on denials is figuring out what to do about them, which brings us to reason number three.

The third reason that denials don't get appealed is that the person responsible doesn't know what to do about it. Many times they understand what the denial is for, but aren't sure what steps to take to rectify it. So over the next several months we are going to be covering the most common denial reasons and how they can be handled.

One denial that is very common is "denied for no coverage or coverage terminated." Seems pretty straight forward. But what do you do? There are actually a couple of things. First of all, receiving this denial does not mean that it is correct. Our local BCBS denies claims for this reason more often than I use a restroom. Many times it is just because BCBS issued the patient a new ID number or changed just the 3 letter prefix. It can actually be quite frustrating. If we receive a denial from BCBS for this reason we go to the BCBS website and do a search on the patient. In most cases we can pull up the correct ID number and resubmit the claim.

If the denial is for a company that does not have those issues, the next thing I do is look at the patient's claim history. Has the payor been making payments but suddenly stopped? In some cases the payor may have paid claims before and after the date of service they are denying. In that case a call must be made to the insurance carrier to question the denial. Hard to believe but they actually do make mistakes! (sarcasm)

Lastly, if the denial appears correct, or if we cannot find any additional information thru the website or a phone call, then the patient must be contacted. Usually we send out a patient statement with the charges, and a note stating "Your insurance carrier states your coverage was terminated. Please contact

our office with updated insurance information." Many times patients forget to notify the provider when they do have an insurance change. Receiving a bill will prompt them to notify you. Usually they call us and give us the updated information over the phone and the claim can get resubmitted.

The Advantages of Flat Fee Billing

The most common way billing services charge providers for their services is with a percentage of the receivables. This is often based on what is actually paid by the insurance carriers and sometimes the patients depending on the agreement between the billing service and the provider. This type of arrangement often works well for both as it is an incentive for the billing service to do a good job as their pay depends on it. There are both advantages and disadvantages to this way of charging the provider.

First of all, in some states it is illegal for the provider to enter into such an agreement as it is considered fee splitting and prosecutions have resulted. It is not common for providers to be prosecuted for entering into this sort of arrangement but it is a possibility and should be considered. Two states we know of that have fee splitting laws in effect are Florida and NY. So as a billing service you may think you are off the hook because it is only illegal for the provider to enter into this sort of arrangement but not so. The problem for the billing service is that you have entered into a contract that is illegal and unenforceable. So if you end up in court for any reason such as the provider didn't pay you for the last three months, basically your contract may not even protect you at all. It can be found to be an illegal contract and not enforceable.

So what's a billing service to do? Why not consider flat fee billing? Most billing services do not want to consider it as they don't know how to come up with a reasonable flat fee and providers are used to being quoted a percentage so they can't compare your price as easily. So if we tackle these two objections, you can start offering a flat fee instead of a percentage and you may find many advantages.

When a doctor objects to a flat fee for his billing instead of a percentage it is usually just because he can't compare it to other offers. Some providers are not aware that this practice is illegal and when they find out that it can get them in trouble they want to hear about other alternatives. A billing service can explain to the potential provider that they do not ever want to steer a provider toward an action that could be considered illegal or get them in trouble. They are here to help the provider and to keep the provider from doing anything that unintentionally that could be considered a problem later on.

Even if you are in a state that allows percentage billing it can be an advantage to the provider to know up front what it is going to cost him or her every month to have someone taking care of the billing outside of the office. From a billing service standpoint I much prefer a flat fee so I know what I can expect each month. With a flat fee I have a much better idea whether or not we are making a profit on that account. When charging a percentage it can fluctuate enough to leave you wondering if the account is worth the work. There are many circumstances that can affect payment that were in no way caused by the billing service who still did the full amount of work, but because the income was down that month, the billing service doesn't get paid either. Here's an example.

We had a provider sent his information by fax a couple times a month so we didn't see him often. He moved his office and didn't tell us. By the time we found out, so did Medicare who stopped his payments as they will if mail can no longer be delivered to the address they have on file. We filed a new 855I for him and waited three months for his application to process before he started receiving Medicare money again. We also waited three months before we could bill him again.

HIPAA 5010 - What It Is and How It Will Affect You

This is a basic breakdown of the HIPAA 5010. There are much more technical requirements, information and explanations.

Well, most of you should know what 5010 is and how it will affect you. If you don't you must have at least heard about it. It seems that all insurance carrier publications are overflowing with confusing information on this transition and the quickly approaching deadline. So we are going to try to break it down for those who still don't really understand what it is and if they need to do something.

First - what is it? HIPAA 5010 is a federal mandate that requires health plans, clearinghouses, and providers to use new standards in electronic transactions including claims, remittance, eligibility, and claims status requests and responses. HIPAA 5010 is an upgrade from the current mandate, or HIPAA 4010A. The new mandate is supposed to increase transaction uniformity and streamline reimbursement transactions.

The deadline for this new mandate is January 1, 2012. All affected organizations and providers should have long ago begun at the very least testing if they are not already compliant with the 5010 mandate or as Ingenix says "As the deadline approaches, affected health care organizations need to upgrade and test their claims management systems to accommodate 5010 and prevent operational disruptions." This means that if your current software is not compliant with 5010 then you will need to upgrade. And before we reach the deadline you will need to have tested your system to make sure it is compliant. Not doing so before the deadline may result in "operational disruptions" or in terms the provider will understand, mess up the accounts receivable.

So how do you know if you need to do something to prepare for HIPAA 5010? Well, if you submit all claims on paper and you don't receive any ERA's then you don't need to do anything. HIPAA 5010 is for electronic transactions only. That was pretty easy.

If you do submit claims electronically or do receive ERA's then you need to see if your system is compliant. Most people submit claims thru a clearinghouse. If you use a clearinghouse then you need to check with your clearinghouse to make sure they are compliant or to see where they are in the testing phase. Most of the major clearinghouses are prepared. You should also make sure that the practice management system that you use to create your electronic batches is going to be compliant as well. Make sure there is nothing that you need to do on your end.

If you receive your ERA's thru a clearinghouse, again you just need to make sure that they are compliant or are on track to be compliant. If you receive any ERA's directly from the insurance carriers you should check with them to see if there is anything that you need to do on your end.

Some providers or billing services submit claims using their own software as a clearinghouse. If you are one of these people you will need to make sure your software is updated by checking with your vendor.

Proper Use of the 59 Modifier

Many people do not really understand modifiers and when they need to be used. A modifier should never be used just to get higher reimbursement. It shouldn't be just added on to get a code paid. Modifiers should be used when they are required to describe more accurately the procedure performed or service rendered.

The definition of the 59 modifier per the CPT manual is as follows:

Modifier -59: "Distinct Procedural Service: Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day. Modifier 59 is used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. This may represent a different session or patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries)not ordinarily encountered or performed on the same day by the same physician. However, when another already established modifier is appropriate, it should be used rather than modifier 59. Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used."

The 59 modifier is one of the most misused modifiers. The most common reason it should be used is to indicate that two or more procedures were performed at the same visit but to different sites on the body. Unfortunately many times it is used to prevent a service from being bundled or added in with another service on the same claim. It should never be used strictly to prevent a service from being bundled or to bypass the insurance carrier's edit system.

It should also only be used if there is no other more appropriate modifier to describe the relationship between two procedure codes. If there is another modifier that more accurately describes the services being billed then that modifier should be used over the 59 modifier.

When using the 59 modifier to indicate a distinct and separate service, documentation should be in the patient's medical file to substantiate the use of the 59 modifier. The insurance carrier may request medical records to deem if the 59 modifier is being appropriately used. If a provider is going to bill using the 59 modifier they need to make sure they are documenting the services provided in the patient's file, showing that the services were distinct and separate.

Use of the 59 modifier does not require that there is a different and separate diagnosis code for each of the services billed. Also, just having different diagnosis codes for each service does not support the use of the 59 modifier.

An example of appropriate use of the 59 modifier might be if a physical therapist performed both 97140 and 97530 in the same visit. Normally these procedures are considered inclusive. If the 59 modifier is appended to either code they will be allowed separately. However, the 59 modifier should only be added if the two procedures are performed in distinctly separate 15 minute intervals. If the therapist does the codes simultaneously then the 59 modifier should not be used.

Medicare Announces Charging for Enrollment

Medicare will start charging fees for some enrollment applications

Wow, I'm not sure why this surprised me so much but when I saw this email I was surprised. Medicare is going to start charging providers who submit enrollment applications? Well it's not all providers, but still it is going to affect many. But the CMS (Centers for Medicare and Medicaid Services) announced that effective Friday, March 25, 2011 Medicare Administrative Contractors will begin collecting application fees for certain provider/supplier enrollment applications. This is for both paper and online, or PECOS, applications.

How much will this application fee be? That is the first question I had. But the answer is not clear. It appears that they are charging $500 for new enrollments for 2010 but since it wasn't effective until March of 2011 I was left a little perplexed. Anyway, it looks like the fee for 2011 is $512 for new enrollments and $200 for revalidations and/or adding practice locations.

Also, the fee is not applicable to all providers. The fees do not apply to physicians, non-physician practitioners, physician organizations, and non-physician organizations. It is only applicable for institutional providers of medical or other items or services or suppliers. It is applicable for the CMS-855A, CMS-855B (not including physician and non-physician practitioner organizations), and CMS-855S applications.

Personally, I think this is going to cause some major confusion. As if it wasn't hard enough for providers to just figure out what forms need to be submitted, now they need to determine if they need to pay. Also, some of the MAC's (Medicare Administrative Contractors) are already difficult to deal with. (Just for the record, some are very pleasant and helpful.) Now they have another way that they can return apps stating that the fee was not included, even if no fee was needed. As we all know, Medicare being a government agency is full of red tape. If the provider makes a mistake they have to fix it, but if the MAC makes a mistake, the provider still has to fix it.

And I find it very ironic that Medicare is now requiring all providers to accept payments thru EFT (electronic funds transfer) but they are requiring payment for these apps by paper check. They haven't developed a mechanism yet for receiving payment electronically. Of course they will have exceptions based on hardship but those will be determined on a case by case basis at the discretion of the MAC. I think consistency will be an issue there. There is a published document but it was a little difficult to wade thru all 110 pages.

I'm usually a "glass is half full" person and as I read back thru this I feel I'm being quite negative. However, after doing thousands of Medicare applications over the past several years, I have seen many problems in the application process. To me, this addition of a fee is just going to complicate things even more. We'll be watching to see how it plays out!

Patients Have Options for Their Medical Procedure Financing

Today, there are numerous services offered to patients to make their life more convenient. Among them are the options for medical procedure financing. This medical service gives the standard terms concerning the method and treatments for the patients financing plans. Some of the these medical procedures include dermatological procedures, cosmetic dentistry, DNA testing, hair restoration, and many other medical treatments.

Additionally, most of these medical procedure financing services provides credit medical which offers financial aid for eligible patients. Applying and registering in these methods is done through a very simple process. At the same time, it also gives several benefits to people. As a matter of fact, it can arrange interest rate with a repayment option and can definitely secure privacy.

On the other hand, applying for medical procedure financing requires an ICD-9 which can be obtained from the physician. By doing so, the healthcare company can effectively secure every patient's billing. In that case, it is advisable for every patient to inform the insurance company regarding the overall coverage of the methods incorporated into these medical codes. Furthermore, it is also equally important to contact a state's welfare facility to check the patient's eligibility.

In addition, patients can also place their medical billings to a credit card. Moreover, there are also many healthcare establishments that provide credit which can be really beneficial to all patients. Most of the time, promotions are even offered without interest as well. This is conventionally done with a local bank where various options can be chosen such as personal loans.

Furthermore, these healthcare financing methods are available for a large number of health issues. There are also lenders that can assist people with their healthcare loan. However, for those individuals who wish to begin a particular treatment, but don't have the money for it, will need to discuss it with the physician. On the contrary, there are limitations to every credit before a patient can be eligible, though these limits ranges from people based on several aspects.

However, for those individuals who need a fast approval for a healthcare financial aid because of some critical emergency, may get assistance by a health insurance. In contrast, the service may vary based upon the conflict and financial requirements. As a result, it is necessary for people to discuss the matter with a medical associate to determine the most effective billing options. Moreover, every patient will be updated with the procedures concerning all necessary medical documents.

Medical Billing Specialist

Medical billing specialist: this is a person who works in the medical field but not with patients. He or she works to ensure that the billing for services and the coding that must accurately describe the medical condition and treatment given, is properly communicated to the insurance company. There are a number of steps involved in the process of entering this field.

You need to at least graduate high school, and have a background in subjects like science, mathematics, biology, and chemistry. This will help prepare you for advanced classes that will be required when you take billing and coding classes. It is possible to begin employment with a billing company with just a high school education, but realistically a medical billing specialist with a degree is much preferred by these employers for obvious reasons.

Always look for accredited schools, whether you plan to take medical billing classes online or in a traditional classroom. The need for accreditation is the same, because it says to a prospective employer that you received an education from a quality educational institution.

Online  classes can allow you the time flexibility to work in an internship and thus gain experience that will make you more attractive to an employer.

A medical billing specialist needs to become certified as a "Registered Health Information Technician" called the RHIT credential. This certification is given by the AHIMA "American Health Information Management Association." This presumes that you have completed at minimum a two year degree at a school that is properly accredited.

The "Commission on Accreditation for Health Informatics and Information Management Association." (CAHIIM) has a listing online of accredited schools and programs for the field of medical billing specialist. You must attend an accredited school or program to take the certification exam, and receive the credential upon passing the examination.

You can also specialize in one of a number of branches of medicine, that have different billing and coding requirements and procedures. Fields like radiology, cardiology, oncology, etc., provide competitive pay and opportunities for advancement within the field of medical informatics.

As a medical billing specialist, you can also choose work from home medical billing and provide services to clients online, giving you flexibility in your time, and the ability to adjust your work schedule around the demands of your personal life. Work from home billing reflects the information intensive nature of the medical billing field and the trend toward outsourcing billing and coding to independent medical informatics practitioners.

Interested In Medical Billing And Coding? - Get All The Details On This Career

Medical billing and coding is a growing career in the medical field. It is an essential position in any professional medical practice of today. The job has changed a bit over the years, whereas tedious administrative duties used to consist of many hours filling out medical and insurance forms for companies to ensure that the doctors and medical professionals would receive reimbursements in a timely fashion. In this thriving world of technology, and the "paperless" office, insurance billing software is the way most professional offices complete their billing process.

The job, itself, may include resolving any disputes that arise regarding unpaid or pending claims. There are a series of steps and procedures which requires the medical biller and coder needs to follow in order for the process to move along in an expedient manner.

The nature of the position and the process usually depends on the various insurance companies and the criteria that is needed for their diverse requirements of billing and coding. Some medical billing and coding jobs are indeed a challenging task and often it is in the professional offices to outsource the work, due to the fact that they do not employ the capable staff.

In examining this exciting career path, the biggest question is "do I need to be certified"? One of the good things to know is that if you do become certified, a higher starting salary, than those who are not, usually always follows. Outlines of raises and bonuses, as well as, a benefits package including health insurance, sick pay, vacations and holidays.

There are many positions that you may be hired for, where your employer would like you to train on the job, to gain the experience and knowledge from other staff members, that fit their specifics needed. This is a good thing, as it does not overwhelm you with information without experience. In this position you would be allowed to "grow" into the position, and the benefits would be that of spending the time in school, and gaining experience without a classroom curriculum.

What can I expect for a medical billing and coding salary? Well, that does depend on experience, certification, demographics, and if you work in a large medical facility, such as a hospital and institution or a smaller private practice. And lets not rule out becoming an independent contractor, working as an outsourced biller and coder, from home.

On average the starting salary is about $25,000 a year, respectively, and those with more experience and certification, can command as much as $35,000 to $50,000 a year. As you can see, it does pay to have the medical billing and coding education. Not everyone desires to work full time, so a part time position, within this field, or a home based business, can provide them with a very lucrative income.

Medical Claims Billing Software

Medical claims billing software is truly the wave of the future. Electronic medical claim billing will only become more computer oriented as time goes on. Medical billing from home will be increasingly common as companies see telecommuting as a way to lower costs.

This trend would simply not be possible without computerized billing systems that leverage medical billing and coding software to make this process cheaper and more efficient. Combine this with online medical billing and the picture is complete!

Medical claims billing software is the factor that is driving all of this. With new federal rules and guidelines for healthcare information security and privacy, it becomes even more important to employ powerful software to ensure compliance with electronic records standards.

These software packages have many powerful features, and are constantly being upgraded to keep pace with changes in government rules and standards, as well as innovations in electronic medical claim billing that require more sophisticated information processing tools to maintain accuracy and reduce costs.

Examples would be functionality that allows the reporting of any number of metrics in various presentation formats. These might involve identifying potential cost saving practices and areas where efficiency could be improved.

The modern medical practice is besieged with financial and legal factors that become a distraction to the physician who wants to focus on practicing medicine. Medical claims billing software will evolve to go far beyond the billing function, and be able to be totally integrated with other administrative functions of a medical practice.

The impact of cloud computing will also be part of this evolving functionality in medical billing and coding software. The shrink wrapped application may give way to the cloud based processing system that can be run from any location.

Medical billing from home will most likely take advantage of this cloud based approach as the actual brand of software become superfluous, and the billing specialist merely uses cloud based software modules to do the processing.

This software will likely interact with applications in use by the medical office, databases of patient records, and possibly other modules that contain rules for various government security and privacy standards.

Medical Insurance Quotes - Things That Can Affect Your Premiums

Medical insurance quotes are available online to anyone who is need of such coverage and does not want to have wait ages in order to find out how much it is going to cost. However when obtaining these types of quotes there are certain things that need to be considered.

The first of these being their medical history and the other is what insurance company they should be using. Should they go with a better-known large company or a much smaller relatively unknown one?

When you do decide to get medical insurance quotes you must understand that your medical history will dramatically affect how much you pay. Also the quote you get online will only be accurate if you provide specific and accurate information about your current health and previous health problems you may have suffered from. If any of the information that you provide is incorrect then this will change how much the quote is immediately.

Certainly for anyone who suffers from or has suffered from a major illness such as cancer or heart disease the premiums to be paid will be much higher. Also you are likely to find that the level of coverage provided is sketchier. Therefore it is wise to speak to an agent so that they can fully explain the conditions of the policy relating to such illnesses in far more detail.

When getting medical insurance quotes you can go to any insurer you want. However the policy will be completely useless if the company you go to isn't reputable. Make sure that you always select companies where they have received good ratings in relation to customer satisfaction and who have been involved in this area of insurance for a number of years.

Also make sure that you obtain several medical insurance quotes so that you can compare each one. It is important that you don't only look at the premiums being charged but what sort of coverage they offer. This way you can make a more informed decision with regards to policy you take out and it will help to ensure that you find a policy, which meets your needs, the best.