January 01, 2007
5 Minutes With
1. How long have you been in the Billing/Coding industry and how did you get into it in the first place? I started in medical billing and coding back in 1992 when working for Whitney M. Young Jr. Health Center in Albany, NY. I was the office Manager. In 1993, I moved to Florida and saw a homemade ad on a bulletin board for a medical biller. I went to the interview at a company called The Coding Edge and was hired, not for my medical coding and billing knowledge, which was minimal, but on my clinical background in medicine. The owners, James McCuen and Sharon Morikone are the experts in the field and they taught me what I know today. They are my mentors.
2. What are some of the tools you use to stay abreast of issues in this industry? I use everything I can get my hands on. I use the Internet for most of what I do. I go to insurance company websites and read their provider handbooks as well as their policies and procedures. I read State laws, provider health insurance contracts and patient benefit manuals. I go to the various medical society websites, and I read many Medical Billing newsletters and magazines such as the Medical Association of Biller's, Codetrends and naturally BC Advantage magazine. For every move I make, the insurance company makes two, so you have to try and stay several steps ahead to keep up.
3. What would you consider to be your most personal valuable asset? My love for this business, my desire to help the provider increase revenue and decrease problems with the insurance companies, and my commitment to sharing my information with my fellow coders and billers. Knowledge is power and it must be shared so we all become better.
4. In 2006, the toughest issue you faced was? There were just a few. The first was my provider, Arthur Diskin, losing his practices to another provider. I've spent the year doing the cleanup. I can say I worked hard getting him 5 and 6 figure settlements. Dr. Diskin is not just an excellent physician; he cares about the people around him so we all felt his loss. The other was just losing my new job I acquired 3 months ago. They too are downsizing, so to those who are new to the business, it can happen to any of us. So, I need to dust off my resume, shine my Buster Browns and hit the pavement again
5. What would you say that you are most proud of in your career? I'm proud to be a part of a growing industry. Today, doctors face many challenges and it is not easy being a businessperson and a provider. Doctors need people like us, who are not afraid of the insurance industry, who are not afraid to fight the appeals and denials, and who loves what we do. I want the doctor to keep his mind on the patient and not worry about all of the things taking place in the background. Leave that to us. I am proud to be the forum moderator of the Medical Association of Biller's free Medical Coding and Billing forum. I've posted almost 7,000 responses there. I am also proud to be associated with some of the best people around like Liz Jones of the Medical Association of Billers, James and Sharon of The Coding Edge, Linda Bungarn in Ohio, Valerie Merritt of NvHima, Duane Johnson of Synergy, David Hamilton of Mnet, Dr. Jin Zou the Godfather of ERISA, and all of the people who help on the MAB forum. No amount of money can replace friends like these.
6. What do you think will be a major change for you in 2007? I do hope to find myself employed again. I also hope we can get the insurance companies to stop fighting us and work with us. I want the medical billers and providers to start re-thinking of responsibilities. With healthcare being provided by the employers, we need to put the responsibilities where it lies - the patient and employer. I hope to continue to go around the country and give seminars so that my knowledge can be passed on to the next generation of medical coders and billers.
7. You have published and co-published several books on billing/coding. Do you have any more in the pipeline? Yes. I am currently writing a whole new book on medical billing. I want to get out of the 20th century and move forward into the 21st century. A medical biller of today is much more than someone with knowledge of anatomy, medical terminology, the basics of ICD-9/HCPCS/CPT, and knowing about the CMS 1500 and EOB. Today, medical billers need to know prompt pay laws, ERISA, provider health insurance contracts, the patient benefit manual, who is responsible for appealing a denial, actually appealing a denial to win, accounts receivables, attorney demands, what someone new must do if they want to work from home, and much more. This new book will explain all of this. Once done, I will re-create a whole new medical billing training program to conform to the new ways in which we need to do things. In addition, I am creating small billing reference guidelines for each State. The guidelines tell you the prompt pay laws, timely filing issues, PIP coverage, HMO laws, workers' Compensation and much more. I have Florida, Ohio and Pennsylvania completed and I am almost done with Illinois. They are very interesting because no two states have the same thing.
8. Finally, any tips for someone just entering the industry? I have many but I will provide a few. The one question I am asked a lot is: "I am new and what do I need to work from home." I recommend training and certification through a reputable organization such as the Medical Association of Billers. Don't let cost guide you. I've seen people spend $36,000 and come out knowing nothing. Investigate not just the school but where you live. Ask providers if they will hire you once you complete your training. If you get a no, why spend the money and then not be hired? The successes in business always researched before doing anything. Use support groups like the MAB and BC Advantage. Don't be afraid of change.
Steven M. Verno, CMBSI, CMMB, CMMC, NREMT-P Director of Reimbursement, Compliance Director Medical Association of Billers Email: firstname.lastname@example.org