October 17, 2005
5 Minutes with
BC Advantage (BCA): How did you get into medical billing? Kathy Young (KY): I was offered a job by a doctor to manage his office. He already had a billing company so I figured it couldn't be that difficult to run a physician's office. But as I worked there, I saw that the billing company was not doing a good job and the doctor was unhappy. So he sent me to billing school, paid for it and that is what started me on the road that I am on now. He sent me to Las Vegas Community College. It took me 12 weeks of going every Saturday to earn my certification.
BCA: What is it that you like most about billing? KY: I loved the challenge. I tend to bore easily and need challenges to keep me interested. Medical billing is never boring.
BCA: What is it that you like the least? KY: I dislike the way insurance companies mess with the doctors. Most doctors are good hard working people. I get so irritated when I get a denial for a claim based on flimsy reasoning. I dislike the way insurance companies say over and over again that they did not receive the claim. How is that possible when I billed it electronically? It is discouraging and I believe it is deception on their part.
BCA: Do you have any advice for someone starting out in the industry or perhaps starting their own billing service? KY: Medical billing is a complicated industry and it is not for the "faint of heart". If you start with an education in billing and like to work hard and learn all of the time you will be on your way. If you want to start a billing service then I encourage you to have a lot of experience in billing and medical office management. Doctor's offices depend on the knowledge of their biller. If you want to be independent, then do your homework and learn all there is to know about the billing process and how it affects the doctor's office. Learn all that you can about starting your own business and then go for it. Being self-employed is fun and scary.
BCA: What features/skills do you feel that someone needs to possess to be able to be successful in the business of billing? KY: In order to be successful, you have to know more than the average biller. You will need to know about billing software (you will have to choose your own), know how to audit charts and compare them to the billing that was done, also your state laws regarding billing and collections, coding and business management.
BCA: How do you stay abreast of the changes within the industry? KY: I get billing magazines, on-line information from Medicare, and follow online billing and coding forums. I also read the updates to the Federal Register and the new bulletins/changes from Medicare. I also love to talk to others in this profession. No person can know everything, but everyone in the industry knows something special that I may not know. I want to tap into that knowledge.
BCA: What type of software do you use and why did you choose it? KY: Presently, we are using Prodata. It's a web-based billing system that allows us to access our claims from any high speed internet. It also allows our clients to make their appointments on our software and we can also bill from home if we need to. The key is to shop around to find one that suits your circumstances, call the references with a good set of questions to ask.
BCA: Do you prefer to percentage bill your physician or per claim? KY: I prefer to do billing on a percentage basis. If I work hard, I come out ahead. It also forces me to do my best for the doctor. If I got paid on a per claim basis, where is my incentive to take the claim to completion? Medicare has gotten worried about percentage billing because of the potential for upcoding. I have procedures in place that keeps me from that. My advice is to create policies and procedures that protect you and your client from up-coding.
BCA: How did you find your first client? KY: Finding my first client was hard and expensive. I always said that I would do billing naked in an outhouse if it would get me my first client. Thank the Lord no one took me up on it. We sent out mailers, we phoned; we walked into offices over and over again. We offered to do some AR Recovery for the opportunity to show the doctor what we could do. We would go into the offices with fliers that had coding or billing techniques just to show them that we knew something special that they may not have known. It took us 3 months of hard work to get out first client.
BCA: What methods have you found work best for building your business? KY:The best way is by referrals. Once you get a client, work hard, get the money in and make them happy. Then you can ask them for a referral or endorsement to their doctor friends.
BCA: Have you continued with further education since youve been working as a biller, if so what? KY: Right now I am in a teaching mode but I would be a lousy teacher if I did not keep current.
Kathy Young is a Certified Medical Billing Specialist Instructor and a Certified Compliance Professional with over 16 years experience in the field. She is a proficient biller and collector with an understanding of the importance of compliant billing in today's regulatory atmosphere. She has performed compliance audits for hospitals and clinics around the United States and established three medical billing companies and two medical practices. Kathy owns her own successful billing company, Resolutions Billing & Consulting, Inc in Gilbert, AZ. She is the president of the Arizona Chapter of the Medical Association of Billers and has spoken at several national conferences on "Raising the Standards in Medical Billing". Contact Kathy at Resolutions Billing & Consulting, Inc. 425 W Guadalupe, Suite 117 Gilbert, AZ 85233 Ph: (480) 632-9292.