July 01, 2007
5 Minutes With
BC Advantage (BC): How did you start in the industry? Melissa Troise-LoDuca (MTL): When I started in this industry I was 20 years old working at a physical therapy practice. I started at the bottom in the billing department, making follow up calls and just learning the business. I decided there that I would become a certified CPT coder. After my certification I took on a job as a billing specialist at a hospital in New Jersey. After couple of years, I moved to a large billing company from New Jersey that was opening a facility here in Staten Island. This is were I learned everything from setting up clients, computer systems and everything there is to know about coding, billing and sending electronic claims and receiving electronic remittances.
BC: Why start your own medical billing business? MTL: I was tired of working with people that didn't care whether or not the money came in for the provider. I felt that a lot of doctors weren't getting their fair share. I knew that I could do a better job, that I could fight for every dollar, and that the doctor should simply understand what was going on with their money.
My business partner, (my father), and I were speaking one night over dinner and decided to put a business plan together. The first thing we looked at was what type of system to buy and how to get our first client. We liked a couple systems out there, but knew we would have to pay for upgrades. That's when my partner said, let just build our own system, so we did.
BC: You created your own software for your office - why and how? MTL: We just weren't satisfied with what we saw on the market. Being able to customize a program to our needs to enhance workflow efficiency and to keep up with the ever-changing laws was of great importance to us. We felt that this would be the best way we could provide for our clients. We knew we needed to stay up to date with the latest changes in the medical field and it doesn't cost us a thing to upgrade. Larry (my partner) is the system programmer, and with my knowledge of the medical field and his 30+ years in the computer field, it's a great success.
BC: You have a website, how is that working for you and how do you maintain that website effectively? MTL: We do have a website, www.Lmmedbill.tzo.com , I created it myself and we host it on our own network. I started by getting a free web page template online and just started typing away. I am a Microsoft Certified Professional, so I do run my own network with a little help from a company call TZO. Now, my website isn't glamorous, but it has produced a client for us. I signed up for a free listing at superpages.com (yellow pages), and the doctor found our website.
BC: How did you gain the clients that you have now? MTL: Without a doubt I would say networking. I told everyone I knew about our business and asked him or her to spread the word to their doctors. It worked! A family member referred me to my first client. Next, proving to your existing clients that you can provide a better service has worked for us. Having existing clients refer us or give a good recommendation to a new client is worth all the hard work. Marketing is another way, the website, brochures, and postcards. It's a never-ending project; it will be the biggest challenge of my career.
BC: What services do you offer your clients? MTL: We create and maintain a patient database to ensure prompt and accurate payments. We also analyze and update all CPT, ICD-9 and HCPCS codes and evaluate and use the correct modifiers to increase reimbursement amounts. We also provide accounts receivable management and follow up on unpaid claims and outstanding patient balances. We file claim appeals when necessary and provide customized monthly statistical reports tracking business activity and productivity. We also provide training for the doctors and their staff on insurance and billing issues and credentialing and contracting for providers.
BC: What are your businesses strengths? MTL: Besides having 10 years experience in the industry, our biggest strength is our business integrity. We strive to be honest and reliable with our clients as well as their patients. Our clients feel comfortable knowing we are always just a phone call away. They know that we work diligently to always ensure that proper payments are received from insurance companies.
BC: What tools do you use to stay up-to-date in this ever-changing business? MTL: I receive monthly newsletters and email updates from all insurance companies utilized by our clients. I go on the web and communicate in Medical Forums with others in the industry and see what new policies procedures and useful information they can provide. The forum has been a great resource for me.
BC: Where do you see yourself 5 years from now? MTL: Five years from now I see my company and myself much how it is today. Our goal is to maintain our family business vibe while continuing to provide the hands on personal service to our clients.