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Thread Topic: billing from home
Topic Originator: Tammy
Post Date August 1, 2005 @ 1:17 PM
billing from home


Tammy
August 1, 2005 @ 1:17 PM Reply  |  Email Friend   |  |Print  |  Top

Does anyone know of any good companies to do billing at home. Please let me know. I have three years experience. thanks.

Sue
June 1, 2006 @ 11:32 AM Reply  |  Email Friend   |  |Print  |  Top

Hi, Tammy
I don't know how this thing works to get any answers from people, but I am looking for the same thing as you are. Billing from home. You hear that it's the "hottest, latest thing to do" but you never see any reputable companies advertise for positions open. The ads in trade journals say that you can make X thousands of dollars a week, and they "will train", but when I looked in to that, for curiosity's sake, the "catch" is that you have to BUY their medical software. We all KNEW there had to be a catch to that.
So, if anybody out there has ever encountered a REAL billing company that will let you bill from home, please get back with me, and of course, with Tammy.
Sue

Dan Young
June 1, 2006 @ 12:09 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Sue,
I am a partner in our billing company, Resolutions Billing & Consulting, Inc., located in Gilbert, AZ.  We are the state chapter for the Medical Association of Billers.  Our business model includes having billers working inhouse as well as working from home.  We can do this because we use web-based billing software which allows us to bill from any computer that has broadband connection to the internet.  Our home-based billers must be highly qualified and be able to work independently, without supervision.  We also utilize interns (externs, whatever) to see if they have what it takes to be a biller/coder.  I would encourage you to take an online course in medical billing to see if you personally like the work.  Also, contact a local billing company to see if they would allow you to intern with them.  You would probably do a lot of filing, but that is part of the grunt work in medical billing.  As the VP of Operations, I still do filing, posting of payments, folding HCFAs, stuffing envelopes, faxing, scanning, researching, etc.  Good luck in persuing a career in medical billing or whatever your heart desires.

Dan

Sue
June 1, 2006 @ 3:32 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Dan, thanks for the reply. I just wanted to let you know that I AM a Biller/Coder and have been for 8 years. I have a CMBS and sat for the CPC, but I have to take it again by December. Blah! It was my own fault, I got there late and didn't get to finish it. Bad timing, oh well. I have taken the whole course, in person, for billing, and on line for Coding. And I really DO love the field!! People think I'm nuts, because it is so intricate and precise. My area of expertise seems to be revenue recapture, because it doesn't necessarily require SPEED like billing does, but does require in depth knowledge of the rules and regulations of the CCI, Medicare, Medicaid, etc. My "pitbull" attitude doesn't hurt either..I never let go of something once I bite into it. I love the research involved, including looking up back articles of different publications with updates on rules that I love to send to the insurance companies to prove them wrong. I recovered close to $800,000 in revenue about to be written off for my Docs (4 OBGYN's) and that's the greatest feeling in the world.
Sue

Dan Young
June 1, 2006 @ 3:48 PM Reply  |  Email Friend   |  |Print  |  Top

Sue,
thanks for getting back to me.  What state are you located in?  You sound like the kind of biller that is needed today in the billing industry.  We like to keep our docs' aging at or below 5% at the 120.  Right now we are at 2%, and that is really bugging us because we know it is an issue beyond our control.  you may correspond directly to me at dan@resolutionsbilling.com

Dan

sue
June 1, 2006 @ 4:26 PM Reply  |  Email Friend   |  |Print  |  Top

Dan, check your e mail
Sue

Ro
June 1, 2006 @ 4:33 PM Reply  |  Email Friend   |  |Print  |  Top

Speed in billing?  You mean coding, don't you?  You don't need any more speed in billing than you do in any office-environment type job.  I mean, sure, you need to get the job done, but "she sure was speedy" isn't something I'd normally be saying about even my best biller, or ME for that matter!  LOL!

Sue
June 1, 2006 @ 6:42 PM Reply  |  Email Friend   |  |Print  |  Top

Ro,
Oh, yes I sure DO mean Billing! At this Pediatrics office I was referring to, they had 16 physicians and two shifts of billers entering information as fast as humanly possible. Incentives were given to increase the number of encounter forms they could get through in one day. And that wasn't the first place I encountered where speed was more important than accuracy. In fact, I was even told (at an outsourcing billing company) when I questioned a physician's unbundling of a surgery, "Doesn't matter, just get them all in by 2:00." Lovely.

Ro
June 1, 2006 @ 7:38 PM Reply  |  Email Friend   |  |Print  |  Top

Oh, it's a matter of semantics, then, as I would call those personnel "data entry clerks".  That's the thing - with the exception of coders, and the fact that in many offices the reimbursement cycle can be split amongst a seemingly infinite number of employees, the term "biller" really doesn't have a standard definition!  Like someone I used to work with once said, "be careful when evaluationg resumes.  'Biller' can mean anything from Financial Administrator to the person who stuffs the claim in the envelopes!"

Crystal Campana,CPC,CCP
June 2, 2006 @ 3:20 PM Reply  |  Email Friend   |  |Print  |  Top

Sue,
I work at a billing/management company and I have told them that I am a compliance profesional and I enter my charges and code my op notes correct cause when you enter it in correct the first time then you wont have all those denals. I also am account manager. My boss noticed that I have few denals than the other workers. See I too had a doctor to come down on me for not unbunling his op note. I spoke to him in a calm manner. Then I inform him I am a CCP threw the Fraud & Abuse institute and they have taught me alot about sending claims the right way. My boss also gave me a practice to manage and no can manage it cause the doctors wife is the office manager. Everybody at work says how can you handle her. I tell them she likes money and I get her claims paid the first time around. Now I now I cant help when the insurance company has no claim on file but I keep on it  and it gets pd within 45 days of the time I first send it. I even call the ins company to get their fax number. I send it with a fax sheet with compliance on it so only the person I address it to to get it instead of anyone else. So it is easy to handle the office manager and doctors. If you let them aware you are for them and not for yourself then they are happy. A happy account is a easy management account.

Crystal

Ro
June 2, 2006 @ 7:52 PM Reply  |  Email Friend   |  |Print  |  Top

You speak the truth, Crystal.  I worked for an MSO and I handled the most difficult account.  Previous employees had quit over this account, or had been asked to be moved to another account.  On the other hand, the client loved my work so much he tried to get out of his MSO and hire me to work for him.  When my coworkers asked my secret, I pointed out that previously, the most money anyone else could collect for him was $500,000/mo.  I was collecting anywhere from $800,000 to $1,000,000.

Too bad the MSO didn't appreciate me as much as their client did, or they would have paid me enough money to stay!  LOL!

Sue
June 2, 2006 @ 10:24 PM Reply  |  Email Friend   |  |Print  |  Top

EXACTLY! Semantics. This place made me feel like the world's highest paid data entry clerk. (I guess there are worse things, LOL!) But seriously, I could have done exactly the same thing with no education or certificate, or whatever.

Bibi somwaru
August 3, 2006 @ 9:42 PM Reply  |  Email Friend   |  |Print  |  Top

Hi i am looking for a medical billing/coding job at home, i read that you have the supplies and send it through email.What would i have to do if i am interested in knowing more about your company.I am still enrolled in school and there will be an externship program at the end of the school that i will register for to do onlne.Please let me know if i may fit a catagory to work for your company at home.I may not have previous experience but i promise that i will work very hard to have you get the confident to have me work from my home for your company.Thank you in advance for your cooperation.

Sue
August 3, 2006 @ 11:52 PM Reply  |  Email Friend   |  |Print  |  Top

Bibi, honey, I have some bad news for you. And I think the rest of you out there will agree with me here, getting a position coding from home with no experience behind you, and no particular account (Dr's office) waiting in the wings to buy your hardware and software for you..is something like rolling a snowball uphill in the middle of August in Florida, before it melts. Aint gonna happen. I really do hate to burst your bubble, but in order to work from home, you need a start up capital of around a hundred thousand dollars. No, I am not kidding. The places that advertise that they are a school, you take their courses on line, you may or may not become Certified (not by the school, but by the governing body AAPC.) , and then what? Well you have to go out and find Docs that are willing to let you do their billing from your home. And how do you do billing from home? NOT on your Mac or Apple laptop, I can tell you that.

I really suggest that you go to the AAPC website and look at what they have to say, or even write them an e mail about it. Sorry.

Sue
August 3, 2006 @ 11:52 PM Reply  |  Email Friend   |  |Print  |  Top

Bibi, honey, I have some bad news for you. And I think the rest of you out there will agree with me here, getting a position coding from home with no experience behind you, and no particular account (Dr's office) waiting in the wings to buy your hardware and software for you..is something like rolling a snowball uphill in the middle of August in Florida, before it melts. Aint gonna happen. I really do hate to burst your bubble, but in order to work from home, you need a start up capital of around a hundred thousand dollars. No, I am not kidding. The places that advertise that they are a school, you take their courses on line, you may or may not become Certified (not by the school, but by the governing body AAPC.) , and then what? Well you have to go out and find Docs that are willing to let you do their billing from your home. And how do you do billing from home? NOT on your Mac or Apple laptop, I can tell you that.

I really suggest that you go to the AAPC website and look at what they have to say, or even write them an e mail about it. Sorry.

Carrielynne Handcox
August 9, 2006 @ 11:24 AM Reply  |  Email Friend   |  |Print  |  Top

Carrielynne Handcox, CBCS, CMT, CMAA
900 West Sunnyside Street
Apartment 3E
Chicago, Illinois 60640
(773) 450-1789
(773) 878-2975
     chandcox00@aol.com

Proficiencies:
"     Microsoft Office 97, 98, 2000, XP, NT and Windows applications including Word, Excel, PowerPoint and Access, QuickBooks 98
"     Certified Office Administration Specialist
"     Experienced medical malpractice legal administrative assistant
"     Extensive experience in administration and management administration support
"     Proficient in records management for clients and employees and human resource law
"     Excellent office, computer, communication, transcription and organizational skills
"     MediSoft (Healthcare Administration)  and PeopleSoft (Human Resources) experience
"     Proficient in legal office procedures, law essentials, administrative office procedures
"     Proficient in Netscape and Microsoft Explorer, Internet researches, Outlook/Lotus Notes email functions
"     National accreditation  CBCS, Certified Billing and Coding Specialist  National Healthcareer Association
"     National accreditation  CMAA, Certified Medical Administrative Assistant  National Healthcareer Association
"     National accreditation  CMT, Certified Medical Transcriptionist  National Healthcareer Association
"     CCS-P  Pending AHIMA certification examination
"     Medical Terminology, Medical Law and Ethics, HIPAA Training
"     Advanced Physicians and Facility ICD-9-CM and CPT-4 Coding, HCPCS Knowledge
"     Medical Billing Insurance Specialist - Medical Coding Associate Certification - Medical Transcription Certification Medical Office Administration Specialist
"     Completion of Pharmacy Technology, Pharmacy Practice Essentials courses
"     Completion of in-house courses such as Time Management, Problem Solving and Conflict Management, Business Communications and Professional Development
"     
Work Experience:
TechSkills Institute - 2004 to Present
Health Services and Professional Business Skills Programs Training Coordinator/Instructor
"     Project Management and Support;  
"     Health Services MicroLab instructor  combined with delivery of training and microlab development  classes include Advanced ICD-9-CM and CPT coding, medical terminology, human anatomy and physiology, pathophysiology, HIPAA law and ethics.
"     Professional Business Skills instructor for Accounting and Office Administration classes
"     Management of Student Learner Management System (LMS);
"     Course Book Ordering / Inventory
"     Coordinator of student completion of course materials and hands-on labs.
"     Proactively coach, and coordinate students through course study and completion.
"     Establish long and short-term goals, timelines and completion schedules.
"     Provided specific program instruction, hands-on exercises for students; Conduct prospective student interviews and consultations
"     Coordinate student completion of course materials and hands-on labs.
"     Proactively contact students to get them involved in their course study and completion.
"     Assist students with the establishment of long and short-term goals, timelines and completion schedules with each student.
"     Record student progress and completion information in the Learner Management System (LMS).
First American Billing Service  January, 2001  May, 2004
       Office Administrator - Medical Insurance Specialist
Responsibilities included;
"     Review of itemized charges, bills or personal data forms for accuracy and/or completeness, completion insurance claim forms based on the data that is provided on itemized bills, claim worksheets or hospital admissions records, which requires the
"     Identification and interpretation of the information to be coded and recorded on the claim forms
"     Correcting or editing insurance claim forms based on verbal or written communication with third party payers
"     Review of payment records and post or adjust records as required.
"     MediSoft database maintenance.
"     Created fee schedules for patients who cannot afford to pay the bill right away and keep track of those schedules until the amount due is paid.
"     Posting of payments
"     Working with insurance companies to resolve discrepancies
"     Experience with online Accounts Receivable systems.  Gained extensive knowledge of insurance carrier procedures
"     Supervisor and administrative team leader to office administration staff
"     Recognized leader in the utilization of claims policies and procedures to handle complex/non-routine claims.
"     Independently review, evaluate, and settle complex/non-routine claims.
"     Serve as an expert resource on complex/non-routine claim issues
"     Independently coordinate/lead special projects.
"     Assist in the training of less experienced claim handlers.
"     Prepare written or computerized correspondence to clients and providers.
"     Resolve claim inquiries from both client and provider.

Bank One Corporation - November, 1999 - December, 2000
        Executive Administrative Assistant - Human Resources
Providing administrative support to Human Resource SVP and 6 person recruiting team including dual support as meeting and event planner which Responsibilities included:
"     coordinating logistics for in-house meetings and external seminars
"     communication and project completion with external vendors, specifically hotel personnel, catering companies, a/v suppliers as vendor liaison
"     organizing speaker communications
"     traveling nationally to and providing extensive support at the annual conference and training seminars as training coordinator  
"     Processing of hiring employees into the PeopleSoft HR database.
"     Standard administrative duties were word processing, letter composition, heavy telephone client contact, customer service duties for existing employees, bank clients and bank partners, file maintenance, assistance in the training of newly hired HR
Administrative support personnel.
"     Provided calendar management, travel, time & expense reporting, meeting planning, phone support, coordinated and maintained business schedules for SVP and six recruiters.
"     Maintained and generated spreadsheets/reports/charts.
"     Coordinated business meetings/video and audio conference calls.
"     Coordinated corporate functions including national training sessions, and in-house training, local city job fairs.
"     Organized travel and hotel accommodations for management with heavy travel schedules.  
"     Conducted office procedures training seminars for in-house administrative staff, including Microsoft Word, Word Perfect, Excel, PowerPoint, and Access
"     Payment and processing of all department vendor invoices for payment with an annual budget of $150K.



Salem Services, Incorporated - December, 1994 - October, 1999
        Senior and Executive Administrative Assistant
Long Term "temp" assigned to several corporations, legal firms and medical offices (management and senior management levels included) in the Chicago downtown area and suburbs of Chicago to perform administrative duties.  Coordinated corporate functions including national training sessions, and in-house training, local city job fairs. Vendor and contractor liaison.  Various administrative duties which included extensive travel/meeting plans, calendaring, reports, presentations, expense reports, conference calls, projects and helping coordinate training events and department functions.  Provided administrative assistance for several medical malpractice and corporate litigation attorneys.  

Tabernacle Community Hospital and Medical Center -March, 1981-September, 1994
        Medical Administrative Secretary in Outpatient Psychiatric Unit.
Responsibilities included maintenance of physician schedules, outpatient scheduling, processing of State and Federal patient claims for payment, resolving insurance company issues, corresponding with Medicare and Medicaid for payment resolution.    This position evolved over time and included medical administrative assistant and administrative assistant positions.

Carrielynne Handcox
August 9, 2006 @ 11:25 AM Reply  |  Email Friend   |  |Print  |  Top

Carrielynne Handcox, CBCS, CMT, CMAA
900 West Sunnyside Street
Apartment 3E
Chicago, Illinois 60640
(773) 450-1789
(773) 878-2975
     chandcox00@aol.com

Proficiencies:
"     Microsoft Office 97, 98, 2000, XP, NT and Windows applications including Word, Excel, PowerPoint and Access, QuickBooks 98
"     Certified Office Administration Specialist
"     Experienced medical malpractice legal administrative assistant
"     Extensive experience in administration and management administration support
"     Proficient in records management for clients and employees and human resource law
"     Excellent office, computer, communication, transcription and organizational skills
"     MediSoft (Healthcare Administration)  and PeopleSoft (Human Resources) experience
"     Proficient in legal office procedures, law essentials, administrative office procedures
"     Proficient in Netscape and Microsoft Explorer, Internet researches, Outlook/Lotus Notes email functions
"     National accreditation  CBCS, Certified Billing and Coding Specialist  National Healthcareer Association
"     National accreditation  CMAA, Certified Medical Administrative Assistant  National Healthcareer Association
"     National accreditation  CMT, Certified Medical Transcriptionist  National Healthcareer Association
"     CCS-P  Pending AHIMA certification examination
"     Medical Terminology, Medical Law and Ethics, HIPAA Training
"     Advanced Physicians and Facility ICD-9-CM and CPT-4 Coding, HCPCS Knowledge
"     Medical Billing Insurance Specialist - Medical Coding Associate Certification - Medical Transcription Certification Medical Office Administration Specialist
"     Completion of Pharmacy Technology, Pharmacy Practice Essentials courses
"     Completion of in-house courses such as Time Management, Problem Solving and Conflict Management, Business Communications and Professional Development
"     
Work Experience:
TechSkills Institute - 2004 to Present
Health Services and Professional Business Skills Programs Training Coordinator/Instructor
"     Project Management and Support;  
"     Health Services MicroLab instructor  combined with delivery of training and microlab development  classes include Advanced ICD-9-CM and CPT coding, medical terminology, human anatomy and physiology, pathophysiology, HIPAA law and ethics.
"     Professional Business Skills instructor for Accounting and Office Administration classes
"     Management of Student Learner Management System (LMS);
"     Course Book Ordering / Inventory
"     Coordinator of student completion of course materials and hands-on labs.
"     Proactively coach, and coordinate students through course study and completion.
"     Establish long and short-term goals, timelines and completion schedules.
"     Provided specific program instruction, hands-on exercises for students; Conduct prospective student interviews and consultations
"     Coordinate student completion of course materials and hands-on labs.
"     Proactively contact students to get them involved in their course study and completion.
"     Assist students with the establishment of long and short-term goals, timelines and completion schedules with each student.
"     Record student progress and completion information in the Learner Management System (LMS).
First American Billing Service  January, 2001  May, 2004
       Office Administrator - Medical Insurance Specialist
Responsibilities included;
"     Review of itemized charges, bills or personal data forms for accuracy and/or completeness, completion insurance claim forms based on the data that is provided on itemized bills, claim worksheets or hospital admissions records, which requires the
"     Identification and interpretation of the information to be coded and recorded on the claim forms
"     Correcting or editing insurance claim forms based on verbal or written communication with third party payers
"     Review of payment records and post or adjust records as required.
"     MediSoft database maintenance.
"     Created fee schedules for patients who cannot afford to pay the bill right away and keep track of those schedules until the amount due is paid.
"     Posting of payments
"     Working with insurance companies to resolve discrepancies
"     Experience with online Accounts Receivable systems.  Gained extensive knowledge of insurance carrier procedures
"     Supervisor and administrative team leader to office administration staff
"     Recognized leader in the utilization of claims policies and procedures to handle complex/non-routine claims.
"     Independently review, evaluate, and settle complex/non-routine claims.
"     Serve as an expert resource on complex/non-routine claim issues
"     Independently coordinate/lead special projects.
"     Assist in the training of less experienced claim handlers.
"     Prepare written or computerized correspondence to clients and providers.
"     Resolve claim inquiries from both client and provider.

Bank One Corporation - November, 1999 - December, 2000
        Executive Administrative Assistant - Human Resources
Providing administrative support to Human Resource SVP and 6 person recruiting team including dual support as meeting and event planner which Responsibilities included:
"     coordinating logistics for in-house meetings and external seminars
"     communication and project completion with external vendors, specifically hotel personnel, catering companies, a/v suppliers as vendor liaison
"     organizing speaker communications
"     traveling nationally to and providing extensive support at the annual conference and training seminars as training coordinator  
"     Processing of hiring employees into the PeopleSoft HR database.
"     Standard administrative duties were word processing, letter composition, heavy telephone client contact, customer service duties for existing employees, bank clients and bank partners, file maintenance, assistance in the training of newly hired HR
Administrative support personnel.
"     Provided calendar management, travel, time & expense reporting, meeting planning, phone support, coordinated and maintained business schedules for SVP and six recruiters.
"     Maintained and generated spreadsheets/reports/charts.
"     Coordinated business meetings/video and audio conference calls.
"     Coordinated corporate functions including national training sessions, and in-house training, local city job fairs.
"     Organized travel and hotel accommodations for management with heavy travel schedules.  
"     Conducted office procedures training seminars for in-house administrative staff, including Microsoft Word, Word Perfect, Excel, PowerPoint, and Access
"     Payment and processing of all department vendor invoices for payment with an annual budget of $150K.



Salem Services, Incorporated - December, 1994 - October, 1999
        Senior and Executive Administrative Assistant
Long Term "temp" assigned to several corporations, legal firms and medical offices (management and senior management levels included) in the Chicago downtown area and suburbs of Chicago to perform administrative duties.  Coordinated corporate functions including national training sessions, and in-house training, local city job fairs. Vendor and contractor liaison.  Various administrative duties which included extensive travel/meeting plans, calendaring, reports, presentations, expense reports, conference calls, projects and helping coordinate training events and department functions.  Provided administrative assistance for several medical malpractice and corporate litigation attorneys.  

Tabernacle Community Hospital and Medical Center -March, 1981-September, 1994
        Medical Administrative Secretary in Outpatient Psychiatric Unit.
Responsibilities included maintenance of physician schedules, outpatient scheduling, processing of State and Federal patient claims for payment, resolving insurance company issues, corresponding with Medicare and Medicaid for payment resolution.    This position evolved over time and included medical administrative assistant and administrative assistant positions.

Leah
August 9, 2006 @ 7:29 PM Reply  |  Email Friend   |  |Print  |  Top

Carrielynne, unsolicited resumes are SELDOM welcome, but those that aren't even directed to anyone are especially ignored.  Who are you sending this to?

But that's not even what I intended to post about - do you have any idea how unwise it is to post your personal information in a public place?  This board is does not require any kind of registration or verification...heck, it's not even moderated.  And now ANYONE who happens to stumble in knows your real name, your real address, your real phone number, and your real email address.

If I were you I'd contact the administrator of this website and ask them to remove your posts.

Sue
August 9, 2006 @ 7:56 PM Reply  |  Email Friend   |  |Print  |  Top

what in the heck is this long thing? A resume? And why did it come to me?

Amanda
August 23, 2006 @ 8:45 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Dan,
I own a billing service and am contimplating hiring some billers to work from home that live here in my town. Did you hire them as subcontractors or employees?  Also, what is the process of hiring someone to work from home??  Any suggestions or things I should look out for??  Thanks.

Amanda

Amanda
August 23, 2006 @ 8:48 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Dan,
I own a billing service and am contimplating hiring some billers to work from home that live here in my town. Did you hire them as subcontractors or employees?  Also, what is the process of hiring someone to work from home??  Any suggestions or things I should look out for??  Thanks.


**  Also do you have any sort of non compete contract with the billers that work from home??
Amanda

Dan Young
August 24, 2006 @ 12:05 AM Reply  |  Email Friend   |  |Print  |  Top

Amanda,
email me at my business: dan@resolutionsbilling.com

Bina
October 12, 2006 @ 3:29 PM Reply  |  Email Friend   |  |Print  |  Top

Amanda,

What town do you live in?

Cynthia
October 18, 2006 @ 8:58 PM Reply  |  Email Friend   |  |Print  |  Top

Dan,

I can appreciate your comments and my question  to you is, "Am I being unrealistic having recently obtain my CPC and CBCS trying to get a company such as your to even look at hiring someone like myself with only Certifications in hand and not previous coding and billing experience? I live in the Denver Area.

Thanks

Dan Young
October 18, 2006 @ 9:16 PM Reply  |  Email Friend   |  |Print  |  Top

Cynthia,

Feel free to email me at dan@resolutionsbilling.com

Steve Verno
October 19, 2006 @ 10:09 AM Reply  |  Email Friend   |  |Print  |  Top

I've read some of the threads and will try and answer.  I have always felt that a forum like this is a wonderful place to help and to me, answering by e-mail may not usually the best way of helping because others that come to the forum can't see the answer that could help them.  I always think of the person down the line that has the same situation and is looking for an answer.  If they see the same question they have and they see a posted response, then we have accomplished our mission to help.  But, this is my personal opinion.  I personally, am not here for any personal or monetary gain.  I am here to extend my experience and training so that I can help those in need.

This industry is being over advertised simply because there is money to be made.  Not in medical coding or medical billing but the training to become medical billers and coders.  You are bombarded with advertisements that you can make good money by working from home doing medical billing and medical coding.  As a result, people are taking classes that can cost from $300 to $36,000.  Some are on-line, some are correspondence and some are at local community colleges and vo-techs.  As a result, the industry is being glutted with people completing the training.  Here in my area, we have a vo-tech churning out 30 EMTs a month in their EMT class.  These people complete the course and now can't get a job.  Why?  There is only 1 hospital and 1 ambulance company in our area.  So, all the jobs are full. The same is with medical coding and billing.  Doctors are already using an inhouse person to do the coding and billing or they are outsourcing their coding and billing to a billing company.  That doesn't mean there isn't work available.  It's like water in the desert, you have to find it.

Hospitals and medical billing companies are always on the lookout for medical coders.  You do see the advertisements that they want someone with experience.  Well, that is an advertisement.  That doesn't mean you won't get hired if you have no experience.  If they need coders, they will take you if you have the training and certification.  They will train you more, in house, with how they do things their way.  Whether you are allowed to code from home is a different story.   Some will allow you to code from home. Some want you to code from home.  So, don't give up when you see the advertisements.  

Medical Billing is a different ballgame.  Some doctors have been burned by a past medical biller that didn't do the job to their satisfaction and it cost the doctor $$$$ in lost revenue.  As I said, some doctors outsource to a medical billing company.  If your intent is to have the doctor give you 100% of his business, then I will tell you that you won't get the doctor's business.  He doesn't know you, you don't have the experience, and you may not know his specialty.  So, instead of wanting the whole pie, try and get it slice by slice.  Doctors always has money sitting and rotting.  I don't care what an office manager will say to me, I know better.  I once went to a practice and was told by the office manager that their A/R at 120 is 2%.  The doctor had me take a look and the A/R at 120 was 65%  He had more than $2,000,000 in the 120 aging area.  It took me 3 years to get most of it.  Some was uncollectable due to bad information that was taken down and not verified.

Look at how you can get your foot in the door.  If you come to me and tell me you want to work from home because you have 3 kids to take care of, you won't get my business. I'm being honest with you.  It doesn't matter if you say you have 1 child or 500.  To the doctor, your main issue will be taking care of your child or children and not his business.  When will you devote your time to the medical billing when you have a child that needs a bath, meals, diaper changes, going to the pediatrician, grocery store, cleaning the house, holding the child when they are crying or taking care of the child when they are sick.  I know what you are going through because I did it at one point in my life when I worked from home because I had a sick child.  I ended up doing the billing late at night when everyone was asleep.  Today, medical billing is a 100% devoted job.  What you learned in class is about 5% of what you will be doing.  There's 95% that they didn't teach you. You have claims to get out, calls from patients-insurance companies and attorneys, appeals to send, copying to get done, answering written correspondence, answering angry patient calls, and much more.  

Getting the billing job is going to be hard but it is out there.  Yes, you have no experience.  But, you have the training, the desire and the heart to do the job.  You cannot give up when you get a denial.  You have to keep going and do your best to get your foot in the door.  Make an appointment with your personal physician.  Offer your services to do A/R clean-up, offer to be a patient financial rep, offer to do appeals of their denials.  Offer to do a free 1 hour per day internship for the next 30 days.  But, never, never, never give up.  You worked hard for your training and certification.  There may be 10,000 denials but one day a yes will come along.  

Here is a letter I created if you have no experience:

Dear (Name of Provider);

I am sure you receive letters like this all of the time, but I am asking you to take a few minutes out of your busy schedule to read this.  This letter is not your typical request for employment that you would receive from someone else.  I am new to medical billing but I chose to become knowledgeable because I have a desire to help physicians increase their revenue.  I obtained my Associates Degree in Medical Billing which shows I have the desire to learn and a commitment to complete what I started.

Even though I currently have no experience, I am asking you for the opportunity to gain experience.  After all, remember when you first started out in medicine.  Someone gave you the chance to become experienced and now you are a much better physician.  I am asking for that same chance that you were given.  By using my training and my commitment to medical billing, I can offer my services to work your accounts receivables, appeal your claims denials, review your current health insurance contracts and compare how you are being paid by your contracted carriers.  I can also be your financial liaison with your patients to ensure that you obtain the correct insurance information, collect the co-pays and deductibles, and educate the patient about their financial requirements.  

If you are willing to give me a chance, my resume is attached for your review and I have excellent references available upon request.  I can be reached at (number) so you can schedule an interview.  

Very Truly Yours,

Your Name


I hope this has helped.

edna
November 11, 2006 @ 11:53 AM Reply  |  Email Friend   |  |Print  |  Top

did you find anything

Heather
December 27, 2006 @ 11:02 AM Reply  |  Email Friend   |  |Print  |  Top

Can you possibly take a moment and tell me the best way to become a medical biller and coder....

I eventually want to work from home....
I dont know if going thru one of these online courses is a good idea or a waiste cuz not recognized in the real world...

I know you said you have to start in a dr. office, can you work part time or will they expect you to work full time....can I intern part time...is it easy once you have experience to get a home job...

I have a new daughter at home and want to get into this field so I can still raise her, Im sure you know what I mean...Is this a realistic concept for me.....can you help me so I dont wiaste the time and money to try to do this only to find out impossible to get into or to get a home based job...Please if you can help me or refeer me to someone who can help answer Q?.....
Thank you for your time..
Please send response to my email.....hmartist14@hotmail.com
Thank you again
Heather..

Steve Verno
December 28, 2006 @ 4:02 PM Reply  |  Email Friend   |  |Print  |  Top

Heather,

Always, and I repeat, Always undergo training.  Medical coding and medical billing, today, is very complex.  It's not like it used to be in the 1990s.  You have so many variables that must be taken into consideration today.  You CANNOT do medical billing or medical coding successfully by buying a book and software.  Training by a reputable organization is a must.

Here is an example of a real claim I was asked to review:

The doctor gives you a superbill with 99214 checkmarked and 6 different diagnosis codes:  (250.00), (716.9), (600.0), (733.0) (599.0) and (715.9).  There are 3 insurances listed:  Medicare B, Blue Cross and Blue Shield, and Medicaid.  You are given the patient's name, address, date of birth, account number, no social security number (the patient refused to provide it), the charge for the 99214, the doctor's tax id number, and the practice address.  

Attached are copies of the insurance cards.  The Medicare ID card has Part A, 123456789D and nothing else listed.  The BCBS card shows a suitcase and the letters PPO in it.  On the card is listed the patient's name, and R76589401.  The Medicaid card just has a 10 digit number (00986343410.  

Attached to the superbill is a typed narrative.  What is documented is as follows:
S:  Patient here for followup.  There are no complaints and patient is in good health.
O:  There are 11 anatomical systems examined.  All systems listed have "normal findings" written down.
A:  All of the above diagnoses are listed
P:  Return for follow-up in 90 days.

That is all that is on the typed narrative.

I am sure you will enter all of this into the billing software and send the claim.  Everything looks good to you.  To a trained coder or trained medical biller, there are many things that are wrong.  An untrained person will send the claim to Medicare Part B and it will be denied.

Take a few minutes and write down what you see wrong.

I always suggest, before doing anything - research, research and research.

Check out the doctors in your area you might want as a client.  Understand, that if you want to work for a doctor that has a specialty, you should know that specialty because each has it's own nuances with coding and billing.  For example, if you don't know anything about dermatology, how can you be effective in billing or coding dermatology?  Find out if there will be any work avalable when you complete your training.  What will you do if you invest good money in training and then no one will hire you?  That is a problem alot of people are experiencing.  

How do you plan on marketing yourself?  How do you think a doctor will respond when you say, " I want to do medical billing from my home because I am a single mother and I want to be near my child so i can raise her myself."  If you were a doctor, how would you really respond when you hear this?

How much time will you devote to medical billing and how much time will you devote to your home and child?  What will you do if you want to take a vacation?  What will you do if your child becomes sick and you need to devote 10% of your time to getting your child well?  These are things the doctor will be thinking.

How do you plan on getting the data?  Will you hand-key the data into your software?  Lets say it takes you 10 minutes to input the patient's demographic information, the insurance information and the visit information such as date(s) of service, CPT, ICD-9 codes, modifiers, charges, payments, etc.  If a one physician practice sees 32 patients per day, then this equals almost 6 hours of non-stop work for input.  Also remember that you need to set up your databases such as insurance database, charge database, icd-9 database and provider database before you do anything.  This leaves you 2 hours for submitting the claims, answering the phones, processing payments and denials, performing appeals, making copies of charts and doing everything else you need to do.  If you start at 9am and work a regular 8 hour day, without breaks or meals or taking care of the house and your child, you will end your that evening putting in overtime or move it to tomorrow where 2 hours you had has been decreased to catch up on the paperwork and there are lots of paperwork to do.

Do you have the money, not just for training, but for starting your own at home business and being able to live for at least 3-4 months with no income?  There is much more than just having a computer and software.  You are starting a full blown business which requires start up money, business licensing, inspections, equipment, supplies, taxes, government red tape (Federal, State, County & City), zoning issues, insurance against fire and theft, patient privacy issues, enrollment with Medicare and Medicaid as a Billing Agent, electronic agreements, and much more.

What have you done to develop a marketing plan, a business plan, a business proposal, and a compliance plan?  How much will you charge to do the billing?  Go too low, you go broke, go too high, you lost a client.  What will you offer to the provider?  Just sending claims?  Appeals and if you say yes to appeals, do you know how to appeal the different denials or incorrect payments?  Will you follow-up on the claim when it is not paid?  Will you send statements?  If so, how many?  What will your office hours be so that when an insurance company calls, you can take it or calls from patients or attorneys?  Do you know how to handle subpoenas and attorney demands for statements and records?  If you are sent superbills, records, letters and EOBs, where will you keep them and how will you keep them secure?

How will you handle a situation where someone calls you and says they're Mrs. Jones' husband and he needs a copy of the bill sent to him, so you do and now there is a formal complaint with the OCR that you have released private information to a patient's ex-husband who is a stalker, has a court order keeping him away from her and now he has her new address and other information? What is your compliance plan state you will do when you get demands from mothers of adult children, demands from ex-wives to send bills to ex-husbands, and letters from the World Health Organization listing 50 patients by name and they need dates of service, CPT and ICD-9 codes for a survey they are taking and there is no authorization for release of information attached. (This really happened 2 years ago).  How will you handle a patient from New York, who came to your doctor's office (in Miami, Florida) and never gave any insurance information, so you are now billing the patient and you get a letter from a high powered attorney demanding you cease billing the patient because the patient belongs to a New York Medicaid HMO but your doctor is not a New York Medicaid provider? The attorney says you are violating New York Law.  How will you handle a workers comp claim where you are in Ohio and the patient is from Pennsylvania, was injured in Pennsylvania, and crossed the border to see your doctor?
What will you do when you are told to bill the patients auto insurance, then when the claim is denied, the patient calls you and says they were driving their car while working for their employer, then the claim is denied, then the patient says he has coverage through the Veterans Administration and through Medicare?

Heather, I haven't even touched everything else, but after just looking at all of this, do you believe someone can do billing without training?

Interning once you complete your training is an excellent way to learn how things work and it gives you experience.  This is also something you need to research first.  Are there internship possibilities available?

I'm not here to scare you away, I want to wish you every success, but research, research and research before you plunk down one penny.  Is this the profession you want to get into? Can you handle a patient that uses the most foul mouth in the world and threatens you with a lawsuit?  Can you handle a call from an insurance company with the patient on the line and they make you feel like you want to throw it all away?  Can you handle a rude and obnoxious paralegal who makes demands and tells you if they don't get the info in 1 minute they will tell you they deem your claim to be denied?  Can you handle a jerk like me who will make you cry within 1 minute of the call because you sent me a bill that I refuse to pay?  There are many that go into this business and fail, just as with any profession, but for those that succeed, those are the ones that love this business and accept its challenges.  I can tell you that there is nothing like the feeling of seeing a check for a claim that was denied or unpaid.  But the work that was put into it is alot and it was worth it.  This is not a profession for the untrained or those that think this is a job that will make you lots of money with no training or experience.  

I am out of work and have been so for the last 2 months.  You will be going up against people like me who have the training and experience and are also looking for a provider to work for.  Now, Heather, I tell you this because once a doctor advertises for a medical coder or a medical biller and you and I will walk in and who do you think a doctor will hire?  Someone with training, diplomas, certificates, certification,  years of experience, and a list of excellent references of other doctors and who will work in the office or someone with no training, no experience and wants to work from home?  

Good luck to you.

Leah
December 28, 2006 @ 8:03 PM Reply  |  Email Friend   |  |Print  |  Top

Heather, this is not something you can do while you rock your baby.  It takes concentration and dedication, none of which are possible with rugrats underfoot.  Futhermore, most folks who manage to land a remote position or start their own business have years of work experience (because the job is too complicated for employers/provciders to put their trust in a beginner), so by the time you're working at home your daughter will probably be in middle school.

There are exceptions, of course, but you need to know your chances going in.

Also realize this is a VERY crowded, competitive field, and as Steve alluded to, it's difficult to land a position when you do have a resume full of experience and credentials.

Amanda Maldonado
December 29, 2006 @ 2:13 PM Reply  |  Email Friend   |  |Print  |  Top

This is so true, I have a five year old and I have been doing billing for twelve years and he even goes to daycare... billing is not as "easy" as advertised it takes concentration.  I think people think because I work from home I don't work as hard but I actually work harder and takes a lot of time management as well.  Medical billing is an awesome career but you can't just jump into it.  I use the analogy that you wouldn't open a construction company without knowing anything about the constructon busiess and medical billing is the same way.  However don't be discouraged because I do have a friend I correspond with that started her billing service from the ground up with very limited experience and she is very successful

Amanda

Beverly P Taylor
January 2, 2007 @ 10:10 PM Reply  |  Email Friend   |  |Print  |  Top

HELLO

MY NAME IS BEVERLY,

IAM VERY INTERESTED IN MEDICAL BILLING AND CODING.  I DID GRADUATE AT THE TOP OF MY CLASS.. I REALLY AM GETTING INTO THIS BUSINESS AND WOULD LIKE TO DO IT FROM MY HOME.  CAN YOU PLEASE ADVISE?  I NEED AN ANGEL OUT THERE THAT WILL PLACE ME IN THE RIGHT DIRECTION!  WILL SOMEBODY PLEASE RESPOND TO ME  SO THAT I KNOW I AM NOT ALONE.

I WILL AWAIT YOUR REPLY.   GOD BLESS YOU!

Steve Verno
January 3, 2007 @ 12:11 AM Reply  |  Email Friend   |  |Print  |  Top

Beverly,

You are not alone.

Can you please define your request further so we can help.

Dan Young
January 3, 2007 @ 10:51 AM Reply  |  Email Friend   |  |Print  |  Top

Hellow Beverly,

First. a little guidance in email Etiquette.  You should already know that all caps is shouting or yelling.  So, please stop yelling.

Second, if you have read the emails already posted, you should also know that most of your questioning has been answere.  

Now, what is the real issue that prompted you to write?  Are you a high school or college grad?  Have you already taken courses in medical billing?  Have you worked as an extern?  A few more details will help.

Dan
Resolutions Billing & Consulting, Inc.
www.resolutionsbilling.com

Amanda
January 3, 2007 @ 12:28 PM Reply  |  Email Friend   |  |Print  |  Top

Hello...  I totally understand what you are saying Dan but in her defense I often write in all caps as well because that is what I am used to doing in my billing program.  I am much better now but it took a long time to break the habit when writing e-mails.  As far as getting into the business even if you took a medical billing class that is really not enough.  As a matter of fact the old billing service I used to work for I did all of the hiring and I would specifically not hire someone that went to "Medical Billing School", not to take anything away from education but in those schools they don't always teach you correctly or the right way.  We had hired a few billers through the schools and they never worked out.  The best advise I ever gave someone is to work for a billing service, even sometimes instead of paying all that $$$ to go to school offer your time for free to have a medical billing service or doctors office have someone train you so basically you are getting free schooling and they are getting free help its a win, win situation.  Then they will probably hire you since they put all that time into the training.  It may be hard to find someone willing to do that but once you do its a great plan.  I told someone else to do this and they had absolutely no experienc and it worked.  I know if someone came to me and offered their services for "free" training I would take them up on it.  Its better to train someone from scratch sometimes rather than find someone that has potentially bad habits and try to change the bad habits.  Anyway...  just my opinion.  Good luck..  you will do great and congrats for graduating top of your class that is definately something to be proud of!!

Amanda

Debra Zandstra
January 4, 2007 @ 1:03 PM Reply  |  Email Friend   |  |Print  |  Top

As in any business, you need leadership skills and tenacity.   If I had tried to "learn everything" before I began my business, I would still be in limbo.  Just remember, Lee Iaccoca, CEO of Chrysler, who turned it back into a highly profitable company from near doom, did not know how to build a car.  He had never worked on the assembly line, he couldn't tell you how to put the knobs on the radio.  But Mr. Iaccoca knew how to hire the right people for the job.  He knew how to motivate his workers.  When offered the position of CEO, he did not say, "well, I need to spend 2 years on the assembly line, then probably 1 year in Marketing and 3 in Design... "  etc.  
Ask any lawyer if they can recite every law in the books, they cannot.  They simply know where to access the information they need and put it to use for their cause.  I did not know Medical Terminology, and I did not and do not have certification in Medical Coding, but I know where to access the information when I need it.  If you submit 50 claims during a particular week and you have 1 that is not paid correctly, then you research and find out what the problem is, then consult the experts in your network, fix it and resubmit it.  If the problem is much bigger, find a bigger expert to assist you on it.
There are too many people on these boards that are afraid of competition or market saturation.  Let me tell you, there is more than enough work to go around.  Do a good job, employ strong leadership skills, seek the advise and assistance from experts in your field, and you'll do just fine.  I would not advise learning in the doctor's office setting.  The reason most billing centers are doing so well is because most doc's can't seem to hire people with the necessary qualities and skills, and this is not where you want to do your learning.  If you don't feel you have the leadership skills to begin your own business, then that is where your learning must start.  If you are simply buying a job, where you are the sole employee, then yes, take the above advise from others and learn coding and billing.
Debra Zandstra
President / General Manager
Synergy MIS

Steve Verno
January 4, 2007 @ 1:34 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Debbie.

I wish to interject here.  I do concur with what you said, but, using Lee Iacoca as the example, Lee Iacocca did not start his own automotive building business where his sole job was to build cars.  Lets say Lee Iacoca wants to start a company that builds cars and he wants to build them himself, if Lee Iococa doesn't know how to build cars, how is he going to build them from his new business? In this scenario, he is not hiring people to build them, he wants to build them himself with no training or experience in building cars.  Would you feel safe driving a car that was built by someone that doesn't know how to build them?

Steve Verno
January 4, 2007 @ 1:45 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Debbie.

I wish to interject here.  I do concur with what you said, but, using Lee Iacoca as the example, Lee Iacocca did not start his own automotive building business where his sole job was to build cars.  Lets say Lee Iacoca wants to start a company that builds cars and he wants to build them himself, if Lee Iococa doesn't know how to build cars, how is he going to build them from his new business? In this scenario, he is not hiring people to build them, he wants to build them himself with no training or experience in building cars.  Would you feel safe driving a car that was built by someone that doesn't know how to build them?

I agree that if you want to start your business and you don't know how to do the job, you hire those that can and you also research your business.  But I am sure you can agree that if you are going to do the job yourself, you should have the training before you do anything else.

My brother is an excellent cook.  He's been cooking for more than 30 years and his dishes are superb.  He can get work at a small diner or sports bar but he cannot get work at a 5 star hotel or at a ritzy restaurant because he doesn't have the training they require.  He also knows and has said so, just because he knows how to cook, doesn't mean he can open his own restaurant because he doesn't know hot to run one.

My other brother has his master degree in hotel and restaurant management.  He know how to run a hotel or restaurant, but he can't cook a lick, so he knows he needs to hire a cook if he wants to open a restaurant.  I know, my two brothers would do excellent in opening their own restaurant.  They did and it was a failure.  Why?  Location, Location, Location!

Amanda Maldonado
January 4, 2007 @ 2:24 PM Reply  |  Email Friend   |  |Print  |  Top

Yes, you do need skills to do the job and some experience, it would be crazy to start a billing service knowing nothing!!  I sort of resent that we as billing services say that to discourage others from entering into the market because that is so untrue.  I believe as well there is enough work for everyone and have gone out of my way to mentor others starting their own business and have become very good friends over the years.  One friend of mine I helped her get two of her clients, so I don't appreciate being told that my advise had other motives because that is far from the truth.  I do believe that you need training and like the other person said, its one thing to open a billing service and depend on experience billers to run the place its entirely different if you are doing the work yourself.  I remember when I first started out I didn't know up from down.  If you are motivated you can learn very quickly but if you jump right in with no experience and invest all the money for startup you could be setting yourself up for failure.  Also something else to think about is no doctor will hire you to do their billing if you have never done it before at all.  Doctors entrust their livelyhood to you that is a huge responsibility so to take it lightly is not responsible.  Another thing... there are some very good billers that work in doctors offices, just because you own a billing service doesn't make you any better than someone working in a doctors office.  I used to work for a billing service that I would never reccommend.  

See what someone started......

No hurt feelings at all but medical billing is serious business and nobody should "fluff" it up.

Have a great New Year!!


Amanda

Debra Zandstra
January 4, 2007 @ 4:22 PM Reply  |  Email Friend   |  |Print  |  Top

Hello Steve.
I think we're agreeing, we just have two different scenarios.  When someone makes a post that they're considering beginning a medical billing business, you address it as though they're going to be a one-man operation, at least to begin with.  I suppose I address it as though they want to begin a business where they do not necessarily perform the functions, but rather, run the show.  Both scenarios are possible, and I've seen both work very well, even without expertise in coding, billing etc.
As one of my experts that I go to for outside assistance, you've provided me with knowledge, experience and expertise that we do not have within our organization - when we needed it.  I do, of course, have to pay for those services and that's something for business owners to take into consideration.  At some point, I may need a full-time expert, for right now, it's much more cost-effective to outsource on an as-needed basis - rather than hiring an expert employee or spending time (and money) in school learning everything myself.  I just want to give another educated opinion, as we have many, many clients across the country who have begun their medical billing businesses, under both these scenarios, and many without learning the billing processes, coding, and terminology themselves and have become quite successful.   I don't want those entrepreneurs to be overwhelmed or discouraged when considering this industry.  There's alot of success to be had out there for the right people.

Happy New Year! and much success in 2007.

Debra Zandstra
President
Synergy MIS
Synergy Healthcare Resources Corp

Steve Verno
January 4, 2007 @ 7:38 PM Reply  |  Email Friend   |  |Print  |  Top

Good evening Debbie,

You are correct, I am posting my responses based on one person starting their own business with no employees.  This is simply because most of the questions I see are from people that want to start their own at home business by themselves and you are talking on a much more grander scale.

I want the people that see these exchanges to understand that our postings are done so that people can see that there are many different answers out there, therefore they can look and make their own decisions.  

I am very admant about my beliefs simply because I was there myself.  I never went to school to become a medical biller.  I was hired due to my medical clinical background.  My first day on the job, I was so confused at the language these people spoke.  Capitation, EOB, PPO, POS, par and non-par and many other words were foreign to me.  When I was shown a remittance, it was like reading Egyptian.  I couldn't tell if the claim was paid correctly or not.  I had to be coached when making my first call to an insurance company and when the person on the other side said NOF, I said what the heck is that?  I was shown a claim form and had no clue about it at all.  I saw numbers that meant nothing to me.  If it has 55 errors on it, you could have fooled me.  I think I went to the bosses every 5 minutes to ask them what something meant.  This is why I encourage people to undergo training.  I hate to think how I would have been to a doctor if I decided to do all of this myself, with no training, let alone undergo the tasks of setting up my own business. But, over the years, I underwent training, became certified and even became an instructor.  That too was hard work.

Two years ago, I did start my own business, but I was not alone.  MY friend, who was an office manager for his father's pediatric practice and I started our own business.  We did all the right things.  We followed all of the laws, started a corporation, did the DBA thing, came up with the supplies, bought software we both knew was good, developed marketing materials, had all of the licenses and inspections by the fire marshall, and was ready for the world as a company made up of two trained and certified coders/billers.  We sent out more than 500 fliers, did the cold calling, made up the nice baskets of goodies, made the office visits, sent out coupons for free work, did a nice newsletter, and after a year and 1/2 of no responses and no thank you's, we packed it in.  You would think that people would hired us, but all we got was, "Thanks, but we already have someone, or Our A/R is just fine or We don't get claims denials, or we'll think about it or some other excuse.  We did everything correct when it comes to advertising and marketing.  We even went so far as to rent a local hotel conference room and sent out fliers for a free conference on doing appeals.  We found a company to offer free lunch.  We even offered to do one free appeal.  While I taught the seminar, my partner would write and print the appeal for them.  No one attended.  We never received one flier back as a mail return.  

So, I don't want people to make the mistakes I made.  THis is why when someone asks about starting their business, I have no problems in telling them what they need.  I have no issues in sharing my knowledge because I believe that we need to all be on the same sheet of music and by helping each other, we can help our providers better.  Some people think my responses are depressing, well everyone that does this job knows this is not a job of sunshine and roses.  I want them to know that this is a hard profession, but it is highly rewarding, especially when you get an HMO to send you a check for $250,000 when all they would say is No to your appeals.  

As you stated, there are tons of opportunities for work.  Unfortunately, I live in an area that is not so.  Where I live, there are NO doctors, NO hospitals, and NO clinics.  I have to go 30 miles just to get to a location where there is 1 small hospital and about 10 clinics of different specialties. But that does not discourage me.  

I will continue to look hard for work, I will continue to give classes and seminars, and I will continue to support those that want to get into our profession.  I do hope that when someone considers wanting to start their own business, they understand it is not going to be a cakewalk.  In addition to obtaining the proper training, they should contact your company to get the best assistance out there on starting their own business.

Leah
January 4, 2007 @ 8:52 PM Reply  |  Email Friend   |  |Print  |  Top

*sigh*

Here we go again.  I thought by now some of you would have done your homework, but I guess I have to do it for you. ;-)

http://www.osha.gov/pls/epub/wageindex.download?p_file=F11973/WH1297.pdf

You cannot just work for free for someone unless

1) they are a non-for-profit or involved in charitable or religious work

2) it is a structured training program - and no, "gaining experience" is not the same thing as receiving training

Now, if you find a not-for-profit hospital thast includes, in its regular volunteer program, staffing the business office, then go for it.  Or if you find a provider who is willing to set up a structured training program, great.  But if you've already graduated the DOL will probably frown on you "training" with the provider.

Steve Verno
January 4, 2007 @ 10:24 PM Reply  |  Email Friend   |  |Print  |  Top

Leah,

We love you when you get that fire in your eyes!

Like I said, I don't want people to make the mistakes I made.

I appreciate your help very much to keep us on the straight and narrow!

Steve Verno
January 4, 2007 @ 10:24 PM Reply  |  Email Friend   |  |Print  |  Top

Leah,

We love you when you get that fire in your eyes!

Like I said, I don't want people to make the mistakes I made.

I appreciate your help very much to keep us on the straight and narrow!

Amanda
January 4, 2007 @ 11:25 PM Reply  |  Email Friend   |  |Print  |  Top

YOu would not actually hire someone, they would only be basically volunteering and its a win, win situation.  As long as you haven't Hired them I don't see the problem.  I haven't actually "hired" somone in this manner but I know it works for others.

Leah
January 5, 2007 @ 7:40 PM Reply  |  Email Friend   |  |Print  |  Top

Amanda, did you actually explore the links?  Have you even visited the DOL site?  Because if you had, you would see that no one can "volunteer" unless you are a not-for-profit agency or the work being done is of a charitable or religious nature.  And even at that, there are restrictions.

But, I guess it's no big deal, as far as I know no one's ever actually gone to jail for violating the wage and hour laws.  It's just fines that are involved.  Hefty ones.

Amanda Maldonado
January 6, 2007 @ 10:04 AM Reply  |  Email Friend   |  |Print  |  Top

I completely believe you it is just ridiculous that if someone wants free training they can't get it.  I guess maybe you would have to have them sign a contract stating that they are getting training???  I don't know.... its nothing I think I will be doing but I know others have.  Thanks.

Steve Verno
January 6, 2007 @ 2:58 PM Reply  |  Email Friend   |  |Print  |  Top

Lets face it, laws are there and designed to protect people.  Laws are created to instill order out of chaos.  How many of us have broken the law at one time or another?  We all have.  We see the speed limit at 25 and we go 30.  On the highway, the speed limit is 55 and we see people, including the police going 60.

We have laws about not writing off co-pays and deductibles, yet we do it all the time.  We know about the laws concerning professional courtesy and how many of us have used our position to get the doctor to write off the bill.  

Sometimes we need to sit back, take a look at the situation and say to ourselves, is this unethical?  Is this a violation of the law?  or Is this the right thing to do?  I was looking at the time payment plans that my provider still has.  With one, I saw the payments of $5 per month coming in as regular as snow in Colorado.  As I looked into this more, this was a 75 year old woman, paying the the medical care for her 18 year old grandson.  He was an illegal immigrant, living with her and he was unemployed.  All she had was her social security but she made that $5 payment on time.  I saw that there was $200 more to go to pay.  So, I called her and told her that her recent check was her last payment and the bill was considered paid in full.  Now, did I break any laws?  maybe.  Was anyone hurt?  Nope. Is the OIG going to arrest me for doing this?  I don't think so.  Because in my mind, this was the right thing to do for this person.  

If someone wants to intern at a medical billing company for free in exchange for the training and experience, with no pay, yes, it is a violation of the Department of Labor laws.  But, who benefits from this?  The DOL?  Or does the intern and medical billing company benefit at the same time with no one being hurt while this is being done?  Look at how many laws an insurance company violates and what do we do about it? many do nothing.  How many times have we put in overtime to get something done and we don't report the overtime because we want to ensure we get the job done right.  How many times have we gone in, off the clock on a weekend or holiday to catch up on our work? We are supposed to be paid, but, do we do what we did because it was the right thing to do?

As a consultant and instructor, my job is simply to provide an informative guide as to what the laws are, what the guidelines are and how things should be done, but I am not there to be the judge, jury and executioner when I see something happening that is wrong.  Even a real judge looks at all of the evidence before making a decision and sometimes finding someone guilty may not be the best way to handle the situation.

Leah
January 7, 2007 @ 9:03 PM Reply  |  Email Friend   |  |Print  |  Top

It's frustrating that the same laws that prevent unethical come-ones in the way of writing off coinsurances are the same ones that prevent your boss from telling his dentist he can forget the bill when he comes in for a flu shot.

But the laws that severely restrict callling just anyone a "volunteer" are the same ones that guarantee your boss can't just suddenly announce to you that on Tuesday and Thursdays you will heretofore be a "volunteer" and in effect cut your wages by 40%.  They are the same ones that guarantee you will be paid for every hour you work and that if you work over 40 hours you will be paid time-and-a-half.  They are the same laws that guarantee if you work for tips or piece rate you will still get a minimum of $5.75 for every hour you work.

Still think it's unfair?

I, personally will gladly forego a professional discount if it means that the provider down the street can't inflate his census by providing kick-backs to the community, and I, personally am glad to see that a few people who can't get jobs are denied one aveneue of gaining experience (because, let's face it, there are other ways to get your foot in the door) if it means that I am guaranteed that I will be paid for the work I perform.

And my last word on this - it's absolutely no skin off my nose if anyone does this at their own risk - but my whole and sole intention of mentioning that this is against the law is because people here continually SUGGEST this as a way to get their foot in the door.  I think it's highly unethical to be advising people to enter into an illegal arrangement as a means of furthering their career.

If you want to do it, that's fine, but I really don't think anyone here should be suggesting to anyone else that they do it.

Steve Verno
January 8, 2007 @ 3:37 AM Reply  |  Email Friend   |  |Print  |  Top

Leah,

You and I and others that provide advice, all that we can do is advise and suggest. We see the same questions being asked over and over again so, we recommend people get training, we recommend people do their research before starting their own business or taking a class, we suggest doctors have one fee for each procedure instead of many, we suggest doctors collect at the time of service, we suggest that doctors have a financial plan and talk to their patients about their financial responsibility, we suggest doctors and biller verify the information before they send a claim, and we suggest many other things to see that things are done right, but that is all we can do.

When I mentioned a coupon for free work, this meant sending a coupon to have one free appeal done, a free superill audit, a free A/R review, a free review of their HIPAA Compliance plan, or some other free service.  Offering a coupon for a free service or work is something done in business every day.  We get coupons for a free oil change, get a shirt laundered for free, tire rotation, a gallon of gas, free flu shots, or whatever the business wants to give to attract customers.  It has been going on since the first caveman sold car insurance.

What I was just thinking is this, when a law student is on summer break and they go to work interning for a law firm, do they do that for free or are they paid?  When a law student clerks for the US Supreme Court, do they do that for free or do they get paid. I ask this because it is 3am, Im half asleep and it just came into my mind and I am too tired to look it up. Im just being curious about this, that's all.

Debra Zandstra
January 8, 2007 @ 9:11 AM Reply  |  Email Friend   |  |Print  |  Top

How about getting creative and 'paying' for a training session, rather than being designated a volunteer?  The fee can be set by the billing center, and can be set very low.   This way you're not breaking a law.

I'm not an employment attorney, but it sounds reasonable, and legal, to me - and worth checking out.

Debra Zandstra
President / General Manager
Synergy MIS
Synergy Healthcare Resources Corp

Steve Verno
January 8, 2007 @ 10:30 AM Reply  |  Email Friend   |  |Print  |  Top

Debbie,

Excellent idea.

Sometimes as I am working on something, an idea will pop in my head.

I too am not a lawyer, I just sound like one having watched old Perry Mason, Matlock, and Law and Order episodes.  As we all know, the barter system is a legal system of commerce.  This used to be a question asked of Medical Billers because hospitals and some doctors would use the barter system to have the patient work off their debt.  

The hospital or doctor would sign a contract with the patient and the patient would come in for a few hours a day, work doing a particular task and over a period of time, the debt would be paid off and both the hospital/doctor and patient came out in a win-win scenario.  If I owe the hospital $30,000, which is better?  Send my account to a collection agency where I could file for bankruptcy because I can never pay this bill or barter to work off my debt?  The hospital gets work done by me and I get my bill paid.  Heck, it may eventually lead to full or part time work with the hospital.  If I want to work off my $300 debt with the doctor, I come in, have all of the non-disclosure paperwork signed and for a few hours per day, at $6.00 per hour, I call the patient's insurance company to verify benefits, find out how much a patient owes for their deductibles and co-pays and how much the visit will cost the patient.  I call the patient to inform them of how much they need to bring or get other insurance if I found the benefits were terminated.  This can be done because a practice called me last week and told me to bring $73 for my visit because they called my insurance and found out I owed a deductible and they found out how much my 20% would be.  I paid when I went in and so did all of the other patients that came in and I can tell you, no one yelled, screamed or did anything to keep from paying.  One man went to his car to get his wallet.  This did NOT drive patients away because there was standing room only in the waiting room.  So, if they can do it, so can we. BTW, as we speak, I just received a call from a doctor's office where I have an appointment tomorrow at 2pm.  The were reminding me of my appointment.  Now, this practice has all of my information already because I gave them my insurance info when I made the appointment.  It's been one week and they reminded me to bring my insurance cards.  The question I have is, why haven't they called my insurance to check and verify what I gave them last week?  This other practice only had a 24 hour notice of my appointment and they had no problem in calling my insurance, verifying benefits and instead of calling me to remind me of my appointment, they told me how much I needed to bring to the visit to pay my part.  Now, this practice tomorrow will spend the time taking my information again, making copies, sending a claim, waiting weeks to get the EOB to find that I still have $70 to pay on my $300 deductible, and then they will spend months billing me for not only my deductible but my 20% of the allowable until I decide to pay the bill, which I will.  But I will wait until I get the final notice letter to pay because I want to teach this practice a lesson that how they are doing things the way they are, are costing them money.  OK, back on track.

But, imagine how much more revenue this practice can gain, how many less denied claims will be received and how fewer statements can be sent, by using the barter system to have the patient spend a few hours a day, working off their debt instead of sending it to a collection agency and taking a chance that the patient never pays or does pay and the doctor loses 40% of that revenue to the collection agency.

I can't see why there can't be a barter between the medical biller and the provider/hospital/billing company.  A contract is signed where the medical biller would come in and work for a few hours per day, in exchange for the training and experience needed to find a full/part time job or to use that training and experience to accentuate their at home medical billing business.  In the contract, the cost of the training/experience is listed, lets say at $6.00 per hour.  At the end of the barter contract time period, the billing company issues the medical biller a 1099B  and the medical biller issues the company it's 1099B so that both parties report this to the IRS as required.  Anyone can google and read the many articles on the legality of the barter system and the many examples of using the barter system to pay off a medical debt.

Just a thought.

Leah
January 9, 2007 @ 9:27 PM Reply  |  Email Friend   |  |Print  |  Top

Internships,are one of the few types of work that is exempt from  wage and hour laws - I thought that was clear in my posts and the links I provided.  The law student is on an internship arranged by his law school for the purpose of academic credit.  And, actually, a lot of internsips are paid, even though most of the paying once still don't pay a lot.

But an internship is not someone who can't get a job becuase of lack of experience so agrees to work for no remuneration.  It fits all but the first of the six tests - it is not a structured curriculum designed to reiterate what is learned in the classroom. Every time I've seen this suggestion to work for free proffered, it's to someone who has already completed schooling and often even has already done an internship.  They are trained, schooled, and interned - they are just being passed over because of lack of experience.

aesiun
August 15, 2012 @ 1:57 PM Reply  |  Email Friend   |  |Print  |  Top

thanks for this awesome post

Yasmen Mustafa
March 6, 2013 @ 11:01 PM Reply  |  Email Friend   |  |Print  |  Top

Hello,

I am looking for a an experienced podiatry biller/coder, mostly billing but must know how to apply modifers. This is a sub contractor position to work remotly. Please  contact me at mcbprofessionals@yahoo.com for more details.



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