Medical Billing Coding - Help me, please i dont know where to start, cpt, codes
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Thread Topic: Help me, please i dont know where to start
Topic Originator: babyblue
Post Date November 1, 2007 @ 10:38 PM
Help me, please i dont know where to start

November 1, 2007 @ 10:38 PM Reply  |  Email Friend   |  |Print  |  Top

I would like to have my own medical billing company but i dont know where to start.

A) Do I have to be certified to be a medical biller?
B) What schools or courses can I take online to learn about medical billing

Please help!!!!

Steve Verno
November 3, 2007 @ 11:30 AM Reply  |  Email Friend   |  |Print  |  Top

I've responded to this question about 25,000 times.

Here is the short answer:

1)  You should become certified.  Remember, you are going to compete against every person out there that is already certified that is also looking for the same thing you are.

2)  I recommend taking a course in person.  An Online course can't answer your questions and if you think our profession is easy, think again.  It is hard, intense, and nerve wracking.

I will also give you some honest advice.  Are you ready, financially and emotionally to open a business.  This isn't a lemonade stand or a tupperware party you are starting.  This is a dog eat dog business.  Insurance companies, patients, lawyers and regulatory agencies will eat you alive if you aren't properly trained and prepared for what is out there.  

99% of those wanting to start their home medical billing business fail.  They fail to plan, they fail to understand everything that is needed to operate a full time business and they fail to know the financial requirements of opening a business.  

You are also competing with every student in a university course, in a medical organization course, in an on line course and taking a correspondence course.  That doesn't count the people who want to start their own business with no training and experience.  They too want the same thing you do.  Oh, I forgot to mention, there are those like me, with YEARS of training, experience and certification, also fighting to get the same thing you want.  So, look at what you are up against.

There are only so many doctors, hospitals and billing companies out there.  THEY ARE ALREADY USING SOMEONE TO DO THEIR BILLING!!! The caps are for emphasis because how will you convince someone to give you their business when they are already using someone that got there ahead of you.  For every one opening, there are now more than 2,000 people fighting to get that one job.  Look around the forum here and on other forums to see how desperate people are to find a job.  

Office managers and human resources people are becoming immune to all of the offers they get every day from people looking for work as a medical biller.  All of the nice marketing ideas are now useless.  Ask yourself, if you were visited 100 times a day by someone wanting to sell you a vacuume cleaner, would you even want to answer the door tomorrow?  Think of the doctors offices, hospitals and billing companies that are bombarded every day with fliers, resumes and pamphlets, not to mention the walk-ins.

BEFORE you even THINK of wanting to become a medical biller, try spending one day visiting every doctor, hospital and medical billing company and ask them if they would be willing to use your medical billing business.  If they say NO, what chances do you think you will have after investing time and money only to hear the same answer again?  

People fail because they don't do any research.  Do you believe Medical Billing is simple because an advertisement says it is?  Do you know your state insurance laws?  Do you know what do to do when the patient says F' You when they get a bill from you?  Do you know what ERISA, COBRA, TEFRA, and STARK is?  Does your state have a no-balance billing HMO law?  How about a PIP law?  How do you handle an irate mother who demands you send the bills to her ex-husband?  How you do handle a three way conversation with an HMO and the member with the HMO berating you for billing their member?  How about the complaint from Medicare that you are now being investigated for Medicare Fraud because you let the claim go out with incorrect information? How do you respond to the provider when his claims are being downcoded or procedures are being denied as inclusive and the HMO says what was paid is correct?  How will you tell the provider he has $1,000,000 in outstanding claims that are over 120 days old and the time limit to get the claims back out has expired so he has to write this off.   This is just the tip of the iceberg that any biller can tell you that you will face every day.  

Think before you do anything.  Is this what you want to deal with on a daily basis?  Are you mentally and financially able to handle this?  Remember, if you don't know what you are doing, your mistakes will affect the insurance company, the provider, the provider's staff, the patient and the rest of us because now the provider won't hire someone that knows what to do and it gives all of us a bad name.

Doctors don't put their names on a list to be sold that says, "Please Medical Biller, use me!!"  Doctors are not going to come to you on bended knee begging you to work for them.  Doctors can pick and choose and they already have.  They want someone with training, with experience and with certification.  There are plenty of those out there also looking for work.  So, if you want to succeed, you have to get ahead of those aready ahead of you.  Like I said, you have about 2,000 people out there, in your area alone, wanting the same thing you want.  Medical Billing is NOT what TV and advertisements say it is.  You can't sit at home with your child on your lap as you smile and work at your terminal.  It is hard work, from 8am to 6pm and it is constant work.  The amount of paperwork alone will boggle your mind and each piece of paper takes training, certification and experience to know exactly how to handle that piece of paper.

November 7, 2007 @ 7:31 AM Reply  |  Email Friend   |  |Print  |  Top

I agree with Steve 100%. Everything he is saying is true. Starting your own business is not as easy as it seems.  I have been working on mine for over 1 1/2 years and finally have landed a 6 month contract with a dr.  Not much but its my reward for putting so much time into what needs to be done.

Be prepared to spend hours doing research on the laws in your state, and just the business in general.

This is not a get rich quick business, and it is alot of work.  You need to know the ins and outs of billing, coding, and the different guidelines.  If you are not familiar with this business it will be even more frustating.

Prior to my research and gathering all of my facts and information, I took an online course in medical billing, one in coding, and have worked in the medical field for over 6 years.

So if you are doing this because everyone says its easy, you will struggle.  If you are very serious about it then I suggest the same things that Steve said, .....take courses, educate yourself, you can never educated yourself too much, and research it.  

If you are prepared to take your time and take the proper steps involved and be prepared to spend about 10,000.00 just to get yourself started the proper and legal way, then I say follow your heart!  You have to have a love for the business and you have to have the patience to "pay attention to detail"

Don't let your fears hold you back if this is something you really want to do, but remember that if you want it to work and be successfull then be prepared to take your time and move at a slow pace, making sure that no stone is left unturned.

Good Luck!!

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