How would you respond? Would you be able to help?
The following question was posted today in our active Medical Billing Community forum where this question is not new to us. We get questions revolving around how to start a medical billing business from home quite often from new individuals in this field.
I say new, because seasoned medical billers and their medical coding counterparts already figured out that doing medical billing from home requires certain distinct steps; however, here is where this new medical billing and coding graduate who asked is right on the mark--she, too realizes that this goal takes time. She states she hopes to achieve it within the next five years.
I've just received my billing/coding certificate and I have a while before I even want to try to take on a home business. But I've looked everywhere and can't find any information on how to do this work from home. Can anyone give me steps to how to begin this process?
Do I go to the provider and ask to be hired but say I want to work from home? Or ... I'm just so confused with all this. ANY help would be nice. I want to start preparing myself for the years to come, because doing this from home is one of my short term (within 5 years) goals.
We have discussed this topic a few times, here at the forum. For most who eventually started their own medical billing business from a home office it was not something that happened overnight.
They have been in the field as an employee with trusted employer relationships for years, and have made contacts with doctors and clinics who have earned their trust.
This would be the point where one could say: "Doctor So-and-so, I am looking for opportunities to do this job from my home office. Would you allow me to take some of your billing home."
So, in a nutshell, your education counts, experience counts, employee relationships count, and trust and references count. Then, when you have all this under your belt make sure your resume is updated and shines, also make sure you have researched and know local and state laws as to what is required via city ordincane and zoning, and such, to run a home business.
Find out how to incorporate your business. Although you could "freelance" it, an LLC provides you with a certain amount of protection.
May be our Steve can add a couple more tips. In the meantime, try our forum's search function for older discussions around this topic.
Medical Billing Is NOT Simple
Medical billers have a simple task: medical billing. That means you send a claim to an insurance company, post payments, respond to outside information requests that relate to the claim, follow up on a claim with no response, communicate with the patient, or their insurance company about a claim that is denied, in review or pended, send statements to the patient and turn over delinquent accounts to the providers debt collection agency. Again, you stay within the boundaries of your training.
What medical billers are NOT:
•Managers of the provider's practice
•Lawyers
•Credentialing staff
•Contract Review staff
•Coders
•Physicians
When someone goes outside their scope of practice, which is basically outside the training that was received, then that someone opens the door to a possible lawsuit.
What Happens When a Patient Can't Pay Medical Bills
Protecting Assets from Unexpected Risks
A new article by San Diego attorney Robert J. Mintz of the Asset Protection Law Center, examines the legal and practical consequences to the patient of unexpected medical bills, far beyond what the individual is able to pay.
What happens if the patient has some retirement savings or some funds tucked away for a child’s education? Will medical bills from an injury or illness wipe out everything that has been saved over the years?
An issue of increasing importance in the legal field addresses the question of how to protect accumulated savings from medical expense related liability risks, according to an article by attorney Robert J.
Mintz in the August edition of the The Asset Protection Newsletter. The problem, according to Mintz, is that a brief stay in the hospital may cost tens of thousands of dollars and a serious injury or illness lasting weeks or months can exceed almost anybody's ability to pay. Is there any advance planning available to protect individuals and families from unexpected medical bills?
The potential for financial disaster is well known and obvious to those who are uninsured. But even for those who are lucky enough to be insured under private or employer plans, the financial risk remains significant.
Uncovered medical expenses due to lifetime policy caps, large co-payments, coverage exclusions and outright denial of claims can result in unexpected medical bills that would financially stagger even the wealthiest individuals.
"What happens if a patient has uncovered medical bills from an accident or illness?"
"Is the family home and savings in jeopardy from these bills?”
"Is there any way to legally protect accumulated savings from uncovered and unexpected medical bills?"
In the Auguest 2011 issue of the Asset Protection Newsletter, Mr. Mintz answers these questions and addresses the legal issues of asset protection against medical expense risks. A complete copy of the article can be read at What Happens If You Can’t Pay Your Medical Bills?
Charging No Show Patients a No-Show Fee? Pe-leeeze! Missed Appointments Happen
I was watching this video clip with great interest. Charging no-show fees has always been a hotly debated and carefully contemplated topic even a decade ago when I was working as a certified medical assistant. So, I was curious what the video might tell me that's (not) new in medical billing...
In watching the video I have to say I completely disagree! While the author says that the answer to charging patients for no-shows is a resounding yes to cover losses and as a form of negative reinforcement to teach patients NOT to do that, my response is a resounding no. Don't charge.
It will simply alienate patients and at minimum, leave a sour taste in their mouth. Honest mistakes happen. We do get stuck in traffic, unforeseen things do come up and we get side-tracked, or we simply forget. Most patients intend to come as scheduled and many no-shows are honest mistakes. Even I, as a patient, have found myself caught up in unforeseen situations and I wound up calling the very last minute that I won't make it.
In my role as a medical assistant, I have NEVER!!!!! Yes, NEEE-VER... seen a doctor sit and twiddle his/her thumbs to bridge the time gap from a no-show.
You have to understand, appointments were scheduled tight, with so many patients per 15 or 20 minute time slots, fully aware that some patients might go over their allotted time in the exam room, while others might be right on the mark, or take up less time, so that in the end it would all even out.
No-show slots were a welcome break to direct the doctor's attention to phone messages attached to patient charts that had come in during the day and needed to be addressed so we could call the patients back with the doctor's instructions; furthermore gaps were filled with last minute sick calls and in the end they were a welcome brake to catch up with the daily grind.
As the day progressed the doctor inadvertently almost always fell behind and patients who arrived on time for their appointment wound up sitting in the waiting room over 30 minutes, or more, just to be seen. A no-show gave us a little breathing room and in the end as the day progressed and closing time finally approached everybody was seen and cared for.
Knowing both sides of the coin, here is where I stand on this topic: if the doctor charges patients up to $125 for no-show then patients should charge the doctor the same amount for the time they are being kept in the waiting room beyond the scheduled appointment time. Let's just call it even, a win-win situation and give and take relationship between a trusting doctor and trusted patients.
In my opinion, while yes, it is fair to say a medical practice is a business, it is not the medical office's job to "train their patients" not to miss appointments, otherwise patients might turn this whole thing around and insist that their time is equally valuable and bill the doctor for exceeded time in the waiting room.
True! But also, I have never seen a doctor twiddle his thumbs because of a no-show either. Medical offices are extremely busy and if, by ANY CHANCE, that slot was filled by a sick-call or wait-list fit in then there were no losses and it is like double-billing to me that is hard to prove, or verify.
Of course, LEGALLY the doctor has every right to charge a patient for not showing up, provided the patient is aware of the charge. But caution! State laws may mandate that a patient cannot be charged for anything that they have not been made aware of.
There may be other circumstances where a patient may not be charged for a no show appointment. The doctor may be contracted with ABC Insurance and that contract may not allow no-show billing.
The same may be for Medicaid patients, or other situations as defined under applicable State law. You can't bill the insurance company for the no show appointment, if there isn't a CPT code, right now, for a no show appointment (e.g. office visit code 992XX).
That's the legal side. I, and that is strictly my own opinion, based on my own experiences, raise my eye brows when I hear the medical profession, where you are dealing with people that have special needs in a world isn't always as perfect as having a perfect memory, a working cell-phone and an environment free of unforeseen events and distractions, suddenly becomes a cash cow and patients dollar signs.
On the flip side, there are patients suing doctors successfully, when the patient has an appointment and waits for an unreasonable time to be seen. I don't sue, I walk out. My time is also valuable and there are other doctors out there that I can give my business to if need to be.
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