MEDICAL BILLING
Medical Billing and Coding at Home
Medical Billing Courses: An Interview with An Employer
© 2006-2008 by JoAnna Gilford
Sheila Spieler has been a Managed Care Consultant for over 11
years, specializing in accounts receivables. She routinely
interviews and hires medical billers for local physicians. We
asked her about medical billing courses and how possible it was
to get a job as a Medical Biller/Coder and work at home without
any initial onsite time.
"First off Sheila, what IS Medical Billing?"
"What are your thoughts about Medical Billing Courses,
specifically the ones that claim "you can work at home" after
training?"
"Physicians cannot afford to hire newly certified medical
billers to work from their home, they simply don't have the
knowledge or experience to properly submit claims. That
doesn't reflect on the abilities of a new hire, almost everyone
entering a new position needs training and practice in
procedures."
"It sounds so easy, take a class and go to work!"
"It's extremely complex. The majority of medical billing
classes only cover a small percentage of the knowledge needed
to insure correct billing and coding procedures. Most teach
basic data input. An established physician can have 10 to 20
different insurance companies, each with specific guidelines,
different coverage and coding procedures. A claim submitted
incorrectly will be rejected and not paid, sometimes for
months! A claim can be rejected because the employer's name was
omitted. A claim can be rejected because the procedure is not
covered at the doctor's office but IS covered as a referral.
There are many reasons claims are rejected, it is the
responsibility of the biller to make sure a claim is properly
submitted the first time. Even a lot of the doctors aren't
familiar with the correct codes for different procedures.
To clarify further, an employer buys coverage for their
employees through an insurance company. The insurance company
customizes the coverage based on the employer's needs. Let's
say you work for employer A and your sister works for employer
B. You both have the same insurance company, but the coverage
can be totally different between the two. The medical biller
would need to know the specific coverage for each employer to
properly submit claims."
"If you were considering taking a medical billing course, what
would you like to see as part of their instruction?"
Medical Terminology
CPT Coding
ICD9 Coding
DSM Coding (Mental)
An in depth knowledge of HMO/PPO/Network Contracts
Physician Credentialing
Reimbursement/Denial Analysis
"How possible is it to work at home as a medical biller?"
"It's possible but only after hands on experience and whether
or not a physician would allow it. The majority of patients are
covered through an HMO or PPO plan. A physician would have to
be very comfortable with your knowledge and ability to submit
claims before they allowed you to work from home. Let's face
it, the medical biller controls the income. High denial rates
cause hardship on the doctor's practice. The claim has to be
accurate, submitted correctly the first time and paid in a
timely manner for the doctor to stay in business. Hands on
training is the only way you will learn the individual
physician's network. An experienced medical biller would
probably have to spend less time in a new job updating and
training before they could work at home. Physicians should
monitor new employees in the beginning. They can't afford to
find out 30 days later that a majority of their claims were
rejected, it takes much too long to resubmit."
Thanks for all the information, Sheila, it was far too much to
print in one article!
All in all, spend time researching a medical billing course and
make sure you are getting the best training you can afford.
Inexpensive classes often don't teach much more than data
entry. Realize you are most likely going to be required to
spend onsite time before you can work at home. Medical coders
are in demand so the market is certainly a good market and not
evaporating. You have time to research and do your homework,
it just isn't as easy as those advertisements lead you to believe!
About the Author:
As manager of Real Jobs Online, JoAnna Gilford is committed
to real telecommuting employment and education. She is the
author of "Work at Home Workshop: The Truth About Telecommuting"
and editor of RJO's daily newsletter.
Resources:
http://home.universalclass.com/i/medicine/healthservices/classes/1759.htm
http://www.billerswebsite.com/
http://www.physicianswebsites.com/medical_billing_coding.htm
http://www.nebazone.com/
http://www.webcom.com/medical/AMBA.htm
http://www.claimtek.com/
http://www.pacificmedical.com/
Scams and Medical Billing
http://pub1.ezboard.com/fmedicalbillingscamwatcharticlesofinterest
http://www.bbb.org/library/medicalbilling.asp
Copyright 2006-2008. All rights reserved. Any reproduction of this article in whole
or in part without written or verbal permission is strictly prohibited.
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