10 Things You Should Do Before You Start Your Medical Billing Business

One time, I saw a newspaper ad saying they are hiring work-at-home medical billers. I called the number (just to find out what it is!), I found out that for you to be able to work as a Medical Biller, you have to purchase their software at a range of $800-1,500 (I thought, it is actually a packaged-medical billing business). They will then train you how to use their software, after (I think) 10 days of training, you will have an access to their so-called doctors database. They promised you can get your 1st client through their database.

Due to my curiosity, I started reading and researching packaged homebased medical billing business. But take note: the training you will get is NOT actually a medical billing training. The bottom line here? you simply purchase the business, pay for their software and start your business! But how realistic is this? I know some people who ended up with no clients at all after purchasing the software! And then later on, Ive read that the Federal Trade Commission warned us about these companies offering homebased medical billing business with their false claims on how you make a lot of money on this business.

Medical Billing is a legitimate business (either home-based or office-based) and you can make good money as long as you know how to do it, the right way. But before that, consider the 10 Things You Need To Do:

1. Try to gain actual work experience. Work as a Medical Biller in a doctors office (or even as a volunteer at your nearest hospital). Do this for at least a year.

2. You should be highly knowledgeable on HIPAA (Health Insurance Portability and Accountability) and how does your current work/practice place complies/follows its rules and regulations. I always emphasize this because it is very important in any health provider businesses

3. Learn the actual know-how on claims submission (paper billing & electronic billing)

4. Learn how you can deal with insurances, can you handle collections? denied/rejected claims? Learn how to file appeals for denied claims

5. Learn how to analyze and optimize proper coding (procedure and diagnosis codes) to avoid rejection & denials

6. Learn how to review and analyze the reasons for unbilled and or aged medical claims

7. Beside learning the medical terminologies, you should also know many medical billing terms and its meaning: (PCP, copay, co-insurance, deductibles, allowed amounts, predetermination, medical necessity, progress notes, prognosis, treatment plan, preauthorization, appeals, referrals, scripts, benefits and eligibility, capitations, HMOs, PPOs, POS, EPO, HIPAA)

8. Learn how to properly post: payments, deductibles, co-insurance, adjustments and write-offs (it is different when you are actually at work doing the postings than what you learned during your training)

9. Feel the medical billing scenario (how is the cash flow? what about the turn-around time of payments?)

10. And the last but not the least, feel the work--- do you like what you do? Do you have the ability and the managerial skill to run your business?

Pinky Mcbanon is an experienced Medical Biller and Coder based in New York. A graduate of Bachelor Science in Computer Engineering. A Medical Practice Billing Consultant. She shares her expertise and knowledge with http://www.medclaimsplus.com. Amie Blog45914
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