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MEDICAL BILLING Frequently Asked Questions
What Will I Do As A Medical Biller? There are two types of medical billing: Electronic Billing and Full Service Billing. Each are described below:
Electronic Claims Medical Billing- Every time a doctor sees a patient a sheet is filled out with information about the diagnosis, procedure, price, etc. The doctor's office then faxes you this information or provides it for office pick-up. Most medical billers pick up this information on a daily or weekly basis. You will then enter the data into your software and send it to a clearinghouse via modem. The clearinghouse sends the information to the various insurance companies. You give your bill to the doctor for your services.
Full Service Medical Billing - Full service billing does electronic claims submission and also prints and mails patient statements, post insurance and patient payments to patient's accounts, does follow-ups on unpaid accounts and insurance, answers patient inquiries about their accounts and produces several month end reports for the doctors.
Which Is Better? Electronic Billing or Full Service? HCFA (Health Care Financing Administration) has mandated that Medicare claims be sent electronically. At the federal level, no actual cut-off date for paper claims has been designated, but many states are taking decisive action. Seventy-five of the largest commercial insurance carriers have united in the National Electronic Information Corporation (NEIC). Their sole purpose is to promote electronic submission of insurance claims in the commercial market. All of this means that electronic medical insurance claims processing is, and will remain, a lucrative business into the next century.
What Are The Start-Up Costs? Start-up costs will vary depending on the computer equipment and software package you purchase. Industry experts estimate that start-up costs for an electronic Medical Claims Processing service is between $200.00-$5,000 for a home-based operation.
What Do I Need To Get Started? Some software packages are very complete and include a number of additional business tools of the trade. If your package does not include coding books, they are something you should acquire on your own. You'll need the Current Procedural Terminology (which contains codes for medical procedures), an International Classification of Diseases (ICD-9CM; this publication contains diagnosis codes), and an HCPCS (which lists Medicare and specialty codes). In most cases, the medical practice you serve will determine the codes they wish to use, but these books will help you identify errors. Click Here to learn more about these items.
What Should I Charge and How Much Will I Earn? Your billing skills are vital to the success medical practice. Therefore, your valuable services should not come cheap! You can decide to charge on a per-claim, a flat-fee (with a cap), or a percentage basis. Average charges range from $1.50 to $4.00 per claim. If you are working full time for one employer, you might charge a weekly rate. (For instance, $450 per week depending on the amount of work required.) Most home-based medical billing services earn between $24,000 - $40,000 per year.
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