medical billing transcription supplier information

If I start a billing and invoicing business, will it have a future?

QUESTION: I'm considering starting a sideline billing and invoicing business. Do you consider this a viable option in view of the fact that more companies are purchasing computer equipment that can perform this function?

ANSWER: The issue for businesses that need billing and invoicing services is time, not technology.

Medical-billing services have been among the most popular home-based businesses in the 1990s, but the industry has become saturated in some areas of the country. Fortunately, a wide range of other health-care practitioners, from chiropractors to occupational therapists, still need this service.

Also, doctors who have tied their practices into managed care can be involved with as many as eight HMOs and PPOs, and continue to have fee-for-service patients for whom filing insurance claims is necessary. Consequently, many doctors are enlisting billing services for a variety of other back-office functions like invoicing, collecting co-payments, keeping track of past-due accounts and handling patients' billing-related calls.

You also might want to check out medical-claims assistance. Claims assistance professionals (CAPs) file claims for people whose doctors don't file private insurance claims.

Resources for finding out more about medical billing and medical claims include:

* The National Electronic Biller's Alliance,

* The Alliance of Claims Assistance Professionals, 731 Naperville Rd., Wheaton, IL 60187, (630) 588-1260,

* Rick Benzel's Making Money In a Health Service Business on Your Home-based PC (McGraw Hill) includes a CD-ROM demonstration of medical-billing software;

* Entrepreneur offers a How to Start a Medical Claims Processing Service start-up guide (800-421-2300). And for the latest costs, income and marketing for these businesses, check out our most recent edition of Best Home Businesses for the 21st Century (Tarcher/Putnam).

From groundbreaking research to the discovery of new treatments, the medical industry is always looking for ways to improve patient care. Surprisingly, however, one area of healthcare has undergone very little improvement over the years: medical billing.

While it's a crucial part of the healthcare process -- allowing patients to receive their insurance benefits and doctors to get paid -- it remains a time-consuming and often-flawed ordeal. Because doctors are too busy with patients to pour over minute details and because claim regulations change constantly, almost 20% of paper claims have to be re-submitted due to errors.

Medical Transcription Billing, Corp. ("MTBC"), a leading medical services company that introduced full-service medical billing for a flat fee of 4% of collections, announced today that it has achieved ISO 9001:2000 certification, signifying that its processes and quality management systems meet rigorous industry requirements. The ISO 9001:2000 standard is an internationally recognized quality management system developed by the International Organization for Standardization (ISO).

MTBC is the first company to apply state-of-the-art software and Internet-based technology to medical claims and patient billings, enabling its customers to reap the benefits of improved practice management and increased cash flow at a reduced cost.

MTBC's ISO 9001:2000 certification was issued only after an extensive external audit of its processes and quality management systems by Moody's International, an international ratings agency.

"The ISO 9001:2000 certification is an authoritative confirmation of our continued commitment to quality business practices," said David Rosenblum, President of MTBC. "Physicians seeking medical billing alternatives to the local 'mom & pop' billing companies will feel comfortable knowing that our ISO 9001:2000 certified medical billing process will provide their practice with both stability and security in the volatile medical billing environment."

MTBC's comprehensive medical billing service includes scheduling, electronic claim submission, follow-up and appeals, as well as patient billings. All patient billing questions are handled by MTBC's specially trained service representatives. In addition to 24/7 Internet access to information on scheduling, patients and billing, MTBC provides customized superbills and other office forms, practice analysis and financial reporting to its 4% medical billing clients. Proprietary software tracks each claim through the entire billing process - from the moment a patient is scheduled, until payment is received - reducing the cost of overlooked claims.

Safe Harbor and Forward-Looking Statements

This press release contains certain forward-looking statements based on current expectations, forecasts and assumptions of MTBC (the Company) that involve risks and uncertainties. The Company's actual results could differ materially from those stated or implied in such forward-looking statements, due to risks and uncertainties associated with the Company's business, which include the risk factors disclosed in the Company's contract (Miscellaneous Provisions of 7.2 F-1 Version 002). Forward looking statements include statements regarding the Company's expectations, beliefs, intentions or strategies regarding the future and can be identified by forward looking words such as "anticipate," "believe," "could," "estimate," "expect," "intend," "may," "should," "will," and "would" or similar words. The Company assumes no obligation to update the information included in this press release, whether as a result of new information, future events or otherwise.

Cunningham Group has launched a new type of insurance plan that protects medical practices, hospitals, clinics, and other healthcare providers that bill Medicare and Medicaid. The new plan, MediKey [SM], takes the guesswork out of coding and protects earnings with special low-cost Billing Errors and Omissions (E&O) insurance, available to healthcare providers and facilities that enroll in the compliance plan. This combined approach enables providers to qualify for the E&O insurance at a favorable rate. An additional benefit is that as healthcare providers gain confidence that their billing is accurate, total revenues are often enhanced because legitimate ways are discovered to code procedures to fully reflect their complexity and the demands placed on the practitioner's time.

MediKey provides coverage on behalf of the insured to settle or appeal an audit, as well as for civil penalties and fines, including defense, litigation, auditing and consulting costs arising from allegations of billing errors and omissions (subject to policy limits, terms, conditions, and exclusions); protection in the event of unforeseen, unwarranted, and unanticipated increases in Medicare/Medicaid payment denials (subject to policy limits, terms, conditions, and exclusions); extended levels of indemnification, with coverage limits of up to $5 million; and cash flow continuity, ensuring uninterrupted operation and patient service during dispute resolution.

Cunningham Group is an independent agency/brokerage firm specializing in physician and surgeon medical malpractice protection, with 54 years' experience serving the medical community.

GlobalCerts(TM) a leading provider of secure messaging appliance solutions today announced that APS Medical Billing & Professional Consultants a Toledo, OH -based medical billing company, has deployed the GlobalCerts(TM) SecureMail Gateway(TM) in its network.

APS Medical Billing is a privately held, non-physician owned medical billing company. Founded in 1960, APS provides billing and practice management services to hospital based physicians throughout the Midwest. Operating as a service bureau, APS supports the billing and practice management needs of radiologists, anesthesiologists, pathologists and emergency room physicians. APS billing software is designed to meet the special needs and billing requirements of hospital based physicians.

APS Medical Billing needed a product that enabled them to comply with the Healthcare Insurance Portability Accountability Act (HIPAA) of 1996, in sending Protected Healthcare Information (PHI) externally among physician offices and health insurance carriers. In their evaluation of products, they searched for a product that was simple to manage and deploy, and didn't require extensive training to use. They needed a product that they could integrate within their network that was compatible with existing email and security applications. "The GlobalCerts(TM) appliance solution made it easy for us to comply with HIPAA," said James Bine, Director of Information Systems for the company. "The SecureMail Gateway(TM) deployment was absolutely painless, almost a non-event. It's extremely easy to use, and requires very little if any ongoing configuration."

The SecureMail Gateway(TM) is an appliance solution that provides reliable secure messaging. The SecureMessenger(TM) feature simplifies secure messaging with any external recipient. The SecureTier(TM) feature automates digital certificate management services which greatly eases administrative efforts and enables rapid secure messaging. No desktop software is required making deployment fast and extremely easy.

Leading Healthcare IT Solution Provider Signs Reseller Agreement Establishing PositivePRO Remote Access Service of Choice for Cerner Millennium Solutions

Positive Networks, a leading provider of hosted VPN and end-point security services, today announced an agreement with Cerner Corp. (Nasdaq: CERN), the leading supplier of healthcare information technology solutions, to resell its PositivePRO service. As a result of this arrangement, PositivePRO is the preferred remote access solution for Cerner Millennium(R) solutions.

As healthcare workers face greater time demands, the ability to work beyond hospital walls is a critical factor in increasing efficiency and improving quality of life. Medical and administrative staffs rely on Cerner solutions to access and update sensitive clinical, financial and scheduling data no matter where they are. With Positive's subscription-based service, there is no software or hardware for hospital IT staff to purchase, install and maintain. Complete set up and end-point security control can be established in 24 hours or less. PositivePRO can scale to support thousands of users without the costly overhead of complicated VPN appliances.

"More than 1,500 healthcare organizations depend on Cerner solutions to keep staff connected and up-to-date with critical medical and administrative information," said Cerner Connectivity and Security Domain Manager Jay Saviano. "With its scalable, affordable and feature-rich service, PositivePRO gives healthcare IT managers the peace of mind to empower their employees with essential remote access."

PositivePRO extends Cerner's stringent HIPAA patient privacy compliance to help healthcare organizations overcome the common challenges of providing remote access, including lack of internal IT staff expertise, lack of help desk support, and burdensome upfront hardware and software expenses.

Unlike traditional VPN solutions, PositivePRO not only provides basic remote access but also provides essential endpoint security features such as:

--Antivirus protection to automatically scan for viruses at log in and update antivirus definitions

--Personal firewall software to protect the system from intrusion by hackers who may want to use employee computers as gateways to the corporate network

--Patch management to help administrators deploy the critical patches and fixes that keep networks safe

--Authentication technology to verify the user's identity

--Spyware protection powered by SpyBot-Search and Destroy to automatically deploy, scan and remove dangerous applications that can capture sensitive patient and financial data

"Positive Networks has developed a service unique to the industry that combines the connectivity and endpoint security businesses depend on for secure remote access," said Positive Networks CEO Tim Sutton. "Partnering with healthcare industry leaders like Cerner will expand the availability of PositivePRO to hospitals and medical institutions across the country."

Following an extensive beta test of its Electronic Medical Records (EMR) software, MTBC, the company known for breaking the cost barriers associated with medical billing, has once again redefined the costs physicians incur in the healthcare industry by releasing Version 1.1 of its free, fully-integrated, EMR.

Although a fully functional EMR program can cost as much as $25,000, MTBC's new program, which includes all of the features available in expensive EMRs, is provided free of charge--no strings attached--to any practicing physician.

"It was not an option to release an EMR that had limited functionality simply because it is free," explains David Rosenblum, President of MTBC, "we sought to include all of the components available in expensive EMRs in a package that utilizes MTBC's services and reflects our commitment to providing the best service at the best price."

Physicians who use MTBC's integrated EMR fully incorporate all of MTBC's billing, transcription, and practice management solutions into one cohesive package. The services available in MTBC's 4-by-4 plan, including 4% Medical Billing, 4(cents) Medical Transcription, and now a free EMR, complement one another as a complete practice management solution.

MTBC's EMR includes modules for automated billing, scheduling, claims tracking, document management, fax functionality, charting, electronic encounter documentation, and complete HL7 compatibility.

All physicians are invited to download the software and provide MTBC with feedback and suggestions for further improvements. MTBC's "Suggestion of the Month" program will award a $100 American Express gift check for the month's best suggestion, which is developed and implemented into subsequent versions of the EMR.

Wall Street News Alert's "stocks to watch" this morning are: Healthcare Business Services Groups Inc. (OTC BB: HBSV), Research In Motion Ltd. (NASDAQ: RIMM), Elan Corporation, plc (NYSE: ELN) and EMC Corporation (NYSE: EMC).

Aggressive investors and day traders may be excited about Healthcare Business Services Groups, Inc. (OTC BB: HBSV) this morning! Yesterday after the markets closed, the company, a provider of full-service medical billing services and practice management solutions and future operator of surgery centers, issued a press release announcing that it has secured a medical billing contract with a large multi-specialty medical clinic and pain management center.

This could be great news for investors! The company's press release states that the contract (a long-term medical billing contract with Multi-Specialty Medical Clinic and Pain Management Center) has the potential to double the company's total revenues in less than a year.

Investors continue to watch the progress of Healthcare Business Services Groups, Inc. Chandana Basu, chief executive officer of Healthcare Business Services Groups, stated, "This contract represents Healthcare Business Services Groups strength and importance in the healthcare services market, a more than $1.7 trillion industry."

Basu continued, "This is the fifth medical billing contract we have signed in the past 30 days. We have successfully been able to increase revenues for our clients between 50% and 200% with our customized billing program and diligent follow-up programs. Such a large contract is significant to the Company and its investors as it represents near and long-term cash flow and the strong upside potential of Healthcare Business Services Groups. We are continuing to pursue additional medical billing contracts to increase the Company's incremental cash flow and are pleased with the continued progress of our campaign."

For more in-depth coverage of Healthcare Business Services Groups visit http://www.backissuesofnewsalerts.us/HBSV0412.html

Prior to yesterday's press release, the stock closed yesterday at around Thirty-Six cents a share.

In case you are not familiar with the company: Healthcare Business Services Groups, Inc. is a provider full-service medical billing services and practice management solutions nationwide. In addition to its core medical billing services, the Company offers the only fully automated medical billing software product, AutoMed, on the market. Healthcare Business Services Groups also plans to develop and operate surgical centers nationwide to provide full-service, low cost surgical center option to physicians and providers. Visit http://www.thenewhbsgi.com for more information.

Stocks showing interesting activity yesterday at the close of the regular trading day were: Research In Motion Ltd. (NASDAQ: RIMM) down 0.4% on 7.2 million shares traded, Elan Corporation, plc (NYSE: ELN) up 1.3% on 7.6 million shares traded and EMC Corporation (NYSE: EMC) up 1.1% on 7.4 million shares traded.

Macro Doctor, an e-healthcare company that specializes in web-based medical billing, clearinghouse and practice management solutions, today announced the opening of its new Arizona division to meet the rising market need for e-health solutions that significantly improve business efficiency, speed claim processing and improve revenue cycles for providers and hospitals. Macro Doctor solutions eliminate the expense and delays of third-party billing services and clearinghouses by allowing practitioners to directly submit HIPAA and Medicare claims to payor organizations using secure web technology.

"Web-based technology is essential for healthcare organizations to be competitive," states Dr. Divas Khaira, oncologist for Phoenix-based Sunterra Oncology. "Macro Doctor's centrally supported, online approach has allowed us to rapidly adapt to changing industry conditions, shorten payment cycles, eliminate lost claims, and reduce accounts receivables. They've allowed us to concentrate on the most important part of our practice, providing quality care to our patients."

Macro Doctor supports both front and back-end applications required for efficient provider operations. The front end or office management system incorporates a complete practice management system with appointment scheduler, online charts and drawings, and an electronic billing system. The back-end software translates and transposes information from the management system into an ANSI and HIPAA compliant electronic format that is sent directly to the payor.

Macro Doctor improves provider business operations, increases revenue and reduces costs by offering an integrated set of Internet technology-based solutions:

--  Integrated Medical Billing System/Clearinghouse - reduces revenue
  cycles from weeks or months to days, eliminating lost claims and saving
  providers up to 50% on medical claims processing by direct submission of
  HIPAA compliant and ANSI formatted claims to payors. Claim tracking and
  reporting begins within 24 hours of submission; users can easily access
  detailed status and payment reports. Optionally, Macro Doctor will
  facilitate automatic attachment of EMR/Claims patient charts, notes and
  other documentation.

--  Electronic Funds Transfer (EFT) - increases provider revenues by
  offering the ability to accept checks by phone and set up direct payment
  schedules. This approach can be delivered at no cost to providers; patients
  appreciate its interest-free flexibility. Macro Doctor is the leader in
  providing medical providers with direct connection to the Federal ACH
  system.

--  e-Chart - incorporates EMR (electronic medical record) capabilities
  that provide access to critical medication, X-rays, allergy and lab reports
  and data from any connected location 24/7.

--  e-Schedule - supports consumer-directed healthcare initiatives by
  allowing patients to schedule appointments online 24 hours a day, 7 days a
  week and receive email appointment confirmation. Once appointment is
  scheduled, a patient claim is automatically generated.

--  e-Draw - enhances patient communication and allows providers to
  document past and present surgical scars and incisions to enhance quality
  of care.

--  e-Reports - a decision support tool that easily generates charts and
  graphs with accounting information to monitor outstanding accounts and
  identify practice trends.
  

A complete web-based software solution, Macro Doctor eliminates the need to separately purchase or install any on-site hardware or software. Providers simply connect their PC and web browser anytime, anywhere to Macro Doctor's secure data center, where the application and data are hosted. Macro Doctor manages and maintains the data and hardware. With Macro Doctor's totally secure environment, the integrity, privacy and exclusivity of all provider information is maintained.

"This is a significant milestone for providers transitioning their organizations to meet rapidly emerging e-healthcare initiatives," says Brady Barger, president of Arizona's Macro Doctor Division. "Practitioner's seeking innovative ways to take advantage of web-based solutions for reducing capital equipment costs, IT overhead and compliance issues can securely and cost-effectively utilize Macro Doctor to achieve business goals without investing in hardware, software, networking, support and training."

Digging out from under piles of medical paperwork gives these families more time for living.

Carolyn and Ed Burnett were on vacation in Florida with their 2-year-old son, Edwin, when they noticed some small bruises on the boy's legs. When the Burnetts returned home to Wilmington, N.C., they received devastating news from their pediatrician: Edwin had leukemia.

Over the past year and a half, the Burnetts have been consumed with Edwin's treatment, which includes daily chemotherapy and weekly trips to the University of North Carolina Hospitals at Chapel Hill, two and a half hours away. While they braced themselves for the physical and emotional toll of dealing with a sick child, they didn't reckon on the stress involved with handling all the paperwork, which was almost as overwhelming as the disease itself.

"The mailbox was filled with bill after bill from doctors, pharmacies, hospitals, emergency rooms and labs," says Carolyn, "and we couldn't decipher them." On the recommendation of a friend, she called Patricia Pane, owner of Medical Insurance Assistance, one of a growing number of private bill-paying services that help consumers plow through paperwork, appeal denied medical claims and get the most out of their health-insurance coverage.

When Pane first visited the Burnetts, she found them sitting on their living-room floor surrounded by stacks of paper. Pane gathered up the bills and insurance statements in a shopping bag and carted them away, leaving Carolyn and Ed with her two rules of doing business: Once you turn over your paperwork to me, don't worry about it anymore--and don't pay any bill until I tell you.

The Burnetts were more than happy to follow her advice. Edwin's medical bills for 1998 totaled nearly $113,000. Of that, Pane identified about $9,000 worth of billing errors and used the credits to reduce the Burnetts' outstanding balance. She also negotiated discounts on their behalf with doctors and health care facilities, so their out-of-pocket costs were held to about $4,000 for the year.

Pane, who charges $60 an hour for her services, also recovered health-insurance benefits for medical bills incurred by Carolyn, Ed and their newly adopted daughter, Grayson. All told, the Burnetts paid Pane about $2,300 last year and think she was worth every penny.

Now that they have eliminated the backlog, the Burnetts just bundle up their medical bills each week and drop them off with Pane. She makes sure that all their medical-insurance claims have been properly processed before telling the Burnetts when and how much to pay. That way they don't have to apply for a refund if bills are overpaid, and they aren't confronted by threatening phone calls and letters from creditors demanding payment.

"It gives you a wonderful feeling to be able to take that burden off people so that they can devote more time to the care of the sick family member without worrying about their bills being paid," says Pane, who started her business five years ago following a career as a benefits administrator for DuPont.

Saving time and money

Pane says it became evident to her during her previous career that consumers need an advocate in the increasingly complex area of health insurance. Add to that the time constraints on busy working couples (who often have to juggle two health-insurance plans) and an elder generation turning to adult children for assistance, and you have a natural market for a new group of service providers, generally known as claims-assistance professionals.

"As baby-boomers like me get older, we don't necessarily have as much time as we'd like for our parents or ourselves, so we hire people to do things," such as file income-tax returns and sort through medical bills, says Susan Dressier of the Alliance of Claims Assistance Professionals (ACAP), a fledgling nonprofit organization in Wheaton, Ill., that recommends a code of ethics for members and hopes to offer professional accreditation by early 2000. (For a referral to an ACAP member or advice on handling medical billing problems yourself, call the toll-free number, 877-275-8765, or visit www.claims.org.)

You don't have to be confronted by a catastrophic illness, as the Burnetts were, to be overwhelmed by medical bills. And even people accustomed to dealing with numbers can be confounded by the complexity of medical-insurance claims.

Keith Briar is a stockbroker and certified public accountant in San Francisco. Briar's elderly father, who lived in Florida, became ill in 1997 and on several occasions was treated at local emergency rooms. His health deteriorated, and ultimately Briar moved his father to a nursing home in California. But by then his dad had racked up enormous medical expenses with doctors and hospitals 3,000 miles away.

"I'm a financial person, but I had no idea how the medical-insurance claims process worked," says Briar. "Every part of a procedure is billed separately, and there was no way to know what had been submitted and what had been paid." When Briar realized that he "wasn't going to become a specialist in medicare and insurance overnight," he went out and hired somebody who was: Wendy Segal of Health Insurance Claims Assistance, in nearby Foster City.

The d.i.d. Circle Organization in late February released a medical billing and

scheduling package aimed at doctors and claims processors.

The Medical Billing Circle maintains billing hierarchies when dealing with the

carriers, patients, charges and claims in common insurance transactions. The

company said The Medical Billing Circle supports an unlimited number of

carriers per patient or charge, and it lets users set up default claim and

policy types from patient and carrier profiles.

The software, which supports transaction-based payments and postings, lets

operators schedule unattended statement, correspondence and claims-print runs.

It also includes limited support for electronic claims submission, and it

allows insurance-company fee tracking.

The software has relational-database capabilities that are shared through a

common software engine with three other institutional-software products from

the company: The Sales Commission Circle, The Incoming Travel Circle and The

Contact Circle.

In 1993 about 6 billion medical claims were processed, burying physicians and health care providers under a deluge of paperwork This forced many medical professionals to outsource their billings and collections to companies capable of wading through numerous insurance codes and government regulations. Electronic medical billing services has proved to be a viable business opportunity for companies with experience in accounting, provider billing and computer systems.

Electronic medical billing services read patient claim forms, inputs the data according to complex coding systems and then submits the forms via computer to major clearinghouses. The clearinghouses then bill the patients or the insurance companies, who, in turn, pay the physicians.

Armed with 14 years, experience in hospital medical billings and a $5,000 investment, Vanessa Best began Precision Health Care Consultants in Jamaica Estates, New York, in 1995. A physician at the hospital where she was employed was leaving for private practice and Best persuaded him to retain her medical billing services - for $1,200 a month. Best's business now earns $38,000 annually. In addition, she was recently employed as a consultant to help launch the medical billing division of the Fidelity Group, a $8.5 million African American-owned insurance, benefits and medical management company in Great Neck, New York.

For new entrants to the industry, home-based medical billing businesses generally net $30,000-$100,000 a year. Most billing services receive $3 per claim processed; of this, a claims clearinghouse generally takes a fee. After a claim is processed, it takes about two to three weeks for a physician to receive his or her money, and depending on the payment terms, another 30 days before the client pays the billing service.

To get started in the business, you'll need a computer, fax machine and a medical-billing software package that meets claim requirements for Medicaid and Medicare. Generally, you can start with as little as $5,000. After a couple of years in the field, you may want to become certified. Certification, which is provided through groups like the National Association of Claims Assistance Professionals (NACAP), is voluntary in most states.

If you're interested in attracting physicians to your service, "you can't be trite or cute," says Norma Border, national director of NACAP. A small business owner, she emphasizes, must demonstrate professional slickness - from the physical presentation to marketing materials. "You have to be aggressive, meticulous, detail-oriented and willing to keep abreast of the constant changes in the health care industry.

Each year, about 15%-20% of small businesses providing medical billing services drop out of the industry, Border estimates. Many of them don't understand the degree to which clients will rely on them for accounting, consulting and analysis. In addition to filing, medical billing services also provide scheduling activities, special reports and profiling - helping physicians determine which services are performed most often.

Medical billing services is a growing industry that can provide you with significant financial rewards. But be warned that it's extremely competitive, and requires aggressive marketing. If you're trying to break into the field, Best suggests seeking out new physicians who are looking to set up private practices and placing ads in local newspapers. "And if your clients are pleased," she says,"they'll refer you by word-of-mouth."