medical billing transcription supplier information

Medical billing services are probably one of the most popular business opportunities being publicized to the home business market. There are pluses and minuses about this type of business. Since the investment is usually around $450 - $500 the company should be checked out thoroughly before investing in their software. It is good if the company doesn’t make any outlandish earnings claims; that is how so many medical billing software companies got into trouble with the Federal Trade Commission in the past.

There is indeed a great need by doctors for this service for several reasons. First, about 10 or 12 years ago federal law began requiring doctors to submit claims for Medicare reimbursements on behalf of their Medicare patients. Many doctor’s offices were not (and continue not to be) furnished with either the computer equipment or the personnel to devote the time to doing the medical billing in this manner. It is also cheaper for the doctors’ office to contract out the medical billing portion rather than hire staff to handle it in house. The increase in HMO’s and PPO’s also has increased the need for this type of service.

Traditional doctors are not the only ones who need the service; dentists, therapists of all kinds, and optometrists are also potential clients.

The downside of the business is that like any new business, it takes time to market your services to new clients. Doctor’s offices are traditionally extremely busy and probably receive numerous mailings and phone calls about hiring contractors for this service. You will need to make yourself stand out from the crowd.

So, how do you choose which company to go with for learning about Medical Billing? Check it out. Here’s how. First, go to the Federal Trade Commission’s web site at www.ftc.gov and look for their page on business scams. See if the company you’re interested in is listed. Look at the reasons the FTC is citing other medical billing software companies.

Second, call you State’s Attorneys General Office (may be called Consumer Affairs), and ask if they have a file on the company. If both of these check out all right, call the company and ask for references from people who have 6 months or more experience with the software and the company. Call those references and ask them not only how it is going for them but what they don’t like about it. Does the company follow through with its claims?

If it all checks out and your intuition tells you it is the right one for you, make sure your expectations are in line with the reality of what kind of income you can expect and how quickly you can start realizing that income. It also wouldn’t hurt to call your own physician, dentist, optometrist, etc. and ask if they are currently using a contractor to do their medical claims billing. If not, would they consider doing so. If they are currently using a service, are they happy with it.

As with any new business, it may take you anywhere from 1-3 years before you begin realizing any real profit.

I’ve stated this before, but I have an acquaintance who purchased a “medical billing at home kit” and because of no background in the field never “took off”.

Others - who’ve earned their stripes, so to speak, in a medical office - could just pull this off.

From Work At Home Momma

"If you are already doing this kind of work and just want to take your experience and build a work-at-home medical billing service then at least you have the leg up in that regard. Besides training there is the expense you will incur in order to purchase equipment, coding and reference books, software, supplies, liability insurance, and more.

If you aren’t already trained in medical billing practices you are probably researching the many companies that advertise about starting your own medical billing business. This is where the scams are plentiful. Before you spend a dime ‘investing’ in one of these ‘you don’t need experience’ training courses do your homework.

Check out the companies creditentials, past clients, length of time in business, and reputation. Be realistic about whether or not you will be able to get trained, outfitted, and hired within a reasonalble amount of time.

A business is tough to start, no matter what kind of business. The business of medical billing isn’t any different."

1st Commercial Credit, LLC. Over the past several years, more and more medical practices have begun to outsource their billings to third party medical billing services. For many medical practices, however, finding financial institutions that are familiar with healthcare receivable financing has been difficult.

According to Raul Esqueda (President and founder of 1st Commercial Credit): “With healthcare receivable financing, the main problem that financial institutions face is monitoring the value of the collateral (receivables) on a real-time basis. Regulatory intervention and restrictive banking policies have created additional obstacles to meet this challenge. At 1st Commercial Credit, we have capitalized on this opportunity by offering InterMedBill (SM) Billing and Financial Solutions - a medical receivable finance program combined with a billing and collection service. The result is a cost of funds package similar to a bank at a prime plus based schedule. Also, the billing and collections option will be cost effective due to our innovative infrastructure.”

Medical practices in the U.S. can now choose one of three offerings from 1st Commercial Credit:

InterMedBill (SM) Financial Solutions - A program that offers working capital using healthcare receivables as the borrowing base. The monitoring fee structure is calculated on a per transaction basis and the financing on the advanced funds is prime plus based. Billing and collection services are not included in this program.

InterMedBill (SM) Billing and Collections - A program that includes billing, collections and accounts receivables management.

InterMedBill (SM) Billing and Financial Solutions - A combined program of receivable-based financing, billing, collections, monitoring and receivables management.

1st Commercial Credit, LLC, is a leading financial service provider of asset-based financing for the healthcare industry (available for medical providers who bill third-party receivables that may include Medicare, Medicaid and HMO’s).

Your practice may have started out just yourself and one person in your office to answer phones, greet patients and assist you in your day-to-day office procedures. Between all of those duties there was also time to handle your medical billing.

As your practice grew, you realized this person was stretched just about as thinly as a person could be and so you made the decision to add another fresh face to your office to free up more time for your assistant to handle your medical billing.

As your practice continued to grow, you saw that your assistant was again overwhelmed and your medical billing was getting filed in a less and less timely manner. But when the choice is to service a patient standing in front of them at the desk or fill out paperwork, which are they going to choose?

You are again faced with the dilemma to either bring on another person and pay more salary, benefits, unemployment, and state and federal taxes or you can consider outsourcing your medical billing.

If you've been hesitant about outsourcing your medical billing because you aren't sure it would actually help your practice, this first fact about medical billing should make your ears perk up: Medical Billing claims filed electronically by a professional agency see reimbursement on the average within 2-weeks. If you are still filing your own claims, you are typically waiting up to 30-days for your reimbursements. Getting your claims paid by the carriers sooner will help your practice realize a greater cash flow and additionally, a medical billing company is trained to get you maximum reimbursement on your medical billing claims and if you are denied payment, it's their job to find out why, correct the situation and get your medical billing claim paid. This is something your staff may not have the training or time to do.

Outsourcing your medical billing can jumpstart your practice in the terms of better cash flow and a greater amount of reimbursements paid, look into outsourcing your medical billing today.

The Centers for Medicare and Medicaid Services updated the healthcare payment amounts for certain medical procedures related to preventative care. The Outpatient Prospective Payment System (OPPS) has ruled in favor of the provider on a few financial issues. There are some medical billing changes implemented in the January 2006 update that will increase your revenue if you use them correctly.

The main medical billing change issued by the Outpatient prospective payment system (OPPS) deals with preventative screening exams. Beginning in January 2006, Medicare will now reimburse at a higher rate for most preventative services provided. For instance: Many patients receive a "Welcome to Medicare" physical. Now, if hospitals provide this service in their outpatient department, the Centers for Medicare & Medicaid Services will issue them 7 percent more payment than they did in 2005.

Another medical billing change for hospitals deals with acute hospital care in rural areas. Beginning in January 2006, these hospitals will now receive 7.1 percent more reimbursement for this type of service, as well as 3.7 percent inflation for acute care hospitals. The Centers for Medicare & Medicaid Services also reduced beneficiaries' coinsurance rate for any outpatient hospital services.

The Centers for Medicare & Medicaid Services also established a temporary payment add-on for additional IVIG (intravenous immune globulin). Additionally, the outpatient prospective payment system also set a threshold of $1,250 for 2006.

The American College of Physicians (ACP) is worried about the current medical billing reimbursement condition. On January 30, 2006 , several recommendations were suggested to reform the system to a new model. The American College of Physicians is slowly watching medical billing reimbursement drop each year and they want a change.

One suggestion made by the American College of Physicians is that practices switch to a new model called the advanced medical home. This medical billing model focuses on patients with multiple chronic conditions. Any practice that is certified as an advanced medical home practice would receive new reimbursements based on a different medical billing model. The model is based on the added value.

The American College of Physicians also suggested that legislators should closely examine the balance between surgical procedures and evaluation and management services. The Centers for Medicare and Medicaid services should properly award physicians for improving quality through medical billing reimbursement.

Another suggestion is that the sustainable growth rate should be replaced by Congress. Each year this growth rate is cut by 5%. This means each year, on average, medical billing reimbursement drops by 5%. When physician practice medical billing reimbursement suffers, healthcare suffers as well.

There is constantly a debate between physicians and Medicare. The physicians strive for additional medical billing reimbursement, while Medicare strives to cut payments. The Centers for Medicare and Medicaid services want to ensure the longevity of the health care program. Physicians want to ensure the longevity of their own practice. There is a balance that needs to be met. Medical billing reimbursement should make both parties satisfied. Perhaps the American College of Physicians and the Centers for Medicare and Medicaid services should meet and discuss areas in which they can compromise on their medical billing issues.

There is very little more frustrating in the realm of medical care than to receive a medical billing claim returned and notated with the words of doom for any medical billing claim: "Medically Unnecessary Procedure". This is frustrating because it essentially means the services were performed for free and won't be reimbursed by the insurance carrier or Medicare.

There's little you can do in your practice to ensure that your medical billing claims have proper documentation to show medical necessity of the procedure. ECGs get regular scrutiny for the necessity of the procedure. If your staff is too overwhelmed by the day-to-day business of keeping your patients happy and your practice running smoothly and now your medical billing is suffering as a result and this has a direct impact on the revenue flow for your office.

If you're experiencing more denials due to medical necessity issues, it is probably a lack of proper coding and proper documentation on the part of your office. A number of these returns could mean it is time to consider outsourcing your medical billing to a company that will make sure each and every claim filed for your practice has the proper coding, documentation and will result in the highest return possible for your practice.

Medicare has released the stats for 2005 regarding The Comprehensive Error Rate Testing (CERT) program implemented last year and it is showing that in the initial stages it has done some good for medical billing. The Centers for Medicare & Medicaid Services heightened claim error awareness by initializing an error-testing program in 2005.

In 2004, the error rate for medical billing was 10.1%. At the end of 2005, this year's CMS error rate was 5.1%. This is nearly half the amount of errors this year than last year.

The Centers for Medicare & Medicaid Services attribute this improvement to the new CERT program. They believe that providers are inherently more aware that their claims may be examined. This causes them to have more accurate and complete medical billing from the beginning. With the new policy, providers are allowed to submit significantly more documentation with their medical billing. Previously, information submitted was not enough to substantiate medical necessity.

Some of the most common medical billing errors on submitted claims are generally due to a practice being too busy to properly document their medical billing claims or medical codings are done incorrectly using incorrect or outdated medical billing codes.

When medical practices utilize medical billing firms for their claims processing responsibilities, errors tend to be much lower. These companies solely deal with medical billing. Your claims will be reviewed prior to submission and checked for errors. This will in turn allow your practice to see a faster turn around on your medical billing claims along with higher reimbursement rates.

Sometimes in medical billing it is difficult to decide when to use current procedural terminology codes 58661 and 49322-59. These codes, like many others seem similar, but in actuality, are quite different. When performing medical billing it is necessary to know when to use current procedural terminology code 58661 versus 49322-59.

There are several instances in medical billing where it seems as though several codes would fit the description. The truth is that most of the time there is only one possible current procedural terminology code that would explain a procedure best. It is important that the personnel that perform medical billing for your practice are educated on these slight differences. It could mean the difference between getting reimbursed on a claim or getting denied.

The medical billing code 58661 (laparoscopy, surgical; with removal of adnexal structures) is used when any part of the ovaries or Fallopian tubes are removed. For example, If a surgeon was doing a cystectomy of an ovarian cyst and ended up removing some of the ovary as well, they physician could do medical billing with 58661.

The current procedural terminology code 49322-59 (laparoscopy, surgical; with aspiration of cavity or cyst) should only be used for the aspiration of an ovarian cyst. If the cyst(s) were removed, this medical billing code would not be valid since it is for aspiration only.

There are several medical billing firms that are designed to keep your practice as profitable as possible. Their staff is trained about the different CPT and ICD-9 procedures for billing to get you the maximum reimbursements. By hiring a medical billing firm to file your claims, you are eliminating the responsibility of having to train your own staff about billing. Medical billing is a skilled process and should be handled by skilled professionals.

If you feel you're finally ready to make the choice to outsource your medical billing, be aware the best choice may not be just around the corner from you. With the security of Internet transmissions, you can use a company across the country and be just as secure as if you were handing your documentation directly to someone across the hall from you.

Making the choice to use a medical billing company for your practice can save plenty of money. However, choosing the wrong medical billing firm can cost millions and in some cases, your practice.

There are numerous benefits to using a medical billing company. One of the biggest is that dedicated individuals will work on your client's medical bills on a day-to-day basis. Average error rate in self-compiled claims is around 30%. That number will drop to less than 1% when you make the choice to outsource your medical billing to a reputable firm.

Another benefit of using a medical billing company is that they lower amount of man-hours needed to run a successful practice. This cuts down on salary costs, vacation pay, and sick days because fewer employees are needed in the office.

After discussing the various benefits of hiring a medical billing consulting firm, it is very important to talk about choosing the right firm. Medical billing companies handle exceptionally sensitive materials and information about your patients. They have access to names, social security numbers, diagnoses, and procedures that were done to these patients. Your practice must be able to trust in the confidentiality of the medical billing firm.

Steer clear of companies that don't spell out what they do for you and the credentials of their employees. Outsourcing your medical billing responsibilities to a consulting firm has several benefits, however, choosing the wrong firm can be devastating to your business - cheaper doesn't always equal better and in the case of medical billing firms, ask for referrals - if a firm refuses to release them to you, that's a red flag.

Outsourcing your medical billing can jumpstart your revenue for your practice if you choose a medical billing partner that is competent, experienced and working for you!

If you feel your practice is busy enough to outsource your medical billing to a third party partner, you're making a smart choice. Just like any industry, there are medical billing partners that will fit the style of your practice and some that won't. To find the best fit for your practice, do a little research on what services a medical billing partner could provide that would be valuable to your practice.

Some physicians have been burned by doing business with medical billing companies that may have very good intentions and promised great results, but simply didn't have the on the job experience to handle the myriad of unusual conditions, unexpected situations, and fast moving changes (some coding numbers can change many times in one year, and a wrong coding number means delays in reimbursements) that can occur in the medical billing industry.

Outsourcing medical billing is a huge step for many practices, but by asking the right questions, you can ascertain how much experience and how much faster your claim payments will be reimbursed.

Find out how the medical billing company charges for their services and what services are included with that fee. A big question on most physicians' minds is if the medical billing firm is LLC HIPAA compliant and how securely is data transmitted? Find out if the medical billing company will provide credentialing of physicians as that is a great convenience.

How will your claims be tracked and how will rejected claims be handled? Get the information up front, remember the more questions you ask about how your practice's medical billing would be handled by the potential vendor, the happier you'll be with outsourcing your medical billing because you'll know how the work flow works and how you can expect reimbursements to be handled.

Now that you know the basics, increase your revenue flow to your practice and outsource your medical billing claims.

You know when you're translating medical billing from the notes, that sometimes doctors get a little bit out of sequence. This can greatly affect your medical billing if you don't straighten it out before filing. Otherwise you can wind up only receiving partial reimbursement for procedures done or worse, an outright rejection of your claim from the carrier.

One of the easiest ways to make sure you get the sequencing right is to read the entire report and make yourself notations on the major procedures done to be sure that you are picking up a good flow of information all the way through.

Get the doctor's summary of the diagnosis and then outline the services performed and allot them by code so your medical billing will flow logically. If you see any modifiers that should be added make a note of them as you go through so you don't overlook a small modifier later that can make or break your medical billing claim.

Check for NCCI edits. This will keep you from doubling up on any services already covered and again will make your medical billing claim flow in a logical manner. If you find there were extra services performed during the procedure, you can use modifier 22 and bundle your codes. This is especially helpful for Medicare claims. Using modifier 22 puts the medical billing claim under manual review and insures the carrier will review the bundled coding and see that all services were necessary for that procedure. This will help get you full reimbursement on special situations that otherwise may have been denied or partially reimbursed since they were bundled medical billing claims.

It starts with a patient who sees a physician. The patient gives the office their insurance or Medicare card and a new medical billing form is generated. No matter what procedures are rendered to the patient, it will be documented in the form of numbers called CPT codes, on the medical billing form.

If the patient has any testing done such as a blood or urine sample, basic evaluation or even a patient history interview, all of this including if the patient is a first time visit or not will be documented on the medical billing form. If there is a reason for the patient not feeling well such as the flu or a bladder infection, it will be documented on the medical billing form in numeric code.

When the patient leaves, there is still more to do. The doctor's staff will complete the coding for the procedures done for the patient and then they will send the form to a third party vendor for processing.

The medical billing partner will check the form for completeness, proper documentation, and correct coding and then submit the claim to the clearinghouse which routes the medical billing claim to the correct insurance company so a reimbursement can be issued to the physician's office for the services that were provided to the patient that day.

This entire process can take about 2 weeks from start until reimbursement, now you know how much documentation each and every doctor's visit can generate and you know why medical billing is so important!