Thursday, February 22, 2007

Medical Billing is the Fastest Growing Opportunity in Health Care

On February 16, 2006 the Health Insurance Portability and Accountability Act was finalized, and enacted. This law is designed to establish national standards for all health care transactions, and to ensure the security and privacy of all health related information. The motivation behind this law is to improve the performance, and efficiency of our health care system. This type of reform has created a need for qualified individuals who can utilize the tools of this legislation, and assure full compliance, and maximum reimbursement. It would therefore be a prudent move for health care facilities to employ such individuals in order to avoid mistakes that could have dire consequences.

The proliferation of medical knowledge following World War II brought about an explosion of diagnostic, and treatment procedures. As a result, there became a need to organize, and standardize all these developing technologies. Here is where the foundations of medical coding were born. Medical coding met these challenges, and allowed for a more uniform way of communicating health information under a common language. By January 1979, standardized definitions, and codes were adopted, and used by health care providers, and insurance companies. Since improvements and refinements of medical procedures are constantly being developed, codes must be added and updated to reflect these changes. Today, the number of medical and surgical procedures have become enormous, so too have the codes to describe them. These overwhelming numbers of codes and protocols have made outsourcing medical billing the standard.

Medical Billing and related occupations continue to be the fastest growing opportunities in health care. Insurance institutions and government agencies are investing huge resources to control claims' fraud, abuse, and establish some degree of reimbursement parity. As a result, more insurance companies, and health care facilities are looking to medical billing experts for help. These companies and practices are looking for experienced and educated individuals; the legal consequences of incorrect billing could be devastating. There is a movement in the industry to make medical billers responsible for inaccuracies, much they way accountants are for tax returns.

At present, there are no standards for educational requirements for medical billers and coders. However, more employers are looking for some formal training at an accredited career training institution. These schools range in training time from nine months to two years, anything less would not be considered adequate. There is a move for certification, and several organizations are sponsoring certification examinations in medical billing and coding. Medical billers and coders earn as much as to per hour in the beginning, and could potentially realize to per hours with experience and additional responsibilities.

Today, evolutions in the health care industry are happening at a very high pace. It is only with the assistance of sophisticated computer programs, and standardized coding procedures that medical coders are now able to describe and characterize the tremendous number and various kinds of medical and surgical procedures. These realities coupled with government regulations, and health insurance guidelines have contributed to the strong demand for experienced medical coders and billers.
About the Author

Jay B Stockman is a contributing editor for Medical Billing Resource. Visit http://all-medical-billing-software.com/ for more information.



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Wednesday, February 21, 2007

Medical Billing Careers Center on Compassion, Expertise, and Patience

Medical Billing Is A Smart Career Choice

The medical profession is one of the highest-demand fields in the United States today. Every aspect of the field requires skilled and/or highly trained workers, and the billing department is no different. Those who embark on a career in medical billing find themselves with skills that can sustain a lifetime. Plus, the field offers a lot of opportunities for employees to reach out and help others. Combining decent pay with a much needed service, the career is a great choice for many who want to go above and beyond "regular" clerical work.

Specialized training in medical billing enables professionals who enter the field to better navigate the complicated world they will find themselves in. Dealing with medical professionals, insurance companies and patients is no easy undertaking, so solid knowledge can really help form the foundation for success.

Before most major facilities will hire a medical billing professional, they require applicants to obtain at least a minimal amount of training in the field. Since medical billing is not like other types of billing services, the need for this special training is absolutely present. Dealing with insurance companies and people who are sick, injured or otherwise feeling poorly is not like sending out a bill for anything else. Compassion, expertise and patience are required in this field as is an attention to detail.

Learning the medical billing field isn't terribly difficult, but it does require patience, practice and time. There are programs available for training that can be found in schools across the country and even online. The keys to success in the field include knowledge of:

* Communication skills. A medical billing professional must be able to work with other medical professionals, patients, insurance companies and so on. Getting information correct and clearly conveying it will be vital.

* Interviewing skills. Asking questions is a part of the field. Communication, of course, falls in here, but interviewing techniques go above and beyond regular face-to-face discussions.

* Medical terms. With the myriad of conditions, ailments and procedures that can be billed for, understanding the terms is essential for a successful medical billing career.

* Coding. Medical billing tends to rely on a fairly complicated coding system that takes every condition and procedure and boils it down to numbers and letters. The codes are very important to understand and know inside out and backwards to accurately bill patients for services rendered. Insurance companies, too, rely on these codes and their accuracy for making sure what's been performed falls in line with what's necessary under different circumstance.

* Medical ethics. Part of the billing career involves handling patient information correctly and honestly. It also involves protecting confidential information at times. Billing experts must learn how to do this to protect their employers, their patients and themselves.

Learning how to become a medical billing expert requires a some specialized training and a willingness to work with people. The career can open doors for a great living and those who know their stuff are always in high demand. Unlike other clerical type careers, medical billing is specialized, and therefore, requires a particular brand of training and personality to undertake.




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Medical Billing Careers

Since time immemorial, a career in medicine has been looked upon with prestige, and people consider it humanitarian and noble. A career in medicine calls for a lot of responsibility and the ability to update one's knowledge on the evolving medical technology. With the passage of time and innovation in the field of science, the medical profession is becoming very challenging. There are a number of fields within the medical career, such as Healthcare Administration, Healthcare Management, Medical Insurance Billing, Medical Office Billing and several others.

Basic Requirements For Medical Billing

The job of medical billing involves a lot of hard work and vast knowledge of medical terminology, anatomy, coding and proper completion of forms. In addition, you need to have basic computer knowledge and a typing speed of at least 35 words per minute. A good temperament is another important characteristic that the person needs to possess, since he is required to deal with a number of patients, their attendants, doctors, medical representatives and other office personnel.

Job Outlook And Employment Opportunities

Medical billing is one of the fastest growing careers in healthcare. The importance of medical billing personnel is on the rise, since several insurance companies and the government are continuously spending substantial time and money to nix fraud and abusive practices. Due to this demand, various companies and practices are constantly on the lookout for trained and experienced medical billers. Personnel could find positions with doctors, hospitals, nursing homes, insurance companies, legal offices, rehabilitation centers, legal offices and consulting firms or they could also work independently.

They could set up an electronic billing system through their personal computers. Independent medical billers can also work as insurance specialists and consultants. The job is lucrative and revolves around helping patients and medical professionals calculate their insurance bills.

Some of the other job opportunities that are included within medical billing are as follows:

- Billing Specialist
- Coding Specialist
- Medical Collector
- Patient Account Representative
- Claims Analyst
- Claims Processor
- Reimbursement Specialist
- Claims Reviewer
- Electronic Claims Processor
- Billing Coordinator
- Claims Assistant Professional

Work Culture

The work culture of medical billers is usually part of an office setup. More often than not, the personnel do not work in close proximity to where patients are diagnosed. They generally have billing offices and services in large corporate buildings, in small suburban offices and in the offices of doctors. They usually work during the day, from Monday to Friday, forty hours a week. However, there are times when, in insurance companies, they are required to work late at night. They are paid well for working overtime and their services are much appreciated by the medical establishment and patients alike.

About the Author

Tony Jacowski is a quality analyst for The MBA Journal. Aveta Solution's Six Sigma Online offers online six sigma training and certification classes for lean six sigma, black belts, green belts, and yellow belts.




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Denials and Delays in Your Medical Billing Claims

Are you wary about fighting a denial on your medical billing claim? Don't be. Sometimes medical billing claims are denied for legitimate reasons and other times a claim that should have been approved might be denied payment. Once in a great while your staff may miscode an item because they simply are not up to date on the CPT and ICD-9-CM rules and just plain old human error will factor in now and again.

Appealing a claim you feel should have been reimbursed is the way to maximize the revenue into your practice. Many practices lose great sums of income every year because they don't appeal denied claims due to either staff constraints or they simply didn't do it. Sometimes those claims get filed away by your staff with the good intention of handling them later but with day to day goings on, later just seems to be pushed further and further away and then your window for appealing a claim denial is gone.

Most denials can be grouped into a few categories:

*recording errors - simple mistakes like an incorrect insurance number or a mistyped date of birth can be all it takes to get a claim kicked back.

*coding errors - these will sneak through now and then even with all the checks and balances.

*processing errors such as incompatible edits.

Delays in medical billing are another issue that will cost your practice a lot of money. Delays can happen due to not getting a preapproval on a procedure or DME item. It also can happen when you forget to include documentation such as time line or medical necessity. Delays in payment due to errors are frustrating. They cost time and money in the form of someone on your staff will have put whatever they are doing aside and research the claim, pull files and resubmit.

If this is happening frequently in your practice, it may be time to consider outsourcing your medical billing. Your medical billing partner will pursue any denials in payment for you. If you get a claim denied for any reason, let your medical billing vendor look into the reason. In many cases they can go over the claim, find the error and/or recode if necessary and re-submit to the carrier and clearinghouse. When you consider claims submitted by professional medical billing firms have a less than 1% error rate, you can look forward to seeing your rate of denials and delays due to errors in coding decrease dramatically. This equals more revenue for you practice and also more time to run your practice and service patients instead of chasing paperwork.

Denials and delays are a fact of dealing with medical billing but you can make the incidence of this occurrence much less if you outsource your claims filing.

About the Author

Kurt Clark is a freelance writer & CEO of Kurt Clark, Inc, a web development firm. Learn more at: http://www.kurtclarkinc.com Based on interview with the Director of Billing at OMG, http://www.outsourcemanagementgroup.com




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Medical Billing Software

Billing software is an application that can make the billing process a breeze at any medical office. Billing software and its use guarantees the practice proficient billing practices with less manual labor involved in handling the process of billing. In fact, software can help the office keep organized and make tax time a hassle free time for the office that takes advantage of such an application.

There are numerous software applications designed for the specific needs of the community. Billing software applications are engineered for family practitioners, clinics, billing service specialists, hospitals, psychologists, physical therapy offices, chiropractic offices, dental practices, and there are even medical software applications suitable for equipment companies. The software applications that have been engineered for medical office management are diverse, providing users with a variety of functions as well. Current software allows users to bill patients, report overdue bills to collection agencies; make patient appointments; handle scheduling; easily submit claims to insurance companies and software serves as an electronic database of patients records.

Clearly, software is something no practice or office should be without. The functionality of the program alone makes the software an imperative tool in every medical office. Current medical billing software applications have been designed to meet with the standards imposed by HIPPA and the fact that any claims made to insurance companies are electronic and not paper means that the office will receive payment that much faster.

There are numerous medical billing software applications designed for the specific needs of the medical community. Billing software applications are engineered for family practitioners, medical clinics, medical billing service specialists, hospitals, psychologists, physical therapy offices, chiropractic offices, dental practices, and there are even medical billing software applications suitable for medical equipment companies. The software applications that have been engineered for office management are diverse, providing users with a variety of functions as well. Current software allows users to bill patients, report overdue bills to collection agencies; make patient appointments; handle scheduling; easily submit claims to insurance companies and billing software serves as an electronic database of patients records.

Medical billing software will undoubtedly help you in your quest to establish more organized business practices. Most doctors and medical billing professionals find that medical billing software helps them execute their billing in a more organized and efficient way. No longer will you have files and piles of information that could be better organized. Your medical billing software will help you index information in a better manner so that you can pull up bills for clients, send them out in an efficient amount of time, and simply keep good records.

About the Author

Medical Billing Management is an informative Medical Billing site that looks into all aspects of Medical Billing from Software to Management. To find out more visit Medical Billing



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How Does the Process of Submitting Medical Billing Claims Work?

Understanding exactly what happens when the claim is sent from your office to the time you are re-reimbursed for your claims, will help make your decision to outsource your medical billing a lot easier. No matter how you get your paperwork to the billing company, the claims submission process is roughly the same for all claims. This standardization in submitting claims, make the reimbursement process a lot faster for you.

You are well acquainted with the procedures for coding and documenting a patient's visit to your office. If you do your own billing inhouse, the claims are then sent by your office staff to the carrier or Medicare for reimbursement. The reimbursement process can take anywhere from 3 to 6 weeks if you are filing your own medical claims.

When you let an outside service handle your medical billing claims, you'll find your reimbursements will happen within a couple of weeks. The process is very simple and also very secure to ensure the highest in patient confidentiality.

First, you transmit your claims for coding to the company you are outsourcing your claims to. At the medical billing firm, your paper claims are entered and double checked for errors and then transmitted in batch orders. If you file electronically from you office the billing company simply downloads your claims via secure server.

Medical billing claims are transmitted via secure, encrypted data transmission. Transmissions are either sent directly to the carrier or to a clearinghouse. Clearinghouses edit the information into a standard format and then send it on the carrier to be processed.

Using a clearinghouse is a good step in catching the occasional medical coding error that might slip by. This method of checks and balances will further help your revenue flow as you will experience fewer than 1% of your claims being delayed due to errors in coding. Then, the carrier receives the claim and usually transmits a confirmation of receipt so the claim can be tracked. Normally reimbursement takes place in about 2 weeks using electronic claim filing.
You should receive a reimbursement check along with an Explanation of Benefits (EOB).

From the ease of having your medical billing claims submitted for you to being able to get a status on any claim with just a phone call or a click of a mouse,to the speed of getting your claims reimbursed, you can't go wrong outsourcing your claims.

About the Author

Kurt Clark is a freelance writer & CEO of Kurt Clark, Inc, a web development firm. Learn more at: http://www.kurtclarkinc.com Based on interview with the Director of Billing at OMG, http://www.outsourcemanagementgroup.com



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Billing Medical Software - The Solution for Medical Centres

Applications in the medical field are used as a medical management system that can automate and track the process of submitting medical claims to insurance companies. It records the process from the first time a patient visits the doctor, through all the visits and diagnosis held from thereafter, till the end of the treatment. Plus it has several automatic processes and reports based on the information entered that can take much of the load experienced to run the medical process in a non-computerized environment.

Some of the features billing medical software has are:

1. appointment scheduling
2. electronic claims
3. flexible reporting
4. claim tracking
5. patient eligibility
6. ability to interact with other 3rd party software

Like other software applications, medical software needs to be easy to use and have the possibility to log the events that occur during the treatment. It needs to have a simple approach to the medical billing process as a whole, which normally, when done on paper, is a very time consuming process.

The advantages of billing medical software can be summarized as:

1. automatic billing computations for patients
2. auditable history of a treatment case at a glance
3. updated patient details availability
4. reduced time to process

Clients can benefit immensely from medical software. Some obvious benefits are:

1. confidentiality
2. eligibility verification
3. claims submission

Apart from offering the above advantages for both parties, this software can automate the billing and collection process as well as offering simplified procedures for the main tasks needed as part of the medical and treatment process.

But who exactly can take advantage of billing medical software?
This software is normally designed for doctors, dentists, medical billing centres and other healthcare professionals who intend to send electronic claims. A good quality billing medical software allows users to work on different modules simultaneously and have the ability to be used in a multi-user network environment. Entering patient details, diagnosis, issuing reports and scheduling appointments are all functions that can be done and are allowed to be done from different users at the same time.

Billing medical software is a must for highly geared medical centres nowadays. Many advantages can be taken from a well written and efficient software. The reduced time to process the work and paper involved, and the total organization of the medical process are just the highlights on which a billing medical software can focus and excel.

Being efficient is a major achievement in today's busy life, especially in hectic environments. A computer with the right software can help reduce the many headaches associated with jobs in medical centres.

About the Author

Sandro Azzopardi is a professional author who writes articles on his web site and local newspapers. http://www.theinfopit.com/technology/software/billingmedicalsoftware.php



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