Medical Billing Forum

General Category => General Questions => Topic started by: dfranklin on June 19, 2009, 01:53:37 PM

Title: Specialty as a New Biller?
Post by: dfranklin on June 19, 2009, 01:53:37 PM
You get 3 votes so you can provide your top 3 choices.  Would like to know learn from all of your experiences and findings on what primary specialty would be best for a new biller to focus on for their marketing efforts. 

Thanks for your help!
Title: Re: Specialty as a New Biller?
Post by: PMRNC on June 20, 2009, 07:23:45 AM
In the same MLN Bulliten:

MISINFORMATION #4: You can opt out of Medicare.

Correction: Opting out of Medicare is not an option for Doctors of Chiropractic.
Note that opting out and being non-participating are not the same things.
Chiropractors may decide to be participating or non-participating with regard to
Medicare, but they may not opt out.
For further discussions of the Medicare “opt out” provision, see the Medicare
Benefits Policy Manual (Chapter 15, Section 40; Definition of
Physician/Practitioner) at
http://www.cms.hhs.gov/manuals/downloads/bp102c15.pdf


Title: Re: Specialty as a New Biller?
Post by: Pay_My_Claims on June 20, 2009, 10:39:48 AM
In the same MLN Bulliten:

MISINFORMATION #4: You can opt out of Medicare.

Correction: Opting out of Medicare is not an option for Doctors of Chiropractic.
Note that opting out and being non-participating are not the same things.
Chiropractors may decide to be participating or non-participating with regard to
Medicare, but they may not opt out.
For further discussions of the Medicare “opt out” provision, see the Medicare
Benefits Policy Manual (Chapter 15, Section 40; Definition of
Physician/Practitioner) at
http://www.cms.hhs.gov/manuals/downloads/bp102c15.pdf



*** I stand corrected Linda***  Medicare does not consider them a Physician. I looked more at the "billing medicare" portion of the question and not the "opting out".  Thanks!!
Title: Re: Specialty as a New Biller?
Post by: Michele on June 20, 2009, 07:47:46 PM
I get that they can't opt out, but can they chose not to enroll in Medicare at all, Par or Non Par, and tell patients that they are not Medicare Providers.  Then if a Medicare eligible patient chooses to come as a cash patient they can??

Just wondering. 

Michele
Title: Re: Specialty as a New Biller?
Post by: PMRNC on June 21, 2009, 09:54:00 AM
No, I don't believe they can take cash from Medicare patients, participating or non participating they still have to file a claim by law.
Title: Re: Specialty as a New Biller?
Post by: Pay_My_Claims on June 21, 2009, 01:49:39 PM
why nobody voting for DME?? I'm offended :-)
Title: Re: Specialty as a New Biller?
Post by: PMRNC on June 21, 2009, 03:19:24 PM
Quote
why nobody voting for DME?? I'm offended :-)

I would never recommend a new biller take on DME.. it's too complex!! I would have to say they are not so hard in regards to marketing though, but that's a catch 22 because I wouldn't market a specialty I didn't know very well.
Title: Re: Specialty as a New Biller?
Post by: lhough on June 21, 2009, 03:41:09 PM
I agree, DME seems hard to me, but probably because I know NOTHING about it but what I have read in the posts.  My speciality is mental health.  I feel comfortable with that since I have worked in that field for almost 7 years.  I think it is the easiest, not difficult at all as long as you verify benefits every time, get authorization and stay on top of the authorization so it doesn't run out and the provider works for free!  Not many different codes to worry about, a bit more if you work for a psychiatrist and there is medication management, but still fairly easy.  Its easy when you know all the ins and outs of a speciality, to me I don't think I could do strictly medical billing becuase I am not familiar with it.  If I did it enough I know I could, but right now I guess you could say I'm scared and want to stick with what I know and then maybe branch out, maybe.  My plan is to become the best in my speciality in the little part of the world I'm in and when someone says they need a biller that knows mental health my name will be the one that comes to mind.  Thats the plan anyway, fingers crossed that some day it will work out that way.  ;D

I love this forum, I have learned a lot from everyone.  I read everything, some I don't understand because I don't know the fields, etc. but it is still very educational.  Just soaking up knowledge wherever I can! :D   
Title: Re: Specialty as a New Biller?
Post by: Pay_My_Claims on June 21, 2009, 05:30:27 PM
Yes it is, but there are not many providers that do ALL DME. The most complex to me is what I am in now, custom rehab equipment. Diabetic supplies is very cut and dry. Because of all the fraud in DME Medicare has cracked down so bad, and the documentation is so much in this field, I would have to sadly agree with you Linda, that you need to be very skilled to do DME.
Title: Re: Specialty as a New Biller?
Post by: PMRNC on June 21, 2009, 08:06:57 PM
My specialty is mental health too, it's easy but can be tedious and there's a lot of babysitting and hand holding because most mental health providers are overly relaxed in the area of urgency . LOL  I had one client that I literally had to fax over in bold on a fax cover sheet...  PLEASE GET OTR DONE FOR JOE SMITH!!!

Later on I took on pediatrics and really like that, the providers are great.. I've never met a pediatrician who I didn't get a long with!
Title: Re: Specialty as a New Biller?
Post by: Pay_My_Claims on June 21, 2009, 09:19:34 PM
YaY pediatricians!!!
Title: Re: Specialty as a New Biller?
Post by: lhough on June 21, 2009, 11:38:10 PM
Oh, you are so right about mental health providers.  When I was still working in the office I actually went as far as taping a big note to the owner's (provider) desk telling him to do the OTR or he will work for free blah, blah, blah.  Also, one of the other owners had a very bad habit of leaving after her last client (sometimes it wasn't the last client of the day, but she didn't read her day sheet, etc) without telling the staff so it got to the point where I would tape a large sign to the back door telling her not to leave the office without seeing me first.  It took several times of doing this before I got her in the habit of coming into the front office to check with us before she was able to leave.  She would come in and say, "Okay Lesley am I free to go?"  Mental health providers are like children in that all they want to do is see their clients, they are so hard to get them to do their "homework", which is their session notes, OTRs, and anything else you need them to do such as signing credentialing contracts.  Most do their notes with no problem, but getting them to do an OTR or even turn in the day sheet each day is a hassle, and that is what gets them paid!  But, I do love a challenge and my personality is that I don't let them slide on anything and I will ride their a** to get what I need from them.  Basically, they do it simply to get me to shut up and leave them alone!  LOL, I can be persistent when I need something from someone. ;D
Title: Mental health
Post by: gderilus on June 25, 2009, 07:23:21 AM
Hello all,

I'm currently taking a medical billing course online and will graduate soon. I'm doing an internship at a physical therapy clinic. She's the only one in the clinic and doing everything by herself. I went to the clinic and we started talking; I just couldn't believe what I saw. I was "SURPRISED". The office is a mess, not organized at all. She hired someone to help her but the person has no experience in the medical billing field at all. None of them know what they are doing. They don't know how to get paid from the insurance companies and don't even know where to start.

None of them know what a practice management software is or a CPT code or even a superbil form. I'm asking myself how in the world they handle the billing. I was telling her about the software and she was wondering if there's a specific one for mental health. Can you guys recommend a mental health software cause I'm not sure which one would be best to use. They do everything in paper and that's why they so unorganized. They don't know how to to patient statement or even be able to tell them how much their co-pay is. These things just motivated me to start my medical billing business. These providers do need help.

Anyway, if someone could recommend a good mental health software to buy, I would appreciate it.
Title: Re: Specialty as a New Biller?
Post by: PMRNC on June 25, 2009, 08:28:13 AM
I have worked on many mental health specialty software's and IMO they are crap. your best bet is to go with a PM Software and just make sure there are good managed care features and authorization tracking. Some of the worst software's I've ever worked on were mental health software's..therapist helper being the absolute worse!
Title: Re: Specialty as a New Biller?
Post by: Pay_My_Claims on June 25, 2009, 03:23:00 PM
If its anything like this crappy DME software, I would say the same thing. I prefer a PM Software program myself as well.
Title: Re: Specialty as a New Biller?
Post by: Michele on June 26, 2009, 08:22:57 AM
I'm confused though, you said you were doing an internship in a PT office, then asked for mental health software?  Did the internship drive you crazy?

Just wondering. ???

Michele
Title: Re: Specialty as a New Biller?
Post by: gderilus on June 26, 2009, 05:44:20 PM
I'm doing the internship in a physical therapy office, but the therapist don't know anything about medical billing. She hired  someone to help out but she has no experience in the field at all. It's kind of hard for me because when I have a question about something, no one can help me. I was telling them about the PM software they can use to handle their billing and they wanted to know if there's a specific software for mental health providers to use.
Title: Re: Specialty as a New Biller?
Post by: lhough on June 26, 2009, 06:24:21 PM
Still confusing, why would a physical therapist want info about mental health software?  ???  Are there mental health providers in the same office as well? Never heard of mental health working  in same office as physical therapist, interesting.
Title: Re: Specialty as a New Biller?
Post by: Pay_My_Claims on June 27, 2009, 12:24:57 PM
lhough, your name should be THOROUGH!!!
Title: Re: Specialty as a New Biller?
Post by: Philip on July 06, 2009, 08:39:53 AM
Please add HOME HEALTH and RADIOLOGY(Diagnostic centers) in specialities. If someone wish to start a medical Billing Company, they wil get more choices.
I am only a beginer I don't know it is correct or not. If it is not, I am sorry.  I really like this forum.
may God Bless you all.