Medical Billing Forum

General Category => General Questions => Topic started by: dgarri on August 29, 2011, 07:40:37 PM

Title: Where do you start?
Post by: dgarri on August 29, 2011, 07:40:37 PM
Hello eveyone,

I am new to this site and am looking for some advice.  I have been in the medical industry for almost 12yrs.  Mostly as an insurance specialist, multi-tasker in the office.  The only thing I can't do is tx the pt.  I have been doing the coding and some of the billing for a Cardiologist for the past 4yrs for hospital/office pt's.  This past Dec I received my CPC from the AAPC and now I am wanting to take on some remote billing from home.  I would eventually love to quit my full time job and work from home only, but I know this is not going to happen anytime soon.  I have read a lot of the post on this site and I am excited to be apart of it. 

I've come up with a name, I have checked on what license I will need here in Florida as far as city/county since I will be doing this from home.  I've talked to my accountant about setting up an LLC, called the bank about a business acct, checked on email and have a few ideas on marketing.  I have no idea what software I am going to use!! Any suggestions would be wonderful - I need all the advice I can get and would be very grateful. :-*
Title: Re: Where do you start?
Post by: Michele on August 30, 2011, 07:38:22 AM
Many people have given information on different softwares which is nice since most of us have only had experience with a couple.  Try reading thru the posts on software.  I think you will find a lot of good suggestions.  Make sure you do a demo of any that you are considering.  It is better to do one that you can actually "play around" in to see if it's a fit for you.

Title: Re: Where do you start?
Post by: dgarri on August 30, 2011, 11:35:47 AM
Thanks Michele,

I have been reading a lot of the post and find them very helpful.  My concern is finding a program that is going to be ready for all the 5010 and ICD10 changes - or is that something I will have to address after ???? I know ICD10 isn't kicking in until 2013 but am really concerned about the extra expense after the fact!  Have you any further info on these things?? I know there are a lot of softwares out there - I just don't want to have to do this more than once if you know what I mean :P  And thanks again I appreciate any and all info.
Title: Re: Where do you start?
Post by: dgarri on August 30, 2011, 06:11:10 PM
Another concern is whether doctors are using remote billers enough to justify embarking on this home based business venture. I know that some are outsourcing over seas and with the implementation of EMR, more are keeping billing "in-house".  I would like some input on the present state of the business and the prospects for the future (trends which only those on the "inside" would know) before making the necessary time and money investments.
Title: Re: Where do you start?
Post by: Michele on August 30, 2011, 07:48:34 PM
Personally I still feel there is as much need, if not more for outsourcing, now than there was in the past.  In this economy providers can't afford to not collect everything they are entitled to, and most billers know that many providers just cannot accomplish this in the office.  Some can - don't get me wrong.  They have a good biller that's been with them for a while.  But most have high turnover and really don't know what the person doing the billing is doing.  Some think that do to EMR they need to bring it in house, but in my opinion they are wrong.  EMR really shouldn't affect billing.  The EMR companies use billing as a sales tool. 

Most PM systems are 5010 ready, or will be.  Most likely you will need to update before ICD 10 anyway, so it won't be added cost.  If you purchase your PM system now, you will need to update in a year or two for other reasons.
Title: Re: Where do you start?
Post by: PMRNC on September 13, 2011, 07:01:48 AM
You want to also check into Errors & Omissions services as well.

I agree about the outsourcing for billing, but not for coding. I do believe many doctors do not want charts leaving office, it really is a huge liability for both the coder and the provider both.
Title: Re: Where do you start?
Post by: Michele on September 13, 2011, 10:44:49 AM
I don't know too many doctors that outsource for coding for that reason as well.  I am always amazed when a dr in another state asks if we will do the coding and billing.  I can't imagine how they would get the patient's chart out for the coding??  We do not do coding, only billing.   ;D
Title: Re: Where do you start?
Post by: dgarri on September 13, 2011, 02:05:24 PM
So are you saying that the doctors office enter the coding/icd9's and you just submit and track the billing?? And if so how do you know that what they are using is correct?  Currently I do both in the office I work in.  I do understand that billing / coding is 2 seperate jobs so I want to be sure I am understanding your process.

Title: Re: Where do you start?
Post by: Michele on September 14, 2011, 07:22:10 AM
They send us superbills and we submit billing, track payments, handle denials/appeals, work aging reports, etc.  But the cpt's & icd-9's are sent over on the superbill.
Title: Re: Where do you start?
Post by: ruthie72 on September 16, 2011, 07:41:56 PM
HI Looks like you have done all the right things so far!! Now all you have to do is get the providers, and as far as the software goes , i got some great advice frome Alicia, you can start off with Practice Mate,  i also looked into Kareo.  i am also in Florida, i have been going from dr to dr to try to find some to let me do their billing at home. You have an advantage that you know some already so GOOD LUCK to you.