Author Topic: starting a medical billing business  (Read 24537 times)

Pay_My_Claims

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Re: starting a medical billing business
« Reply #30 on: February 07, 2009, 07:02:38 PM »
gderlius, do you mean no experience as in you have never worked as a biller, but have been trained, or you have never worked or trained as a biller..............just curious

gderilus

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Re: starting a medical billing business
« Reply #31 on: February 08, 2009, 07:41:05 PM »
I have never worked as a medical biller before but I'm currently working on my Associate degree and I'll graduate in 4 months


I'm thinking about starting my own business, but I have a communication problem. I'm not a sale person and I don't really know how I would present my business to a doctor and persuade them on signing the contract with me. I was wondering if there are people out there who can act as a sale person on behalf me. If there are, how does it work, do we pay them a percentage on every contract they signed.
Any help please.

Pay_My_Claims

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Re: starting a medical billing business
« Reply #32 on: February 08, 2009, 07:58:17 PM »
Honestly, I am not for anyone trying to have a medical billing business that has never worked, or at least trained in this field. So many people think its just some data entry field and its not. For every person getting in this field, not knowing the business it makes it literally harder for the ones with the experience because providers don't trust outsourcing as much. If you are financially able to, maybe you should become the partner. Get an experienced biller who knows the field, and go into it with them,

Michele

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Re: starting a medical billing business
« Reply #33 on: February 09, 2009, 05:39:58 AM »
There are people out there who will market for you and they all charge in their own way.  Some will charge you an hourly fee, some will charge per appt, etc.  More recently it is becoming popular to charge a % of the contract signed.  But it can be done.  There are some people on this forum that do it, so maybe you can hook up with someone.

Good luck

Michele
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Michele

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Re: starting a medical billing business
« Reply #34 on: February 09, 2009, 05:48:03 AM »
I didn't read Pay_My_Claims response before I posted, sorry!

I understand Pay_My_Claims concerns, they are very valid.  Unfortunately there are a lot of 'experienced' billers out there too, that also give billing services a bad name.  When we started, my mother (and partner) had no experience in medical or billing at all, but I had worked at an insurance company for several years.  Looking back though, I didn't have 'billing experience'.  It can be done but as Pay_My_Claims stated this is NOT just a data entry job.  You really need to know what you are doing and be the type of person that is going to do it right. 

In my opinion it is more important that you take your job very seriously and treat it as if you are collecting your own money, not the doctors.  That you do whatever you need to to learn what you need to know.  Sometimes experienced billers are closed to learning anything new because they already know everything and that can be a huge handicap. 

But there is no better training than actual experience!

Michele
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Pay_My_Claims

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Re: starting a medical billing business
« Reply #35 on: February 09, 2009, 11:11:46 AM »
You really nailed it Michele. You may have not been a biller but oh my!! insurance experience is such a key part of the process. Knowing the rules and regulations of insurance especially Medicare, Medicaid, Tricare, and Work comp is essential. Yes the experienced biller does kill us, but her experience doesn't make her qualified. He/she has just been doing the job for a long time and the provider is probably frustrated at the insurance company for low reimbursements instead of realizing his experienced, but not knowledgeable biller isn't doing the job. What I wanted to convey to the poster was don't go into this business just because of what you may have heard on the internet, tv commercial or by word of mouth. I know cosmetology is big business, but I know its not for me. Not only am I not qualified, but its nothing I want to do every day 8 hrs a day. For anyone, find out what you enjoy doing and learn how you can do it and success is at your finger-tips. I love my work, and I know things will happen for me!!

Thanks Michele!!

Michele

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Re: starting a medical billing business
« Reply #36 on: February 09, 2009, 11:38:42 AM »
Very true.  When we interview to hire we always look for someone who 'loves' billing.  You either love it or you don't.  There isn't much room in between. :)

Michele
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PURPLELADY

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Re: starting a medical billing business
« Reply #37 on: February 25, 2009, 08:21:52 AM »
Hi All !!!!

  The purple one is back!!! (lol)  Now, all we have left to do is the business license and the business
bank acct.  I am currently working on the process of how we do business.  My question is what should my invoice include when billing the dr for our services?  Is it pt name, $ he received from ins co, etc.  Also, when picking up the charges from the drs office, should I confirm the amount of charges received before leaving his office?  We will be using Paypal merchant services @ 30.00 per mth and 3.1% +.30 for ea transaction.  Should we include the transaction fees when billing the dr or is it something we just have to
take?  Hope to hear from you soon.

Michele

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Re: starting a medical billing business
« Reply #38 on: February 26, 2009, 06:57:42 AM »

Welcome Back!  :)

When we invoice our providers we just include the amount owed and any previous balances they may still have.  If they want more detailed information I provide them with a report that shows all the transactions for the month including patient names, amounts billed, amounts collected, etc.

For the number of patients that are billed/pd on in a month, I couldn't possibly list all of them on the invoice.

Depending on the size of the office and the format you are given the information, it may be impossible to confirm the charges prior to leaving the office.  Some of our offices don't have the charges listed (amounts) on each claim, and it could take you some time to manually add them all up.

As far as the paypal fees, that is really up to you.  I personally feel you should just make your fee to the doctor enough to cover ALL of your costs of doing business.  I don't like charging a fee for my service, and then a fee for paying for my service, etc.  It looks like you're nickel and diming them to death.  Just my personal feelings.

Michele
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PURPLELADY

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Re: starting a medical billing business
« Reply #39 on: March 01, 2009, 08:39:53 PM »
Thanks Michelle, that was good info.  Now, I'm trying to get some "order in the campsite".  Can you please help me with putting things in order???  I would really appreciate it.  Here's our current status... We are going to purchase the ez claim software for 395.00 + 145.00 (for print image format module).  We have decided to go with office ally as our clearinghouse.  I havent signed with them yet, we are still confirming electronic transmissions between the insurance co and office ally, so far so good. Do I really need both? Office ally charges for submiting claims on paper and  sending statements to patients. So I figure ez claim would be good for that along with any reports I'll be sending to the docs.  Just how important is that print image format when sending claims to office ally?  Do I really need it?  Also, should I request the drs info in our contract or use another form for their credentials, facility location, tax id#, etc?
Just to confirm...our billing service info goes in box#33 and ein in box#25 on a hcfa, right?  Do you have any good suggestions for marketing and or creating websites?  That"s all I have for now. Hope to hear from you soon and THANKS SO MUCH TO MICHELLE AND ALL WHO HAVE ASSISTED ME WITH THIS PROCESS, I REALLY, REALLY, AM THANKFUL.  GOD BLESS YOU ALL!!!!
 

Michele

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Re: starting a medical billing business
« Reply #40 on: March 03, 2009, 06:37:02 AM »
Sorry it took me so long to respond.  We had an unexpected death of someone in our church Sunday night, and it really knocked me out. 

Anyway, I will try to help you out, but I'm not familiar with EZ claim so it is hard for me to comment on that.  Also, I've not used Office Ally so again I'm not familiar with the way they work.  From the way you are explaining it, you need a software to prepare the claim file to be submitted to Office Ally, so it sounds like you may need both. 

As far as Box 33, that would be the practice that you are billing for's billing information.  For example, if you are billing for Middleville Family Practice and the checks go to you then you would have:

Middleville Family Practice
Your Street Address
Your City, State Zip

But if the checks still go to them then you would have:

Middleville Family Practice
Their Street Address
Their City, State Zip

And their tax ID goes in box 25, not yours.  Your tax ID should never be on a claim.  The money isn't being paid to you, but to the provider, even if the checks are mailed to you.

Michele
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Pay_My_Claims

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Re: starting a medical billing business
« Reply #41 on: March 03, 2009, 11:31:49 AM »
Sorry it took me so long to respond.  We had an unexpected death of someone in our church Sunday night, and it really knocked me out. 

Anyway, I will try to help you out, but I'm not familiar with EZ claim so it is hard for me to comment on that.  Also, I've not used Office Ally so again I'm not familiar with the way they work.  From the way you are explaining it, you need a software to prepare the claim file to be submitted to Office Ally, so it sounds like you may need both. 

As far as Box 33, that would be the practice that you are billing for's billing information.  For example, if you are billing for Middleville Family Practice and the checks go to you then you would have:

Middleville Family Practice
Your Street Address
Your City, State Zip

But if the checks still go to them then you would have:

Middleville Family Practice
Their Street Address
Their City, State Zip

And their tax ID goes in box 25, not yours.  Your tax ID should never be on a claim.  The money isn't being paid to you, but to the provider, even if the checks are mailed to you.

Michele


You were right about officeally, you can use your own, or practice mate (who they partner up with)

PMRNC

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Re: starting a medical billing business
« Reply #42 on: March 03, 2009, 12:47:17 PM »
What is reason behind purchasing EZClaim?

When you are just starting out.. I like to recommend one important thing.. DO NOT fix/price your services. instead (and it's a marketing edge) base your charges/fees on each practice and doing a thorough practice analysis first. As a new billing company you could lose big time by creating a price/fee schedule too early. Too many variables are involved when you are a third party billing company. You want to be competitive and you also want to base your services on the type of practice, volume, current A/R ..etc. In all the years I've been doing this I've noticed that doctors take you more seriously when you tell them you need to examine the practice first before you give them a quote.

Linda Walker
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PURPLELADY

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Re: starting a medical billing business
« Reply #43 on: March 15, 2009, 09:12:59 PM »
Thanks for the info.  I want to purchase ezclaim to print self-pay statements, reports for dr, and claims (540.00). Office Ally has a fee for everything that they have to print to paper and send.   

I am also offering pre-collection services.  What should I charge for that service? It includes mailing stmts,
phone calls, researching bad addresses and then referring accts to collection agency (dr choice). Should it be 20% like the collection agencies?

When I get my first client, Along with the contract, I need to have all the dr credentials, what insurance are they par with, facility info, tax id, etc so I can set it up on my software and clearinghouse.  Is there a form established for that or do I have to create one?  Thanks

Michele

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Re: starting a medical billing business
« Reply #44 on: March 16, 2009, 06:11:44 AM »
I've never been involved in pre-collections or collections so I really can't comment on what to charge, although it sounds as if the 20% would be in line.

I'm not aware of a form out there for gathering all the info from the provider.  We made our own, that way we know that we are getting exactly what we need.  It's not a lot of info so it's an easy form to create, and you can make changes easily as things arise (i.e. NPI number!).

Good luck with that first client!

Michele
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