General Category > General Questions
NY based billing company billing for NJ Provider?
RichardP:
So you're saying if I have accounts all over the country, I need to have an S corp in every state.
As I stated above, the larger issue here is that states have the right to regulate commerce in their states. If you are going to conduct business in any given state, it is up to you to find out what those regulations are. That is the legal answer. The pragmatic answer is that, doing the billing for a doctor or two in a given state is not likely to attract the attention of that state's regulators - so you could get away with doing nothing. The problem is, if you somehow screw up someone's billing and you get sued by the patient or the doctor, that suit will be governed by the laws of the state that the doctor(s) or patient(s) resides in. You probably don't want to find out in the middle of a law suit that certain regulations you didn't know about actually do apply to you and you have been ignoring them. In the long run, it is to your benefit to contract with a local business attorney who can find out what, if any, regulations affect you in the states where you are conducting commerce. Think of it as insurance.
galinafl26:
Got it. Yeah, I am not a coder but a biller. I bill what the doctor writes down. At the end of the day, the doctor is responsible for his billing not me. My job is to submit what the doctor bills and to make sure it gets collected. Honestly, I've been in this business for a while now and I haven't heard billing companies getting sued unless they were dong fraud or adding things to get paid more. In this business from my experience, you do what you are supposed to do, collect what you can and that's it. Its very simple.
Thanks for clarifying that.
PMRNC:
--- Quote ---Got it. Yeah, I am not a coder but a biller. I bill what the doctor writes down. At the end of the day, the doctor is responsible for his billing not me. My job is to submit what the doctor bills and to make sure it gets collected. Honestly, I've been in this business for a while now and I haven't heard billing companies getting sued unless they were dong fraud or adding things to get paid more. In this business from my experience, you do what you are supposed to do, collect what you can and that's it. Its very simple.
Thanks for clarifying that.
--- End quote ---
Not sure what coding has to do with any of this.. but I have to say I completely DISAGREE with your assessment that you just "bill what your given" Along with Fraud comes Abuse, there's a difference. Also the law gives NO lead way for "ignorance" If you are given a code to bill and YOU are supposed to know what your billing and you don't, that's a no no. I'm not trying to take away your experience in this business, however I feel saying what you said is irresponsible. I have seen MANY billers and even office managers/billers in house get sued INDEPENDENTLY because they are JUST as libel. With fraud and abuse guidelines there is NO excuse for ignorance. A biller "SHOULD" know. it's THAT simple. Again, not trying to take anything away from you, but I don't think it does justice to those getting into this business to think it's simple data entry and your off the hook. It does not work that way at all. That is why it's imperative to have E/O insurance.
RichardP:
We never just bill what we are given. We are constantly giving work back to our clients for a re-code when we see where the client could legally code differently to get paid more, or where he did work but failed to code for it (the old, I see that you did A; I know that if you do A you also have to do B, but I don't see any codes for B listed on the fee slip).
galinafl26:
With all due respect, I've been in this business probably a bit longer than most people here. Not only have I've been in this business longer, I have an MPH in healthcare administration as well so as far as laws are concerned, I think I know them better than anyone on this forum. Having said that and clarifying that, I am not saying that a biller's job is simply data entry however, at the end of the day, its the doctor who is responsible for their billing! It's the doctor that has to know what is going on in their practice! At the end of the day, its the doctors responsibility to CHECK what the biller is billing, what codes she or he is using, what is collected, etc. The point I was trying to make here is that its still the doctors responsibility to know what is going on in their practice. Yes if you are given a code you should know what that code means however its the doctors responsibility to know the codes, not the billers! As much as you don't want to think of yourself as only a data entry person, you are DOING DATA entry. You are entering the information the DOCTOR gave you to bill. Maybe you don't want to look at it this way but hey we all doing data entry. To collect, is a different story, yes I agree, it's much more complicated that than, but as far as entering the information from a super bill is called DATA ENTRY. I don't agree with you on a lot of things you say on this forum and the advice you give to people that are just starting, but everyone is entitled to their own opinion. This is just mine.
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