Starting a New Medical Billing Business

[Marie_w01]

Hello, thank you all for all the advice in regards to starting my own business. I have a few additional questions... regarding adding medical coding as a additional service to my new company. With that said should I contract a coder or should I use the CPC that maybe in the physician's office? Also, what about services such as per-auths, scheduling, ect? Finally should I market as a full practice management business or simply a claims/AR service? Thank you again 

[Michele]

Hello, thank you all for all the advice in regards to starting my own business. I have a few additional questions... regarding adding medical coding as a additional service to my new company. With that said should I contract a coder or should I use the CPC that maybe in the physician's office?

I'm sorry but I'm confused.  If the physician has a CPC in the office why would it be part of your service?  We do not have certified coders on staff.  We do have coders who did not take the certification test because they didn't want to get into coding, and we offer the providers help if they need it, but we do not code.

Also, what about services such as per-auths, scheduling, ect?

This is a decision you need to make based on your situation.  We do not offer scheduling services because that would not fit with what we do.  We don't want to be on the phone with the patients all day, and most patients schedule when they are at the front desk.  As for pre-auths, we have tried that in the past but for us it doesn't work.  The provider gets a phone call for an appointment and takes down the information.  Then they fax it to us to check.  Then someone on our end needs to look up the info and get it back to the office.  We find it's easier to have the providers do that themselves.

Finally should I market as a full practice management business or simply a claims/AR service? Thank you again 

Again, this is something you want to decide based on what you want your business to be doing.  We market as a full PM business, but we cater our services to what the client needs.

[Marie_w01]

Thank you so much for the reply. My apologies I did not want to cause any confusion. I am in the process of starting my own medical billing business and I was seeking clarification regarding which services do I offer to the physician. Which services do you find more marketable? I live in a highly competitive area, so I am looking for a way to stand out, so I though offering medical billing and coding would be a great way to set me part.

Many Thanks 

[Michele]

No apology needed!  I just was unclear on that one question.  It's good to try to find some way to set yourself apart/above the other services.  Good luck! 

[medwave]

Make sure to have excellent references. A lot of healthcare providers will ask for them.

Like any job application, references play a huge part in building trust between an employer and employee. Similarly in the medical world and between two companies doing business, it’s important that the medical billing group furnish excellent references. This enables the medical provider to understand the over protocol, worth ethic and success rate of the medical billing group.

[PMRNC]

Make sure to have excellent references. A lot of healthcare providers will ask for them.

Also compliance plan and completed Risk Assessment, can't tell you how many billing company's don't know it's required and is part of their BA Agreement/terms.

[cflorez]

PMRNC, Can you explain what this compliance plan & risk assessment  is. As a medical biller is this something I need to be concerned with. Is it something I suppose to me doing.

[PMRNC]

PMRNC, Can you explain what this compliance plan & risk assessment  is. As a medical biller is this something I need to be concerned with. Is it something I suppose to me doing.

HIPAA holds BAs to the same standard now as the CE. This means it is REQUIRED to have following:

Your named privacy officer
Your HIPAA privacy and security risk assessment
Your privacy and security policies and procedures (with updates and change log)
Log and audit trail for information access
Evidence of your training or your employee’s training for those policies and procedures
Evidence that you perform routine and consistent auditing to ensure your policies and procedures are being performed.
Employee disciplinary plan in place for any HIPAA/HITECH Breaches

The BA agreement is not just a piece of paper it's still a contractual obligation that you meet the requirements of the BA Agreement.

I have a blog post here that may help: http://billerswebsite.com/medicalbillingblog/?p=662

[Marie_w01]

Thank you so much for all of the information. I have also  purchased one of the packages through Alice and Michelle’s website. The books are very informative.  Thanks again 😊

[cflorez]

PMRNC. Thank you for that information. Can we study in advance for the these test CHRS and CHIS. Or are they fairly straight forward. What benefit to me as a Medical biller beside a requirement.

[PMRNC]

We do not have study guides and I don't believe we will incorporate them any time soon if at all. The exams are straight-forward but they are meant to actually be a "teaching" exam, meaning they will show you where you might need help. Many new billers fresh out of a course or class, with NO experience won't pass it and I'm very honest and up front about that. Both certifications also require CEUs. We are also currently working on an ERISA certification also.