Medical Billing Vs Medical Coding Business

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How is a medical billing different from medical coding?

This is a question people ask me about daily.   Although these are two very different jobs, understanding both is essential in becoming an expert in your field. If you are thinking of starting a medical billing company, you don’t need a coding certification but it certainly helps to understand how medical coding works.

In the beginning, I went to Clark University for medical billing and coding. I had a very strong knowledge of medical terminology, anatomy, and coding when I graduated. I did not get certified after I finished.  I had researched medical billing businesses and found out how lucrative they could be. I went on to start a medical billing company and became a certified reimbursement specialist.

There were three factors that made me take this direction:

  • I wanted to be a business owner
  • I wanted to work from home
  • I wanted to make a lot of money
  • I wanted to support my children on my own

Think about what you want, are you ready to start a business of your own? Do you want the freedom of making your own work hours? You can visit me at www.jennifergomm.com if starting a medical billing business is the right path for you.

Job Duties of a Medical Coder

A medical coder analyzes the documentation of services with a healthcare provider (physician, nurse, chiropractor etc.) and determines the appropriate procedure code (CPT- Current Procedural Terminology) or HCPCS (Healthcare Common Procedure Coding System) to match the services provided. They also use the diagnosis code (ICD10 International Classification of Disease) that has been documented by the healthcare provider.

Because of the extreme importance placed on accurate coding, medical coders must often coordinate with other members of the staff to get more details about a particular patient.

Choosing an incorrect code could result in a loss of income for health care provider. In a large professional setting where the two professions are separate, medical coders are more concerned with compliance to universal meanings of codes.

Often, a medical coder works freelance, in a facility, or a physician’s office and are paid an hourly salary. This makes it more difficult to go into business for themselves and make a lot of money.  

Job Duties of a Medical Biller

A medical biller takes the assigned codes that the coder or healthcare provider chooses and enters them into billing software and submits them to the insurance company or appropriate payer to be paid.

They follow up and complete the whole revenue cycle process (post payments, appeal denials, and bills patients) and ensures it is completed.

The biller also has daily interactions with insurance companies and patients to make sure the claims are paid correctly and timely.

Eligibility verification is another big part of the biller’s job.  Incorrect eligibility can lead to unhappy patients and lost revenue.

They have direct communication with patients and healthcare providers about understanding their payment obligations. These might include copays, coinsurance, and deductibles. As stated above, in a properly run office this is done before they are seen. 

They are responsible for choosing the correct billing format, payer id’s, addresses, modifiers, and any required documentation. Most of their efforts are spent making codes conform to specific payer requirements to describe medically necessary services for reimbursement purposes.

Lastly, medical billers are not allowed to choose the CPT code. This violates ethical practices as they might pick higher paying codes.

How Are Their Jobs Similar? 

Both medical billing and coding share some similarities. They both work in the healthcare setting. They do share some duties such as collecting documentation, collecting accurate facility and patient information. Both jobs are absolutely crucial to the cash flow of facilities and physician offices. It is also helpful for both to have a knowledge of how it all works to aid one another.  The U.S. Bureau of Labor Statistics classifies medical billers and medical coders as Medical Records and Health Information Technicians.

No matter the differences in the job duties, both billers and coders must be detail oriented, use correct coding, and stay compliant with the current government regulations. They need to have good communication skills as they deal with patients, doctors, and all other related staff. They need to have computer knowledge, as most of the software today is on a computer, cloud or server based. Lastly, both need to possess integrity, and the law requires the PHI (protected health information) follow HIPAA guidelines.

If after reading this, you are interested in starting your own medical billing business please visit me at www.jennifergomm.com.  I offer one-one business coaching and a monthly membership to assist you in your billing business startup.

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Estimated Start Up Costs For Your Medical Billing Business

Estimated Startup Costs

This is only an estimate, I have seen some do it for less and of course, some do it for a lot more. At the end of the day, your drive and skill are the key factors in your success.

Computer – $500 or more (could do a monthly payment plan)
Software – $150 a month cloud-based per provider
Training – $800 for AAPC or AMBA (not needed to start if you have the experience or a great coach)
Clearinghouse fee – Usually included in cloud-based software but Office Ally is $20 a month.
Quickbooks or similar bookkeeping program – $9.99 ( the online version that is awesome!)
Phone line (VOIP) – $35/month
Furniture – $200 ( Or free, if you can get a desk and chair and perhaps a printer table)
Fax/Printer/Copier Machine – $300
Reference books- $0 you can get everything you need online
Paper & HCFA Forms- $20
Phone – $30
Marketing materials, and business cards, fliers, etc. – $300 (Facebook, LinkIedIn, Google Plus are free and give you organic free traffic)
CPA (Certified Accountant for tax issues) – $250
Local Business Licenses and Fees – $200 This can vary depending on your State

Optional:

Coach/Mentor- $99 Month

 

Billing Biz Hub Manifesto

BILLING BIZ HUB BOSSES ARE A NEW BREED OF WOMEN BUSINESS OWNERS THAT ARE AWARE OF THEIR WORTH.  BILLING BIZ HUB BOSSES ARE GOING TO CHANGE THE COURSE FOR ALL THE MINIMUM WAGE EMPLOYEES THAT HAVE AN AMAZING ABILITY TO BECOME THE MEDICAL BILLING ROCKSTAR THAT DOCTORS NEED TO RUN A SUCCESSFUL BUSINESS!  BILLING BIZ HUB BOSSES ARE NOT AFRAID TO STAND UP AND START A BUSINESS WITH LITTLE TO NO START-UP COSTS BECAUSE THEY WILL FIND A WAY TO GET CLIENTS THAT NEED THEIR SERVICES. BILLING BIZ HUB BOSSES WILL NOT LET THE BIG CORPORATIONS TAKE OVER THEIR JOBS BECAUSE PHYSICIANS NEED US TO KEEP THEIR SMALL BUSINESSES GOING. BILLING BIZ HUB BOSSES WILL CONTROL THEIR OWN BUSINESS AND NEVER WORK FOR SOMEONE WHO PUTS THEM DOWN OR DOES NOT KNOW THEIR WORTH. BILLING BIZ HUB BOSSES HAVE ETHICS AND KNOW THAT AT THE END OF THE DAY, THEY HAVE MADE A DIFFERENCE IN THE LIVES OF DESERVING PHYSICIANS OR CLINICS. BILLING BIZ HUB BOSSES KNOW THAT EVEN IF THEY FAILED IN THE PAST AT JOBS, RELATIONSHIPS, COLLEGE, OR ANYTHING ELSE IT DOES NOT MATTER, THEY WILL SUCCEED. BILLING BIZ HUB BOSSES WILL NOT BE DEFINED BY COLLEGE DEGREES OR CERTIFICATIONS, SKILL & DETERMINATION WIN EVERY TIME. DEFINE YOUR OWN DESTINY, CREATE YOUR OWN LUCK, CHANGE THE COURSE FOR WOMEN IN BUSINESS, AND REMEMBER, AMAZING THINGS HAPPEN WHEN WOMEN COME TOGETHER AND SUPPORT EACH OTHER!!!

How to start a medical billing business from your home webinar is coming soon!

Why you should build a WordPress website for your medical billing business

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I know what you are thinking, I do medical billing so why should I be concerned about where my website is or SEO (Search Engine Optimization) or having a blog. If you have followed me for a while, then you know I have done it all in my business from building a website to running a Facebook ad. I always recommend WordPress to my coaching clients and I’ll tell you why.

What is the first thing you do when you need something, perhaps a new washer dryer, computer, or car?  You google it.

Think about your clients, how will they find you?  What will they see when they google you?  Wouldn’t it be nice if they found you on their own, saw you were an expert in your field and called you to inquire about your business without you having the cost of marketing?

 

This is organic reach and it’s free.

 

What if you kept a small blog, updated your potential clients and posted this on all your social outlets?  Again, this is a huge way to get in front of anyone needing your services and giving them insight on your knowledge and expertise. We are living in an era where the internet rules the world. It is important to have a solid website, and WordPress can offer you the tools you need to develop a website that can stand tall in the market and is more recognized by Google. It is also one of the most popular blogging tools and blogs are a great way to get free eyeballs on your business.

 

So, let’s look at some of the top reasons why you should use WordPress for your business:

 

WordPress is simple and easy to set up, update and manage.

 

You don’t have to be an HTML coder or an internet champ to use WordPress. All that is needed to create your website on WordPress is a web browser and an internet connection. With this platform, you can have your website up in just about two minutes. WordPress is a perfect starting point for businesses and when you are ready to customize your site, you can easily do it even if you do not come from a technical background. Using the friendly visual editor, you can update all your content, be it blog posts, pages or custom posts.

 

WordPress comes with thousands of professionally designed themes.

 

WordPress brings to you several themes, and many of them are available for free! These themes let you professionally design your website, without the expense or pain of hiring a professional designer.

 

WordPress is quite versatile.

 

Regardless the nature of your business, WordPress is up for the task. It is capable of handling everything from blogs to business websites and even e-commerce. From a business point of view, this is a great asset as the scope of your website is not limited. You are free to branch out new projects and add additional functionalities.

 

WordPress is SEO friendly.

 

Organic SEO is the buzzing word in the industry today. It is something we get to hear a lot these days and the good news is that WordPress has many options that can help you get an edge over your competitors in the search engine results. WordPress offers you certain features as well as plugins that can monitor the analytics for you and drive traffic to your site.

 

WordPress is an open source program.

 

Another feature that makes WordPress perfect for your business is that unlike many other website building platforms, it is an open source program. Open source refers to a program that is available to the public for use and/or modification from its original design free of charge. This means it’s free from limitations and commercial restrictions allowing you to use it the way you want and host the site wherever you want. You do not even have to be scared that changes in someone else’s business plan or model will impact you.

 

WordPress is not expensive.

 

WordPress is one of the most cost effective websites. You are definitely getting the most out of the yearly cost.

 

WordPress offers many features.

 

WordPress offers some powerful attributes, such as email harvesting, blogging, dropdown menus and commenting. You can also add various plugins with just a few clicks for additional functions such as social media feeds, slideshows, event calendars, video albums etc. Hence, it can be said that with WordPress you can plan and develop with confidence.

 

WordPress has been around for a while.

 

If you don’t know, WordPress is more than ten years old. During these ten years, it has been tested, refined and enhanced, and in the process, has evolved into a top-notch web publishing platform.

 

WordPress is compatible with mobile internet.

 

In this high-tech era, you cannot assume your clients will visit your website only from a full-screen computer or laptop. Mobile internet is the need of the hour and the usage of mobile internet is booming. If your site is not compatible, it may not look good on smartphones and customers might not continue showing interest in your website. There are several WordPress themes that are designed to be mobile friendly or are responsive, which means your visitors are free to visit your website on their smart devices. Not only this, The WordPress dashboard is created to work on full-screen computers as well as smart phones so that your website can be managed from anywhere, anytime.

 

Free support is at your fingertips.

 

Have you ever run into any sort of issue while using WordPress? Well, there are several videos and articles available that can help you with these issues. Whether it is about troubleshooting plugins or installing themes, WordPress offers you documented solutions to most of your problems. The time that can you save on troubleshooting these issues can be spent doing other creative things in WordPress. If you are one of those DIY sorts, you can save money by reading and fixing, instead of hiring someone to fix these issues for you.

 

WordPress is loved by Google

Google, the king of search engines, loves WordPress and this is a great plus! You might wonder why? Well, it’s because:

 

  • Google really likes text-based websites, and WordPress is text-based.

 

  • Google loves sites that are mobile friendly, and WordPress can be made as responsive as possible for all the smart devices.

 

  • Google really respects websites that come with logical architecture, and WordPress is indeed designed in a very logical manner.

 

  • Google loves Search Engine Optimization, and WordPress is SEO friendly and helps you rule over your competitors.

 

  • Google is fond of blogs, and WordPress is popularly known as a blogger’s tool.

 

WordPress is definitely the website to consider when building your medical billing business website.

 

You can reach me at www.jennifergomm.com join my $29 monthly membership or the one-one coaching packages.

How can I find the right medical billing program?

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Medical coding and billing jobs are in high demand and growing according to the Bureau of Labor Statistics. That is great news if you are thinking of starting a medical billing business from your home.

 

Like all other “work from home” promises, you should look for qualified coaches, programs, and tools to help you.

 

Quality online medical billing courses do exist so be sure to do your research and choose one that is legit.

 

Watch out for these red flags:

 

  • Programs promising instant success, without doing all the hard work necessary to start a business or get certified.
  • Programs that are not taught by certified medical billers, coders, and or successful medical billing business owners.  
  • Programs that don’t specialize in medical billing.
  • Programs that don’t have a large social media following or credentialing.
  • Programs that cost more than $2500.00.
  • Programs that offer a “certification” from a company not recognized in the USA.
  • Programs that don’t offer payment options.
  • Programs that don’t have references; you should be able to talk to past students.

 

You want to look for programs that prepare you for the certification exams recognized by the industry. They include:

 

AAPC – The American Academy of Professional Coders

AMBA – The American Medical Billing Association

AHIMA – The American Health Information Management Association

 

Make sure your program includes all areas of billing including:

 

  • Anatomy
  • Medical terminology
  • Coding
  • Insurance rules and regulations
  • Billing software programs

Do your research, ask how long the school has been around, if it’s accredited, ask about instructor experience, and if they help you get placed in a position upon completion. Ask if there is a refund policy. The time you put into researching the program you choose will ensure your success upon completion. If you are ready to start your own business and would like to know how I went from zero to six figures in just two years, visit me at www.jennifergomm.com and join my membership or one-one coaching program.

How to thrive in this economy by starting a home based medical billing business.

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There are two industries that seem to defy the tough economic times. These are IT and health services businesses. Medical billing happens to be a combination of the two.

Watch the on-demand webinar to find out how I started my business and reached six figures in two years.

Why is it lucrative?

Most medical billing companies operate on a commission basis.  They generally get 4-10% commission on all revenue that they generate for the practice or facility.  For a company that has multiple clients, this income really adds up.  Also, you maintain complete control of how your business will run, how big it will get, and who your clients will be.  Gone are the days when you worked for one boss and had to put up with mistreatment just to collect a paycheck.

In these economic times, is this a good business to start?

Many healthcare providers are now outsourcing the billing due to ever changing regulations and in office time management.  These constant regulation changes make it hard for the organizations to stay profitable. Outsourcing is helping them cut costs and increase their efficiency. Common areas that outsourcing is being done include medical claims processing, accounts receivable management, and patient statements. Moreover, given that healthcare is rarely affected by the economic pressures, you can be sure to be in business even during an economic recession. The healthcare billing industry is booming, making this a job with longevity.

The demand is being fueled by:

  • Ever changing insurance regulations
  • Increase in cash flow
  • In office time management
  • Technology experience requirements (most billers are not proficient in computers)
  • More focus on patient care
  • Reduced stress in the workplace
  • Reduced errors
  • Less need for in-house staff

Do I need a certification?

Although a certification will definitely make you a standout, it is not a requirement. Many medical billing business owners do not have an official certification but they have enough experience to qualify as a competent business owner and medical biller.

You can get a certification in this business at a very low cost, the American Academy of Professional Coders and the American Medical Billing Association offer great certification programs and are considered reputable in this business.

Why is it a business for you?

This is a business that you don’t need a college degree to start, has very little overhead costs, and you can run right from your own home.

This is a business that is great for single moms, retirees, and anyone that has a desire to become an entrepreneur. The business gives you the flexibility of setting your own hours.  Although most insurance companies are open Mon-Friday, 9am-5pm you can decide to make important phone calls at that time but do your other work at night or on weekends.

The best part about starting your own medical billing business is, you can also operate the business remotely anywhere in the world.

Would a coach or mentor be helpful?

Absolutely!  To avoid many mistakes in business, and also in the medical billing field, it would be advantageous to have a coach or mentor to turn to for advice. You can join my membership and get all the benefits of my webinar, book, and direct email to me to map out your action plan in starting your business.

You can also sign up for one-on-one coaching