Some Accounts Are Not Worth Taking

When you are first starting your medical billing business, it is difficult to imagine but unfortunately it is true. Some accounts are just not worth taking. When starting out most billers wait with great anticipation for that first account. There is great excitement when that account is found and the contract is signed. We rejoice and celebrate. It may take a couple months for the stark reality to set in or you may start to see that it's not working as expected right from the start.

You may find that as you start your first account you just are not getting all the required information when you need it. Maybe the office was supposed to have the claims ready for your first pick up last week and you still haven't seen them yet. Sometimes you get a packet of claims with 25% of them missing ID#s, dates of birth, or diagnosis.

You may expect a large packet of billing and set aside a certain amount of time to complete that work to find that nothing is sent or a very small packet. Sometimes provider offices neglect to send you the eobs on time and you make needless claim status inquiries.

When we first started our billing services, we took on a couple small accounts that amounted to so little that it certainly was not worth the trouble. At that time it was still beneficial to us as it gave us needed experience in submitting these claims and practice with our software. We set up systems that we would develop as the years went by. The important thing to recognize is that when you get to a point where these accounts are not worth the work that they cause you, it is time to give them up.

Other accounts are not worth the work they present right from the beginning. They may never seem to be able to get everything together to send to you or they make unusual requests and demands that create an extra work load for you. You need to learn to recognize these and see them for what they are. Work with any office before you give them up. See if improvements can't be made to make the situation work for both of you. Check out Solutions Medical Billing for more information on dealing with providers.

Medical Billing in a Box

We have released our newest package for medical billing services just starting out. It contains 5 books, 5 special reports, 50 blank CMS 1500 forms, our completed package of CMS 1500 forms for mental health billing, workbook, and for a limited time we are offering a free 15 minute consultation with either Michele or myself. The five special reports are not available elsewhere. We wrote them special for this package.

The five special reports are:

"Insurance Denials - Learn How the Pros Handle Them to Get Your Claims Paid"
"The Secrets of Authorizations and Referrals, What You Need to Know to Prevent Denials"
"How Participation With Insurance Carriers Affects Your Billing Business"
"How to Choose the Best Practice Management System for Your Business"
"Learn the most effective marketing technique we’ve ever used"

The books are:

"How to Start Your Own Successful Medical Billing Business"
"12 Marketing Strategies To Grow Your Medical Billing Business"
"How To Complete a CMS 1500 (HCFA 1500) Completely and Correctly - Line By Line Box By Box"
"Secrets to Signing Up Your First Doctor"
"Basics of Medical Billing"

For more information on this brand new package visit Medical Billing Live

Training New Employees

One of the most difficult tasks in the medical office is training new employees. Even when an employee comes to you with lots of experience, it does not mean that the new employee will be able or willing to do things the way you want them done. We find that some of the people we have hired who come to us with experience tend to do things the way they learned in a previous office. That is not always a good thing.

Some new employees learn much quicker than others. When we hire a new person, we try to establish what their strong and weak points are as soon as possible. We find some people are natural at making and answering phone calls and some hate talking on the phone and do not do as good a job. Sometimes when we hire a person for a job we find that they are better suited for a different one than what we intended. We try to work around the employees strong points as long as it works for us. But if we hire someone for a specific job and they are no good at it we find it best to let them go before we waste any extra time in training. If we can use them in another position that they are good at, that is great but if it isn't working, we let them go.

Training a new worker is a huge time consuming job which keeps others from getting their own work completed. If you don't watch all the work they do to make sure it is being done the way you want it done you may find yourself redoing it. This can take longer than it would have taken to do it yourself. Generally speaking we find it takes months to a year before a worker is trained well enough to stop checking their work.

When first starting to train a new employee it is crucial that you check everything they do. As the new employee gets more experience we've learned to spot check the areas we feel were potential problem areas for them. With all the things there are to learn in the medical billing field it takes time to develop a great employee. Once we have a great employee we do everything we can to keep them happy so they stay on. It's so much easier to keep a great happy worker than it is to train a new one.

Secrets to Signing Up Your First Doctor

We recently completed our latest medical billing e-book and added it to our e-books for sale on our website Medical Billing Live. We wrote this book because so many people starting this business don't understand why doctors hire billing services or how to approach these doctors to get their business. We offered some marketing suggestions as well and explained how important your marketing efforts are, especially at the beginning of your carreer.

When we started our business in 1994 we really did not understand what our worth could be to a medical office. It took years of experience to fully understand why a medical billing service could do a much better job at bringing in the money than many offices can do in-house. Our efforts in this book were to shorten the learning curve for those who want to get started in this business.

ICD10 Codes Go Into Effect in 2011

Many of us have heard about ICD10 codes but don't understand what the effect of use of the ICD10 codes will mean to individual billers. Well the Department of Health and Human Services has announced a proposal to change ICD9 codes to ICD10 codes effective October 1, 2011. What are the differences and how will this affect all of us in the medical billing field?

ICD10 codes are an important part of the effort to develop nationwide electronic health records. The current ICD9 codes which were developed 30 years ago are expected to run out of available codes next year. ICD9 codes are limited to 17000 codes where ICD10 codes will allow for 155000 codes.

The new codes will help identify specific health conditions and help with the implementation of electronic medical records. As with all changes to the medical billing industry, it will be interesting to see what challenges arise as a result. If it is anything like NPI numbers and new CMS 1500 forms, we will all be in for a surprise.

Dealing With Insurance Denials

One of the most difficult tasks in the medical office for the billing department is dealing with insurance denials. Unfortunately many claims are denied for a variety of reasons and if not handled properly no payment will ever be made on that service. Most offices are extremely busy and it can be difficult to find the time to take care of these problems. If your office does not have the time and resources to take care of these denials, your receivables will greatly suffer.

Denials can range from no coverage to treatment notes needed. Each individual denial needs to be looked into to determine how you will get paid for that date of service. Many times it will take only a phone call to fix the problem, but that phone call can take as long as 45 minutes to accomplish the preferred outcome. Some denials will entail the resubmission of the claim. An incorrect diagnosis code is an example of this. Some denials will result in billing the patient for the service but it may still take a 30 minute phone call to be sure that you are doing the right thing.

The secret to handling denials effectively is to act as soon as possible on the denial. Many denials have a time frame that must be adhered to. Then, you need a good system in place for dealing with the denial. When a claim is denied find what works best for that problem and use the same method each time you get that denial. Find the most effective solution to each denial and use that solution as soon as you receive the denial.

For instance, when we get a denial for medical records or treatment notes, we immediately type up a note and fax it to the providers office to let them know that we need the records. We then put the denial in the front flap of the folder designated for that provider. As soon as the notes are sent to us we go to the provider's folder and retrieve the denial. We print out a new claim form and attach a copy of the denial and the notes and note the computer that the records were sent with that claim.

Sometimes denials are completely incorrect. Usually a phone call to the insurance company can resolve the problem. We sometimes have claims rejected at the edit stage of an electronic submission for no insurance coverage. A call to the insurance company or sometimes checking their website may tell us that the prefix of the identification number has changed. We change the prefix and resubmit the claim. Or we may have made a typo in the ID# that needs to be corrected.

We have had claims that were accepted, but applied to the deductible. After the patient was billed we received a call from the patient stating that they either don't have a deductible or that it has already been met. Sometimes the patient is wrong and sometimes the insurance company is wrong, but all these challenges must be dealt with if you are to receive payment. The more you delay in dealing with the problems, the better the chances are that you will not be paid.

Letter to an Anonymous Medical Billing Service

We’re sorry. You lost a client today and they signed up with us. We don’t like to see any billing service struggle to survive. We sincerely don’t like to take a client away from another billing service. There are plenty of new doctors and offices that decide they can’t handle in-house billing any more to try to take a client from another service. But one of your clients called me and asked how I would handle a certain situation.

Please let me tell you why it happened. Your client explained that she called you, her billing service, and asked why they were not receiving payments on a particular patient. You didn’t know. We told her that wouldn’t happen in our office and explained our system of tracking the claims. She told us that her billing service wouldn’t call on a claim unless she called and asked them to. Basically all your service is offering is submission of the initial claim. Anything else is extra work for you.

She went on to tell me that if the office asks the billing service for a report it is weeks before they bring it in. Weeks!! That is totally unacceptable. If the provider requires a report, you should run that report that day and fax it over. They asked for the report because they want it not so they can ask you about it again next week.

STOP!! You have to change that. You are called a billing service because you offer a service. If you offer only the service of submitting the claims, it’s not much of a service. You need to understand that other billing services are offering more than that and you need to step up to compete.

Submitting the claims is only a small part of the job you can offer your clients. Every time you find something else you can do for your clients, you solidify your relationship with them. Tracking your claims is just as important as submitting them. You must start running and working regular aging reports. You need to get a system in place for tracking your claims. You need to be reading your electronic reports and correcting any problems. You need to be reporting regularly to your clients about any problems you are encountering.

We hear enough about billing services providing poor service. Let’s all step it up a little and do a better job for our providers. We offer a valuable service when done properly. Most medical offices are much too busy to handle the billing portion of the work. Make sure you have everything under control with great systems in place for not only submitting your claims, but for tracking them, too.

If your providers are not getting the service that other billing services provide, they may not be happy. They may call me tomorrow.