The Business of Medical Billing

This industry is such a balancing act in many respects.  When we are first starting our businesses we can’t find enough providers who hire us.  As we grow, we find we have more work than we can get done and we need to hire and train someone.  Once you start hiring and training people it can be difficult to know when you need to hire the next person.  Is there enough work to justify another person?  Is there enough income to cover the additional costs of hiring another person?  Who will train the next person and how will that affect their work load?  We find we are often questioning if we are ready to hire another person.  Is this just a busy time frame due to a few projects or do we need another full time person?

Last month we tried something new.  We hired a person to fill a position we had never hired for previously.  We found that as we grew we found new needs.  We bill for over 50 offices.  We assign certain accounts to each worker.  We also cross train all accounts so if someone is out or they leave someone else can take over that account.  Then we also have one person who continuously works aging reports so each provider’s aging is completed every 4 – 6 weeks.

Over the years as we added accounts and insurance carriers offered ERAs or electronic remittance advice we found that it was taking a lot of time just to download all these ERAs and take care of the denials on the reports.  We tried having one person do the reports on Monday and Wednesday and another on Tuesday and Thursday and a third person on Friday.  This worked, but it entailed problems too.  We found we had to keep rearranging who could do which accounts because so much time was being spent on the ERA downloads.

Last month we had someone approach us asking if we were hiring.  We were not looking for someone, but thought what if this person could learn just the ERA downloads.  She wanted to work only part time as she has a special needs child.  The downloads took a little less than 4 hours most days.  It was a difficult job for her to learn, but now 4 weeks later it is working great.  It has freed up three other workers to spend more time on their own accounts and take on a little more work.  We filled a position that we were not aware was a need.  Keep your eyes open to such possibilities.  Sometimes we are so used to doing things one way we are unable to see a better way.

Is this a good time to get into Medical Billing?

Alice asked me to jot down my thoughts for this month’s newsletter and I thought “I don’t have time to jot down my thoughts!  I’m swamped.”   But then I stopped to think “Why am I so swamped?”  And that gives me the topic for my thoughts.  Over the twenty years we have been in business we have heard one question above all others:  “Is this a good time to get into Medical Billing?”  The answer has always been “Yes!” but now I say it with even more enthusiasm.

Lately we have been receiving more calls than ever inquiring about our services or asking for help.  Providers are being hit from all directions and they need help making sure they are not losing money.  PQRS, EHR, Meaningful Use, low reimbursements, higher out of pocket costs, and the list goes on.  It is more crucial than ever that providers make sure that the person handling their billing is doing a good job.  Gone are the days when providers could afford to lose a little here and there (not that I ever understood those days anyway!).  In order for a provider to stay afloat they need to make sure they are collecting all that they are entitled to.  So when anyone asks us “Is this a good time to get into Medical Billing?” we say “Absolutely!”

The next question we get asked is “What do I need to do to get started?”  That question cannot be answered in one sentence.  It really depends on your background.  Do you have any experience in medical billing?  Are you looking for a career or do you want to start your own business?  Do you have any experience in owning a business?  The answers to those questions will determine your next step.  Most people we come across have little or no experience in medical billing.  If you have no experience you really need to learn medical billing even if you plan on starting a billing business and hiring others to do the work.  You need to understand billing to know that they are doing everything right.

There are a lot of places that will tell you they will teach you all you need to know.  The problem is many of them are extremely outdated and can be outrageously priced.  Many are taught by people who have never done billing or who haven’t done billing in forever and they don’t really teach actual day to day billing. The billing field changes literally daily so it is so important that you are learning current billing and that whatever method you choose is up to date.  Alice and I have written several books on medical billing but our books are for specific parts of the business and just can’t teach you what you need to know to actually do medical billing.  So in 2013 we teamed up with Merry Schiff to create reasonably priced, current online medical billing classes.  You can read more about them at:  A Step Above Medical Billing Study Course..  So if you are considering a career in medical billing, Yes this is a Great time to get into it!