Tables of Content
1. Introduction
For any business to acquire its name in the field, the most important aspect is attracting customers. When it comes to a very specific niche, the number of clients is also less. However, there is always a way out. Here's everything you need to know about the medical billing business. Before we understand how to grow your newly formed business, you need to first understand what medical billing is.
2. What Is Medical Billing?
The meaning of medical billing lies in its name, that is, it is the process in which a healthcare provider submits claims to patients to receive payment for the services that have been used by the patients.
So is it just sending out bills and receiving payments? Well no, as you will be taking care of medical bills there are many factors that you need to consider such as:
Patient's insurance, if any
Accurate coding of the diagnosis and procedures performed
Billing the patients
Follow up with the insurance company to pay the patients on time
Tracking and processing the payments
That's a lot of work and responsibility. So let us see why we are focusing on medical billing projects from the USA.
3. Understanding The US Medical Billing Industry
Overview of the US Healthcare System:
If your business is to take care of medical Billings from the USA, then you need to understand the healthcare system of the USA and how such processing takes place. Here are a few things to know about the US healthcare system:
There is no universal healthcare
Healthcare in the US is quite expensive
Even though that is the case most people in the US have health insurance either private or state given
Once health insurance is provided the patient gets a PCP, that is Primary Care Provider.
An appointment needs to be taken to see your PCP, if it's an injury or you are sick you get the appointment as quickly as possible.
Now that you know the specifics of what you are dealing with and are familiar with what responsibilities come with being a medical biller, let us look into the various types of billing systems in the USA.
4. Types Of Medical Billing Systems
Closed Medical Billing System
In this type of system, the medical bills are kept safe within a specific organization or personnel. An Electronic Medical Record (EMR) is a digital tool which contains all the data related to a particular PCP's patient. This data can be shared within the same organization but will not cross its boundaries, hence a closed billing system
Open Medical Billing System
As the name suggests, in open medical billing systems data can be given out from the organization and is not bound to a specific healthcare provider. This kind of system is mainly seen in larger healthcare facilities which have various departments under control.
Isolated Medical Billing System
This kind of system is different from the other two as there is no involvement of healthcare organizations in the billing process. In this system the patients themselves maintain the billing system through a PHR, that is Personal Health Records.
Being a medical biller, one should be aware of all the systems and ittheirorkings for better services. Now that you have an overview of what the system is made of, let us see what qualifications you need to become a medical biller
5. Acquiring Skills And Qualifications
This field helps individuals even without college degrees in finding stable jobs. If you are willing to take up this job along with its opportunities. Here's everything you need to know about the job of a medical biller:
Job Requirements
Extensive knowledge of medical codes
Help determine charges for each procedure
Communicates with the insurance company for charges that need to be covered
Detail-oriented, analytical and organizational skills
Prerequisites
Obtain a high school diploma or its equivalent
Having a degree is not mandatory but a bachelor's degree increases the candidate's chances of getting selected
Background check with no criminal history
Medical Coding Training
Complete medical coding training from an accredited institution such as ABHES (Accrediting Bureau of Health Education) Is mandatory
The course provides a detailed knowledge of coding foundations, revenue cycle and billing, healthcare communication etc.
Medical Coding Certification
Certification after graduating from an accredited institution is necessary as it shows employers that you have mastered all the necessary skills.
Certificates can be obtained after passing certain examinations.
A few certificates include Certified Professional Coder (CPC), Certified Coding Associate (CCA) and Certified Coding Specialist (CCS)
Once you have established the necessary skillset the next step is to increase your business. Here's how you will get more medical billing clients
6. Finding More Clients
When starting with a business it is tricky to find clients. However, the right marketing strategies will boost your business in just a matter of time. Here are some of the ways you can attract more clients towards your newly found medical billing business:
Research the competition in your area
This goes without saying that keep your friends close but your enemies closer. Surely this is no war but you should always have an idea about who you are up against. If you are a local company or operate at a national level you must know the companies in your neighborhood.
Select a niche and master it
Medical practitioners and healthcare organizations need specialists as they overlook and master one specific type of billing. Moreover, if you offer a speciality which is taken up less by your competitors then this gives you an upper hand in the competition
Seek referrals
Customer satisfaction is always essential in any business. And the best zero-cost marketing is always with the help of satisfied customers. This can be achieved over some time in the long haul. While working with the client it is extremely important to build a rapport.
Develop marketing strategy
Putting your business online is now the best and easiest way to grow the business. Medical practitioners need medical billers on an urgent basis. This is where the search engine helps in highlighting your business.
Hire specialists
Opening up a business needs thorough maintenance too. Hiring specialists who take care of the growing business is important. For example a graphic designer for visual representation, and appealing business cards. With the help of these, the employer gets an idea that you have taken up the effort to bother about the appearance of your business
7. Conclusion
Medical billing is a trending profession. It is a booming industry as it does not require a person to hold a special degree to become a medical biller. Being a medical biller comes with responsibilities such as processing and receiving payments and keeping track of the insurance companies that are compensating the patient accurately.
Although the business is slow when it has just started, due to ever-increasing healthcare in the USA, a medical biller turns out to be an essential component in the billing system.