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 Medical Billing and Coding

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Medical Billing - What is it?

What is Medical Billing?

Medical Billing involves collecting data for completion of insurance claims and entering it into billing software program. Insurance claims need patient information, copies of insurance cards, copy of encounter form where the doctor documents the kind of care that was provided and the specific code for that procedure if performed.
The Biller is also required to verify patient benefits prior to the doctor providing care. The Biller must know the claim submission guidelines before submitting to an insurance carrier. Most claims are submitted electronically but still some claims are sent on paper and biller should know how to fill out HCFA-1450 or HCFA-1500 forms. Once the claim is sent, the Biller then performs patient and third party payer follow-up. Timely followup and management skills are required to get an approval for a claim.
Many a times, claims are denied and at such junctures, an efficient biller should rectify the errors and review the EOB (explanation of benefits). For claim rejections, a good knowledge of appeals process is certainly helpful. Besides these, biller has to take the responsibility to determine whether a certain charge has to be written off or billed to the patient. If the patient has to be charged, it is the Biller's job to process the invoice for the same.
Apart from these duties, accounting and maintaining all the information and receivables is necessary to get the complete billing picture.
Can you make a living doing this?
Undoubtedly yes and not only living, one can definitely earn a good lifestyle. The average range of salaries and earnings are around 20,000 to 40,000 a year with quite a few even earning to $100,000 a year. Those who have their own business earn more and with experience, the paycheck keeps on growing. Developing new clients and becoming a billing consultant will help to increase the paycheck.
Do you need experience?
Medical Billing is a business that requires skills, experience and education. If one is deficient in any of these, it becomes difficult to get clients. Experience coupled with education leads to a successful Medical Biller. Many novices just get some medical billing software and try to establish their business only to find that no one is coming to them. Besides, the number of fraudulent software vendors are on the rise trying to fool us in to the easy process of being a Medical Biller only to find later how small mistakes could severely jeopardize a client's practice. A good number of doctors and practices have been severely affected due to the errors of inexperienced medical Billers.

How much can I expect to earn?


Most of the medical Billers earn between $20,000 to $41,000 a year. It depends on how many clients you handle. The more clients you have, more will be your earnings. A rough estimation is around $4 per file submission.  With around 5000 claims a year per doctor, this makes around $20,000 a year from one physician practice. Most Medical Billers serve 2-3 doctors with the most experience ones serving 5 doctors easily. This makes their earnings to go up to $100,000 a year.

So all in all Medical Billing is a career of choice which is currently recession proof with an ever-increasing demand for quality Billers, Coders and Claims Specialists.

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