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Medical Billing is the Fastest Growing Opportunity in Health Care

by: Jay B Stockman
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On February 16, 2006 the Health Insurance Portability and Accountability Act was finalized, and enacted. This law is designed to establish national standards for all health care transactions, and to ensure the security and privacy of all health related information. The motivation behind this law is to improve the performance, and efficiency of our health care system. This type of reform has created a need for qualified individuals who can utilize the tools of this legislation, and assure full compliance, and maximum reimbursement. It would therefore be a prudent move for health care facilities to employ such individuals in order to avoid mistakes that could have dire consequences.

The proliferation of medical knowledge following World War II brought about an explosion of diagnostic, and treatment procedures. As a result, there became a need to organize, and standardize all these developing technologies. Here is where the foundations of medical coding were born. Medical coding met these challenges, and allowed for a more uniform way of communicating health information under a common language. By January 1979, standardized definitions, and codes were adopted, and used by health care providers, and insurance companies. Since improvements and refinements of medical procedures are constantly being developed, codes must be added and updated to reflect these changes. Today, the number of medical and surgical procedures have become enormous, so too have the codes to describe them. These overwhelming numbers of codes and protocols have made outsourcing medical billing the standard.

Medical Billing and related occupations continue to be the fastest growing opportunities in health care. Insurance institutions and government agencies are investing huge resources to control claims’ fraud, abuse, and establish some degree of reimbursement parity. As a result, more insurance companies, and health care facilities are looking
Today, evolutions in the health care industry are happening at a very high pace. It is only with the assistance of sophisticated computer programs, and standardized coding procedures that medical coders are now able to describe and characterize the tremendous number and various kinds of medical and surgical procedures.
to medical billing experts for help. These companies and practices are looking for experienced and educated individuals; the legal consequences of incorrect billing could be devastating. There is a movement in the industry to make medical billers responsible for inaccuracies, much they way accountants are for tax returns.

At present, there are no standards for educational requirements for medical billers and coders. However, more employers are looking for some formal training at an accredited career training institution. These schools range in training time from nine months to two years, anything less would not be considered adequate. There is a move for certification, and several organizations are sponsoring certification examinations in medical billing and coding. Medical billers and coders earn as much as $8 to $10 per hour in the beginning, and could potentially realize $30 to $40 per hours with experience and additional responsibilities.

Today, evolutions in the health care industry are happening at a very high pace. It is only with the assistance of sophisticated computer programs, and standardized coding procedures that medical coders are now able to describe and characterize the tremendous number and various kinds of medical and surgical procedures. These realities coupled with government regulations, and health insurance guidelines have contributed to the strong demand for experienced medical coders and billers.

About the Author

Jay B Stockman is a contributing editor for Medical Billing Resource. Visit http://all-medical-billing-software.com/ for more information.

Dr. Jay B Stockman is an individual contributor to Google Health Co-op

Dr. Jay B Stockman's public Google Health Co-op profile

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Medical Billing Articles (updated Frequently)

Does your Medical Office, Medical Supply or Medical Testing Company need Financing?
By: Marco Terry
Do you own a business in the medical field? Learn about a little known way to finance it.

Although many experts speak of gloom and doom in the medical industry, the fact is that this industry keeps growing by leaps and bounds. Every year, the demand for medical services, medical testing (e.g. MRI Centers, Testing Centers, etc) and medical supplies keeps getting stronger. This trend is expected to continue as the population ages.

However, even though the growth trend looks good, running a medically related business keeps getting more and more challenging. In the past, doctors and medical suppliers could expect to get large and quick reimbursements for their services. Cash flow was reasonably easy to manage. However, Medicare, Medicaid and 3rd party insurance companies have put in place strict compensation guidelines. These guidelines can be summarized in two simple points: you can look to receive less money than before and you should be prepared to wait longer to get paid.

This creates a financial “perfect storm” for medical industry companies. On one hand, you are getting paid less and waiting longer for your money. On the other hand, your operating expenses remain the same or perhaps are higher. You still need to pay your employees and your suppliers. In almost all cases, this limits your ability to pursue new opportunities and grow your business. In some cases, it may even threaten your ability to continue to operate your business.

Is there a way to “fix” the cash flow problem?

If your business’s main cash flow problem is not being able to afford to wait 30 to 90 days to get paid by insurance companies and Medicare, then factoring your invoices could be the right solution for you.

The factoring proposition is very simple. Factoring is a way of financing, in which a factoring company provides you with advance payments based on your outstanding accounts receivable (or invoices). You get funding as soon as you invoice. The factoring funds it and waits to get paid until the insurance companies or Medicare pay the invoices.

Factoring has advantages over loans and lines of credit. First, factoring financing lines do not have arbitrary limits. The maximum amount of monthly financing is solely determined by your ability to invoice. If your business grows, your financing grows automatically. Also, factoring companies don’t require the same collateral that banks do, so new businesses or doctors’ offices can usually qualify easily.

How does medical factoring work?

The process is fairly simple. Once an agreement is established with a factoring company, it works as follows:

1. Your office submits your weekly (daily or monthly) billings to the insurance company and to Medicare/Medicaid. (note: sometimes this task can be handled by the factor on your behalf)

2. Your office sends a copy of the billings to the factoring company.

3. The factoring company advances you up to 85% of Net Collectables within 48 hours. Funds are sent by wire or direct deposit. The remaining 15% is called a “reserve” and used to settle billing discrepancies at time of payment. This is returned to you once the invoices are paid.

4. The factoring company waits to be paid by the insurance company or Medicare/Medicaid.

5. Once the factoring company is paid, they settle out the transaction and rebate you the remaining 15%, less their fee.

The advantage of medical factoring

Factoring is ideally suited for medical offices and testing centers that are growing quickly and cannot afford to wait the usual 30 to 90 days that it takes to be paid by insurance companies or Medicare. It can provide you with ongoing financing, streamline your cash flow, and most of allFree Reprint Articles, relieve the stress of not knowing when you’ll be paid.

ABOUT THE AUTHOR

Invoice Factoring Group (http://factoring.qlfs.com) can provide you with a free medical and doctor office factoring quote. Marco Terry, the president, can be reached at (866) 730 1922.

Copyright © 2005 Commercial Capital LLC All rights reserved. This article may be reprinted, provided the resource box is included with live links


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