Re: How do you get a job as medical biller without any medical billing

[Steve Verno]

YOu can get a job as a medical biller, but without the proper training you will have many problems.

Many places only require the position to have a high school diploma, but in the end, they wind up firing the untrained person they hired because the untrained person caused them to lose hundreds of thousands of dollars.  So they learned.  Now many employers are giving preemployment tests to see if the candidate knows medical billing.  I took three of them when being hired as a temp medical biler.  On my first day on the job, they had me doing many things that an untrained medical biller cold not do.  I had a 2 foot stack of EOBs and correspondence to process.  Many were timely filing denials, many were  benefit denials.  I had to resend about 2,000 claims that the insurance company said were never received. There were about 10 calls every 5 minutes based on statements sent to the patient because the patient didnt know why they were being billed even though they had health insurance.  Training allows you to handle these with few problems. 

How would you handle an angry patient being billed when Medicare denied the claim  because benefits were exhausted. The patient is yelling an screaming at you that you F**ked up their claim and that is the the language they use. They scream you are incompetent and they should not have to pay because you screwed things up. If they arent doing this on the phone, they are in your office screaming at you in person.  Next you get a call from their lawyer ordering you to stop billing his client. Then you get a call from Medicare saying you cannot bill the patient because you did not use the appropriate modifier on your claim showing you had the patient sign an ABN form.  The patient is also screaming at you saying they never signed any form, yet there is one in their record. Even when shown the form they still deny signing it.

Also, there is a huge difference between billing for a doctor and billing for a hospital.

The doctor would normally use a cms 1500 form and the hospital would normally use a UB 04. 

[Steve Verno]

go to school and learn.  

You havent even seen the tip of the iceberg.

A degree in economics and $5.00 can buy you a cup of coffee but it is not medical billing and it wont help you know everything there is to know about medical billing.  

lets say you have a new Medicare patient and the patient was seen by the ARNP.  Can you bill this under the NP's Medicare number to Medicare?  

Another patient has Medicare and VA benefits.  Which is primary and which is secondary?

Your doctor billed Aetna for $300.  The doctor is not contracted with Aetna. Aetna paid $75 and said the payment is usual and customary and wont pay anymore.  Aetna says you canot bill he patient for the balance. Aetns tells the patient they dont have to pay you any money.  What do you do?

You have a patient with Medicare primary and Medicaid secondary.  Medicare applied the $150 payment to the patent's dedictible Medicaid paid $15. How much do you collect from the patient?

You have a patient whom you call who says they were in an auto accident and now give you State Farm Insurance. You bil State Farm and they deny the claim for TPL.  The patient's lawer says to bill Blue Cross and lue Shield.  What do you do?

You receive a letter from a debt collection agency representing United healthcare.  The agency says they want the $500 United paid back in 1999 because they werent primary and medicare is primary.  What do you do?

You get a call from law office.  They want a bill sent to them for their client for a date of service of 1998.  If they dont get the bil in an hour, they deem that the patient owes you nothing.  What do you do?

You bill a patient with Multiplan.  Multiplan calls you with the patient on the line saying your providers charges are too high and hey tell the patient not to pay you.  What do you do?

These are just a few situations you may find yourself in that the trained medical biler should know how go handle.