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billing vs coding sm

Posted By: CrispyCritterMT on 2008-11-25
In Reply to:

I'm posting here because hardly anyone visits the billers & coders board.  Could someone tell me the difference between medical billing and medical coding?  I have the impression that the biller just inputs data already coded, etc. for insurance and the coder actually assigns the codes thus needs more indepth knowledge. Would being a medical biller help in becoming a medical coder?  Has anyone done either or both?  What is the pay range for each?  Thanks. 


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billing and coding
Does anyone know how much money is to be made with billing and coding? 
Med. coding and billing

Hi, I am currently a transcriber.  (leaving the field because as you all know this field is getting too ridiculous).  I am planning to attend a billing and coding school locally.  I was wondering if the hours vary for coding/billing or are the working hours typical 9-5 or 8-4, etc.    TIA


MTs switched to billing/coding?

Curious whether there are any MTs out there, or anyone who knows info, on going into billing and coding...


I'm considering training for that in my spare time now, so that I have the opportunity later, if I decide to pursue that.  Are there a fair amount of work-at-home positions in billing and coding?  After my newbie days, I've never had trouble finding MT work with good companies, so I wondered if billing was as widespread, at home.  I haven't found nearly as much info out there on at-home billing, other than get-rich-quick scheming.  Anyone know if the pay is on a similar scale?  Opportunity for PT and FT, like MT?  Similarities and differences (not on the actual job, but work issues like benefits, flexibility, etc.)


Thanks for any help!


There's medical coding and billing.
nn
Why would billing/coding not be offshored?
x
MT vs Coding/billing At Home?
I am trying to decide between medical transcription and billing/coding.  I am a SAHM and cannot work outside the house, I have small children at home and they won't be in school for another several years.  So I must have an at home job.  I haven't taken any courses yet, so I am trying to decide which road would be best.  I know with MT that MTec and Andrews are really good schools and you can work from home after their program.  Not sure of good schools for billing or coding, maybe Career Institute (I think that is the name).  Are there other good schools??  Can you find an at home job with either job route??  Any help would be wonderful!!  Thanks!
medical billing or coding newbie

alliedschools.com


Has anyone tried either their medical billing or coding training courses??


Did you like it, would you recommend it?? I'm tired of working at a restaurant and would like to learn a career but I just want make sure that I am learning from a school that will actually lead me somewhere(specially that it cost 1600 dollars)


So please let me know what you think about them and if there is other schools that you will recomment over them!


 


Thanks


Besides, most coding is billing work. Any better possibilities? NM
nm
Does anyone know of a website, like this one, that deals with Medical Coding/Billing..sm

My husband is curious and wanting to get into Medical Billing/Coding and work from home like I do with transcription.  Does anyone know of a website, like this one, that offers so many jobs from home and information regarding coding and/or billing?  Thanks.  Also, if anyone has input on this please let us know.  Would love to find out which course is the best, etc....thanks!


I will quit also...I'm hoping to get into doing something else, such as medical billing/.coding
n
I should have specified, hospital inpatient coding and doc office coding are very different.
They follow different coding rules and an entirely different set of codes. I learned both while earning my B.S. in H.I.M., and both are challenging, though inpatient more so simply because there are more codes.
Honestly, you could get a job in a med rec dept without ANY certificate; some computer experience and your experience as an MT would get you in the door. It might just be doing chart assembly/completion, filing, etc., but there are certainly jobs in MR that don't require specific schooling. Then being in the dept you can really learn more about all the functions and pick the one you REALLY want to spend time, money, and effort on for additional schooling.
I've thought about coding. My DH does medical coding and I think with an MT's medical termino

background and anatomy and physiology knowledge, a transition into coding wouldn't be hard at all.  From what I can tell by looking through my husband's books, an MT would have to learn insurance regulations and legalities.  We've basically got all the medical background down or we should be if we're worth our salt as an MT.


I even contacted AHIMA and found that the qualifications for taking the CCS or CCP coding exams are completion of the a coding program, RHIT program, or RHIA or related work experience.  Transcription is part of HIM, albeit the red-headed stepchild of the HIM department, but a part nonetheless and so satisfies the qualification of having work experience.


The test is tough though.  My husband didn't pass it his first time out and I think I read something like only 20% or so pass it the first time.  So it would probably be best to take some sort of formal coding class, in my opinion.


Anyone know if coding would pay as well as MT? Is coding being outsourced too?
xx
billing
Most hospitals pay vendors monthly as it comes from different account than their payroll.  You can spell out every 2 weeks in your contract, but don't be surprised if they change it.  Same with late fees -- many hospitals won't allow for them.   In my contracts I have it as payment is due within 10 calendar days of invoice date.  (be careful using just 'days' versus calendar days -- can really stretch it out with weekends and holidays if you don't).  Be prepared for occasional late payments as your invoice often goes through MANY hands before payment is made.  Your actual client usually has nothing to do with accounts payable department.  For the most part, unless you are lucky enough to have an actual person to contact in accounting, they really don't care how big/small you are or what your cashflow problems are -- you're just another vendor.  Usually once you are in their system, things go pretty smoothly. 
IC billing....sm
When I turn my bill in I now have to list each and every patient, whether it was a chart note, the number of lines and the amount charged. Let me tell you that is one long list. Does anyone else have to do that? This was just started in an office I have worked for for ten years! Thx for any input.
IC billing
I have to do that on a ledger but now what I do is keep the spreadsheet open on my computer and as soon as I finish typing the report, I enter the info. Isn't that bad. The office wants to do a cross check on the patients to be sure the doc dictated that particular patient and if not, they can tell the doc.
IC Billing
I use Abacus. I make a folder on my C-drive for each doc and when finished with the report, I save it to that particular folder. At billing time, I simply click on C-drive then "invoice" and all that info prints up. I have a template with all my particulars like my name, SS#, etc., copy and paste the info in my template and there you go. It literally takes me a couple of minutes to pull an invoice at billing time.
Med billing from home
Does anyone know of any medical billing companies that hire (work from home) billers?
chiropractors and billing
I used to go to a well known chiropractor and my visits were only 40.00 because I did not have insurance and paid out of pocket. My doctor told me that if after 6 visits to a chiropractor you are not a lot better than don't go, waste of time and money. I had to stop going as I could not afford it. If she is the office person, then I would nicely call her and ask her how many visits he has been to their office for, because you got a bill and want to make sure it is correct, as you are paying out of pocket. Maybe if you don't accuse her of anything, she won't take it so personal. Good luck, you are in a very tough situation. Sometimes chiropractors do help a lot, especially neck, back and sports injuries.
Well, if that's how she's billing the client SM
then that's how you should be billing her (just characters and spaces).  I'm sorry you're going to be losing money.  I'd be unhappy too.  Maybe you can work on your shortcuts/macros more so that you are typing less for the same amount.  No real words of wisdom for you...sorry.
Billing/payment
On my larger accounts I close out on the 25th to 28th, since I keep daily line counts in an Excel program, I print that out, do my bill in Quick Books, get the bill to clients by 28th to 29th, I give a 1% discount on my larger accounts if they pay within 48 hours and they do so I have my checks always by the 1st.   I have two smaller accounts that I bill on the 15th so I have cash flow throughout the month.  I have never been stiffed, they have never been late, they never question my line counts and always write thank you on the invoice.   This works for me.  I know everyone says don't give away 1% as a discount but it works for me so I do it. 
re billing - am I being a total *ash*?

I have plenty of clients, no shortage of work. Recently I started picking up some extra legal transcription from a company who is swamped & always begging for help. It's not something I've had much opportunity to do and it's fun to do something different. But they're totally out of the technological loop. I bill all my clients by an Excel spreadsheet attached to an email, and I have a master spreadsheet set up that keeps track of all my invoices for me. They are the only ones who can't open it. I know they can because someone who used to work there could, but now they have a new person and no one there can open it. Of course they can probably right click and "open with" some kind of viewer, but why is it my problem to teach them that? (here's where the "am I being a total a$$ question comes in!)  I'm tired of their clueless clerk emailing me five times every time I send her an invoice asking me to resend it and having to respond "If you can't open it, it's not going to help to resend it."  Sure I can mail it, but why should I when I have plenty of other clients?  Do you think I'd be an a$$ for unceremoniously dumping them? would you do it in a quieter way and leave the door open for further work? 


They are so technologically out of the loop, it's not even funny. I asked them for an electronic copy of one of their style guides for easy searching, and they said they don't do that and they "don't keep" things.  They just have one hard copy they are xeroxing over and over.  I knew it was somewhere, it had obviously been typed it on a computer. It's a .pdf file on the web! Someone had downloaded it directly from the court's web site. They are supposed to provide me with the names of judges and attorneys on the tapes but they don't and I have to struggle to hear names and spell them phonetically or designate unidentified voices somehow so I can tell them apart and then go back and globally replace them when I hear the name or I'm sure of the spelling. This adds countless time to transcribing their cases AND THEY HAVE THAT INFORMATION. I've asked them for lists or links for judge's/attorney names so I can at least search when they don't give them to me.  No dice. I have since found good links on the web, of course.


I'm worried about getting in deeper with them, I'm not overly familiar with legal work and I'm just going to keep coming up against their not being able to provide me with the tools I need. Every time I have to find something for myself it's costing me money, obviously, being paid on production.  They annoy me and I seem to have a very low threshold for that.  But it's valuable experience and they are desperate, the owner won't be happy.  But she's as clueless as her staff.


WHAT is "verifiable billing" ... (sm)

... and what are "ambiguous line counts" (mentioned by someone who has a web site related to verifiable billing which I cannot for the life of me figure out).


I charge X amount for a 65-character line.  I take characters w/spaces, divide by 65 and voila, there's my line count.  How much more "verifiable" can that get?


Can someone explain to me what this means in case the person who mentions this doesn't ever reply to my question? 


Question about IC billing

Hi, I am new to the IC area of MT, having always worked for services before now.  I have a friend who wants me to type letters for her practice.  Is it usual to charge for the address and reference lines along with the body of the letter?  Makes quite a big difference in the line count.  Thanks!


Any advice on switching to med billing from being an MT?

I just can't seem to make any money working at home with the kids talking to me constantly with transcipriton so I am thinking about switching to something I don't have to listen to.  Maybe medical billing.  Any advice anyone? 


Thanks


I didn't find anything about billing, just
header info, when job was dictated and when it was transcribed, who typed it, stuff like that, but nothing about billing or discrepancy in line counts....
I used to do billing for ophthamologist about 10 years ago though; sm
we charged $1800 per eye with a $500 facility fee. That included anesthesiologist fees, outpatient procedure, free standing surgical center in tx. You can always deal a bargain when paying cash up front so call and ask them their cash discount up front fee. everyone has one.
Billing questions for MTSOs..SM

I've had this account for about four months now.  They are very slow payers.  I originally was going to bill them once a month, but then decided to do bi-monthly.  I still haven't gotten payment from the 11/30 invoice, so I inqured today and the office manager said they are changing their billing process and I need to submit a monthly invoice.  I also wonder how long she would have went without paying the 11/30 invoice if I hadn't of called. 


I figured they want a monthly invoice to make things a little easier on their end like they want to pay all their bills once a month.  I called her to verify what day she would like to be billed on/by and she said it doesn't matter.  I just need to put a due date on the bill, as she is making a folder with all their bills and paying the bills by their due dates.  I told her my bill is due upon receipt and she said that is fine just put the due date as the next day, which makes no sense to me because they have never paid sooner than three weeks.


Does this make sense?  It sounds to me like maybe the office is having money troubles and didn't want to pay my last invoice.  I remember an MTSO here saying that she gives her clients a percentage break if they pay within so many days.  Does this work?  All I want is my money and fast.  I have bills to pay too.


I appreciate any ideas or thoughts regarding this subject.  Thanks!


PS - I personally know the MT who had this account before me and they never paid late.  She always received the check within a couple days after receipt of her bill.  I just don't get it.


letter billing, plse sm
I was wondering how some of you bill for letters and envelopes. I charge by the gross line for chart notes but wanted some ideas about letters. They are relatively short letters on the whole, like a paragraph or so. Do you charge gross line, charge for the blank lines, do a flat fee, charge for envelopes? Thanks for any input.
Transcription versus Billing
Before doing MT at home, I worked in an office for over 10 years, many doing fulll-time billing.

The office job I had certainly paid more (and it was guaranteed despite productivity).

I am now employed at home dut to family situations.

I guess my answer would be that you have to determine what is most improtant to you. If it is flexibility you desire, go for MT. There are very few billing/coding jobs based at home.

Should you choose to pursue billing, immediately get certified. Many places are now laying off employees who are not certified, depsite years of experienc.

I have done both. If you have any questions, feel free to email. I will let you know what books etc required and the CPC sites.

Many have helped and encouraged me on this site. I would be happy to return the favor.

Billing once a month is not a biggie BUT
do it on a Net 10 or Net 15. Never a Net 30. You could end up doing 2 months work for free eventually. No account is worth that.
Maybe they should have thought about that before their billing problems surfaced. Do you think that
helped their business sis.
Bytes versus characters? Does anyone do their billing this way? sm

If billing by bytes do you divide this by say 65 (standard line), same as for characters?  Thanks so much.


 


 


What are the best at home medical billing courses out there?
Have a friend who is interested in training to become a medical biller/coder from home and I really have no idea where to tell her to start.  Can anyone help?
Tell your friend she is not likely to get medical billing job from home

I would venture to say 99.9% of medical offices use a computer system for their billing which has HCFA formatting and electronic submission built right in. It is pretty easy to do coding in the office setting too. In good conscience, could not recommend investing money in training for either field...


I was on balanced billing once and found out I was paying a lot more that way! nm
x
billing on clinical psych narratives
I am an IC and am being asked to give a quote on transcribing some narrative/office notes, etc for a clinical psychologists office.  In detail, it is a 1" margin around the page and there are headings on a template that you fill in either one word phrases or paragraphs.  It did not look that difficult.  I would have to pick up tapes, e-mail reports back on a daily basis an so I believe that gas and time doing so needs to be counted in.  I am needing some advice on how to propose either by the line (gross or otherwise) or page (either full or half etc).  Any advice would be greatly appreciated.  Thanks in advance. 
Considering past billing problems, why cheat anyone out of even 2 cents? nm
;
needing info on billing/invoice programs

Can anyone give me a good program to invest in that would allow me to keep a line count and also provide invoices? Also, is there a recommended HIPAA approved transferring site to transfer files through the net? Thanks a bunch!


I do MTing, as well as billing. Although I have worked for the same doctors for years, I subcontrac
for $18 an hour.  I'm looking to stop though and stick with transcription. If you think the medical transcription world is not so great these days, then try billing. I'm so sick of dealing with PPO networks, HMOs, Medicare, Medicaid and all the crap, rules and regulations that come with it. It gives me migraines and my job is never done. At least with transcription, you do your reports, upload them and it's over. With billing, I am constantly fighting with insurance companies who want to rip you off at every turn.  When I finally get sick of all MT-ing, then my next money is a travel agent. Something fun!!!!
Coding
Try the Billers/Coders board. Much more info there.
Coding
nm
Coding sm

I have been thinking for quite a while about getting into coding.  Are there any MTs here who are also coders?  Are there any reputable "on-line" coding schools?  I really would like to do this.  27 years is enough.  If anybody knows about this, feel free to e-mail me.


 


Thanks


Coding

I used to work in a Doctor's office and do coding, electronic insurance billing, statements.  I loved it, but I had to quit because of my kids.  If my kids were older, I would still be doing it now.  I fell into coding when I was a Medical Assistant and it lasted 16 years.  Maybe I will get into it again when the kids get older. 


As far as any online schools that good, I don't know.  But what I can tell you is from my experience, working from an office or hospital is the best place to be for coding!!


MT to coding

I will try to be brief (please don't think me curt but there is much more I could say that I just don't have time to go into).


First to be a professional coder, you will need to be nationally certified.  There are 2 national organizations that provide proctored certification.  The first was AAPC and has an excellent program for both office-based and hospital-based coding certifications.  You can do the home program or find a company who provides classroom instruction and testing.  Either route will cost you about $1500 and about 3-4 months investment.  The other national is AHIMA.  You would need to look at their website to find the details for them, as I did not utilize them.  They cater more to people who are already in the field and need certification.


Because AHIMA's umbrella covers more than just coding, hospitals tend to give more credibility to their credentialling, but since AAPC set the standard and has the largest number of members, they have to be doing something right.  Both companies require prior coding experience, personal recommendations and membership in their organization.  If you have no previous experience, they have apprenticeship programs.  The CEUs to maintain your certification is about 20 per year with each organization.


Your investment in resources to perform your job is greater than in MT.  You will probably need a lap top and several programs to perform your job if it is not provided by an employer.  You can be a consultant if you can't get a job as a coder.  You could get additional certification and become an instructor and teach.


The next issue is home versus on-site work.  Some MT companies are beginning to combined MT and coding into their at-home programs; however, if you have no experience and no liability insurance and no support network, you could find yourself out of a job if you cannot produce quantity and quality quickly.  Finding a on-site coding position is difficult without experience unless you get lucky and find an office to give you a chance.  Many, many times your best bet to find a job is by networking through your local national's chapter or showing exceptional talent in the classroom setting and getting a referral from the instructor.


Coding is different from MT in that you are held liable by the federal government if you make a mistake.  Yes, the doctor is ultimately responsible, but the wording in the law states that the person who submits the bill is as guilty as the provider.  There are monetary and jail time penalties - and how much of each depends on how well you can prove it was accidental because the government assumes the fraud was intentional unless proven otherwise.  Better have insurance.  Because of this law, that is why you are seeing a greater need for certified coders...hospitals in particular do not want to expose themselves to the liability of the Office of Inspector General with unqualified personnel.


I got a coding auditor position on the outpatient side of a hospital.  I went to the clinics and performed audits of the previous quarter for every doctor at each clinic.  I scored everything, compiled reports, provided education to the doctors who failed the audits, provided monthly ongoing education and a coding hotline for daily unusual circumstances.  I was paid about $20/hr which was the low end of the spectrum for a hospital employee.  Physician offices tend to pay $12-15.  When I relocated to a different part of the country, I could not immediately find a coding position, so I went back into MT.  It took another year before I found a management company where I could code, but by then I needed to return back across the country due to family issues...and I let my certification lapse and continued with MT.


coding

what is the best way to get into coding?  I have thought about an online course. 


Coding and VR
It occurs to me that since coding is the up and coming field in which to go, why isn't that already automated? Since VR is coming at us at warp speed and entails much more than coding, why is that coding is not the first to be peopleless? Any ideas?
coding

I have experience in medical billing for 12 years and transcription for four years and I am also going back to school to pursue coding and take the national exam to get my CPC.  Coding is the new future as this transcription business is falling apart everyday.  It is so hard to make a decent wage.  These National companies are indeed a sweat shop taking advantage of the DR’s and paying us a pathetic price.  I make 12 cents a line working for a local physician, but I have lost 4 doctors already due to outsourcing.  I am running fast back to school because I think in the next couple years there will be VR everywhere.  What a shame to such a good profession.  This is just because someone was a little bit too greedy.


Good luck with coding. 


 


Coding

I am taking a continuing education class through my college for 8 months with medical terminology, which I really do not need as I have enough of that, but I am sure it will not hurt, and anatomy and physiology plus the coding.  I have also heard of the Carol J. Buck books and I am also going to purchase them once they come out in the first of January.  I heard these are good books.  I am one of those persons that needs someone to teach me and do better than trying to read out of the book and doing it on my own, but the Carol Buck book would not hurt as an addition.  This is the way to go for me as I have been burned too many times in this transcription industry in the last four years.  It is a shame it is like this way.  There is too much negativity.


Coding
That is not true in my area. We have a college here (actually where I went to school for transcription - I was in the last class before they started the coding class in 1992) and every student is placed at several different hospitals for an internship - you are then offered a position at one of the places where you have interned if you are good and show potential. If not for this type of program and the interaction that the college and the medical centers has - I would have struggled like many to get an MT position - but I just took up as an employee where I had left off as a student after graduation. I know many people who have gone through this program and they all went to work in coding immediately after graduation. I only have 2 semesters necessary for coding, so I am thinking it would probably be worth it. Sorry that this is not the situation in every area.
Coding

I've actually thought about coding as well.  I was an ART/RHIT so I've done a bit of it and liked it, but I liked transcription better.  That was then; this is now.  If HHS would ever stop messing about, the US would start using ICD-10 like the rest of the civilized world.  This is very different from the current ICD-9-CM, so even experienced coders will have to take classes.  Some of my coder friends say they would consider retirement at that time.  Perhaps it would be our opportunity to make a switch. 


Airline job, huh?  I hope he means Southwest because the old major carriers aren't doing well.  I do wonder about Sir Richard Branson's new Virgin America, though.  Of course, maybe you'd get free/reduced fare miles and the paid vacation time to spend them on as part of the benefit package.  Got anywhere you'd like to go?  Taking son along is optional. (she smiles)