For those of you who are involved in the medical billing industry and don’t know what barcoding has to do with your job, hopefully, this installment on barcoding will give you just enough information to be informed and not so much as to confuse the stuffing out of you. Barcoding is kind of a behind the scenes process that ties in to your retail sales operation, if you have one.

The medical industry has been shortchanged. No doubt about it. While we can walk into a supermarket and pick up just about any item and find a UPC, or Universal Product Code, the same can’t be said about all medical items. Yes, there are many that do use the UPC code to stamp the item’s description and price, but there are still many items, usually equipment items, that just don’t have this luxury. Because of this, if a customer goes into your retail establishment and wants to get a walker, most likely the cashier will have to manually type the price into the system, which better be displayed somewhere on the walker to begin with or you’re going to be standing around a long time waiting for a price check. Yes, it’s a messy process that nobody likes; not the patient or the worker.

Barcoding to the rescue. Most DME software packages offer barcoding as an option. This is not to be confused with simply reading an existing barcode on an item, which you can do as well. This is the process of actually creating your own barcode labels for an item so that the item description and price can be stored in the system and thus scanned just like any other item when a patient comes in to make a purchase. So, how exactly does this work? Actually, it’s very easy.

The first thing is that the barcoding software has to be installed into the stock DME system. Usually there is an extra charge for this. Then, after the installation, the barcoding hardware has to be set up. This consists of a special printer and some peripherals that are specially made to print out UPC labels, even though they are technically not the same. The format is similar but not exact. Of course you do have the option of printing out your labels in UPC format. This also usually costs extra.

What you do is type the item description and price into the software at the computer. After you do this, you simply choose the option that says generate barcode or something similar. Make sure there are labels in the printer when you do this. After you choose the option, the label will print and you’ll have your UPC code ready to be scanned when a customer makes a purchase.

While this all may seem very simple, there is a lot of technology that goes into this process. Barcoding systems are usually thousands of dollars in addition to the cost of your standard DME system. And the labels themselves aren’t cheap either. So if you decide to get into barcoding for your sales, you want to make sure you do enough volume to justify the cost.

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Michael Russell Your Independent guide to a target=_blank target=_new href=http://medical-billing.guide-for-you.com/Medical Billing/a

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Medical Billing Specialists

In the world of medical billing, nothing is more dreaded by billing companies than allowable tables. There are numerous reasons for this. In this particular installment on medical billing, we’re going to cover the main reasons why allowable tables are such a pain the backside.

Before we do that, it would probably be a good idea to explain what an allowable table is for those who are not familiar with them. Allowable tables usually refer to Medicare billing, though there are other government carriers that also have allowable tables. An allowable table, as applied to Medicare, is a table of prices for each item that can be billed to Medicare. In other words, let’s say a patient needs a wheelchair. If wheelchairs can be billed to Medicare, they will have a table entry for how much Medicare will pay for that wheelchair, whether it be to purchase it or rent it on a monthly basis. Sounds simple enough and it is. The problem is what this actually means to the medical billing company.

The first problem this presents is actually getting the allowable tables from Medicare. The reason this is important is because a medical billing agency has to know how much they are permitted to bill for each item. If they overbill for the item and actually expect to get paid that much, it is going to come as a big shock to them when their payment is considerably less than what they expected. So a medical billing company must get these tables setup in their system. To do this, they have to get them from Medicare. Guess what? It’s not a free service. They have to pay for it and it’s not cheap.

Then there is the matter of actually loading these allowable tables into their system. This has to be done just so or nothing is going to bill correctly. This is a common problem with an allowable table update. Sometimes the files are corrupt, sometimes the software has a bug in it and on and on. Agencies hate when it comes time to have to do an allowable table update, which is usually done four times a year, every quarter.

The bigger problem is when a company bills for a certain item that costs them a certain amount of money and they are hoping to get a certain return on that item. For example. Let’s say a company is selling a wheelchair to a patient for $350. The wheelchair costs the company $250 and they hope to make $100 profit on the sale. Medicare has the allowable set to $350 so all is well. Then, the next quarter update comes out and Medicare lowers the allowable for that wheelchair to $300. The agency now can only bill for $300 and can only make $50 on each sale. This cuts their profit margin in half. This is more common than you know and it drives medical billing companies crazy.

The sad part is, there is nothing that can be done about this. Medicare will allow what it will allow and that is the end of it. The company has no other choice but to absorb the loss. Yes, allowable tables are a real pain in the backside.

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Tags: medical billing seminar, medical billing coding, home based medical billing, medical coding and billing course, durable medical equipment billing, medical billing specialist, billing medical program software, medical billing work from home

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Medical Billing Specialists

Medical billing agencies take a lot of things for granted. They purchase a piece of DME software in order to do their daily billing and they expect everything to run perfectly. Well, in the real world, it isn’t quite that simple. There is a lot of work that goes into putting out a piece of medical billing software. While we’re not going to attempt to dive into this process in great detail, we’re going to try to give you a decent idea of what goes into getting your DME software to you. In future installments, we’ll cover this in more detail.

The first step in the process is actually deciding what is going to go into the software itself. This is usually determined by the owners of the company, but frequently, the programmers have a big say in the final product because they may know what is and what isn’t possible. Just because management wants something doesn’t mean it’s going to be done.

The next step is to actually begin the design of the software itself. This involves specifications that are general as well as detailed. The software needs to be given an overall look to go along with the individual bells and whistles that it comes with.

After the software is designed, piece by piece, each section is given to a QA person to test. It is their job to make sure that the section of the software that they are testing works the way it is supposed to, whether it be billing, printing forms, updating prices or whatever. Because medical billing software is so complex, a team of QA people are usually assigned to test it.

If any bugs are found in the software through testing, the QA people send the software back to the programmers. This process continues until the software is found to be bug free.

The software is then given to the support people to learn. The reason for this is because they are the ones who are going to be taking calls from customers who have problems. So it is their responsibility to learn every inch of the software that they can.

Finally, after everything is completed, the manuals are written by the QA people or tech writers, depending on how the company is structured. These are the manuals that are distributed to the medical billing companies who buy the software.

When all of that is done, the software is then packaged in a nice neat and pretty box. This box is made by the graphic artists team. If you don’t think presentation is important, think again. Presentation is almost everything in the business world.

After the software is packaged, it is then given to the sales people to distribute. These people usually have leads to companies looking for medical billing software. That’s where they start.

It’s a very long process from start to finish. So when you finally do get your DME software, try to understand that a lot of hard work went into getting it to you.

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Michael Russell Your Independent guide to a target=_blank target=_new href=http://medical-billing.guide-for-you.com/Medical Billing/a

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Tags: medical insurance billing, medical billing seminar, durable medical equipment billing, electronic medical billing, medical billing software company, medical billing school online, medical billing home business, billing home medical specialist work

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Medical Billing Courses

In this world of technology, you have to wonder what would happen to the medical billing profession if suddenly all the power in the world went out and the computers stopped working. If you never thought of how catastrophic this would be, this little eye opening look at a hypothetical situation should get you thinking about having some backup plans for your medical billing business.

The problems with not having a computer to do your medical billing in today’s day and age are mind boggling. There are actually a multitude of headaches that you’re going to have should your PC and network decide to go south for an eternity.

For starters and this is just for starters, every medical billing establishment that processes claims via software, is physically tied in to medical insurance companies like Medicare, Medicaid, Blue Cross and a number of others. If the computers shut down, all communication stops. This not only means that no claims can be transmitted to the insurance companies but it also means that medical billing companies can’t get critical updates like Medicare Allowable Tables, HCPCS codes, DX Codes and a ton of other things.

Then you need to add to the above problem the trouble you’re going to have printing forms. For those of us who don’t use electronic billing and actually submit paper HCFA 1500 forms, well, that brings us to the next crisis. No computers means no printers work either. So your forms are basically recycling for the next day’s paper collection. And even if your printer is still physically working, there is no way for data to get to it since the computers are down and all the data is stored in them.

This is quite a pickle isn’t it. Well, believe it or not, all is not lost. At least it doesn’t have to be if we simply realized that the electronic world could come crashing down at any time and because of this we need to have an alternate game plan. Does such an alternate game plan exist? Yes, it does. Will it be easy? No. It will take a lot of prior thought and preparation, but it can be done.

The first thing you need to do is always keep communication between you and the insurance carriers open by having a phone number on hand to speak to an actual representative. This way if problems arise, you can at least ask some questions. By relying only on computers as a means of communication, you are looking for trouble.

The next thing you have to do is, every time you enter a new patient into your system, print out a paper copy of their records. Also print out a paper copy of the items to be billed. This way, if your system should crash and you have to send in a claim, you can still do it. How?

Well, you know those forms that are pretty much useless except for that recycling? If you have all that information already printed out, you can, with some effort, hand fill out the HCFA 1500 forms. Yes, it will take some time. But if you’re billing a $3,000 wheelchair, so what? You’re also going to have to make sure that you have envelops to go with those forms and an actual mailing address that is printed out somewhere. If it’s in the computer only, then you’re going to have to call the insurance carrier for their address. You do have their phone number, right?

Yes, trying to fix a nightmare like this won’t be easy, but if you want to get your medical billing done, this is what you are going to have to be prepared to do. You’ll be glad you did.

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Michael Russell Your Independent guide to a target=_blank target=_new href=http://medical-billing.guide-for-you.com/Medical Billing/a

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Tags: medical billing system, lytec medical billing software, medical billing home, online medical billing courses, medical billing services, medical billing course, medical billing companies, electronic medical billing software

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Medical Billing Software

In this installment of medical billing, we’re going to examine some common problems that you may run into with one of the more common add-ons to a medical billing package, barcoding. We’ll not only examine the problems but give possible causes and solutions to them. Of course each case may be different.

One of the most common problems you will run into with barcoding when you’re trying to scan or enter a new barcode is that the barcode doesn’t take. In the case of trying to enter the barcode, the keys don’t seem to be typing anything. In the case of trying to scan a barcode into the system, the scanner doesn’t seem to be picking anything up. What should happen is that as you scan the barcode, the barcode itself should appear in the barcode text box and the system should beep. Instead, nothing happens.

In both cases, especially if both are happening together, the most common problem is that you have an IRQ or COM port conflict with your hardware and your PC. This means that the IRQ or the COM port the barcoding scanner device has been assigned to is also being used by something else on your computer. What you’re going to have to do in order to correct this problem is go into your system configuration, view every device that is connected to it, such as modems, printers, etc. and jot down the IRQ and COM port for each of these devices. When you find the conflicting device you’re either going to have to move it to another port, or if there is no place to put it, you’ll have to uninstall it or move the scanner to another computer. Those are your only options.

If there are no conflicts, then it is quite possible that the scanner is simply not functioning and not only that, it’s locking up the keyboard. To test this, just unplug the scanner and try to type any barcode entry into the software. It should work fine.

Another common problem with barcoding is that when you print out the barcode labels themselves, they either print off center or get cut off or simply just don’t print right. This is usually a simple matter of going into the barcode printing options and see what label size the barcode is set for. Yes, there are a number of sizes and you have to set this up in the options. If you don’t, it usually defaults to the most common size. If you’re using that size you’ll be fine, but it you’re not, you’re in trouble.

Another common problem with barcoding is that when trying to set the type of barcode you want to use, such as UPC or generic, the correct code doesn’t come out. This is actually one of the stupidest problems. In most software, you can’t just pick your barcode type. You have to also save the screen itself or it defaults back to whatever was there.

The above tips should take care of most barcoding issues that you’re likely to run into when doing your medical billing.

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Michael Russell Your Independent guide to a target=_blank target=_new href=http://medical-billing.guide-for-you.com/Medical Billing/a

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Medical Billing Services

In the medical billing world, we have gone way past the days of the clerk sitting in the doctors office punching out her bills by hand and popping them in envelops. Today, things are a lot more sophisticated. Bills are generated via computer and in some cases, the biller never even sees a piece of paper or a form. Yes, we’ve come a long way. Unfortunately, with this sophistication also comes a lot of headaches. Why? When you’re dealing with machines, especially computers, they have a tendency not to work right on occasion. This is especially true on the retail sales end of medical billing, the problems common to which we will be covering in this installment.

You would think that with many supermarkets now having automated checkouts that scan your item and register the price for you without the cashier having to punch in numbers manually, that this process would be just as simple for the billing agency who also runs a retail operation. Well, for the most part it is. However, there are things inherent to medical billing and retail sales that you don’t have when going to a supermarket.

One of the biggest problems and the most annoying to the patient, is when they’re getting a prescription filled and the biller has to run it through to see if the insurance covers it and the computer is down. The question should be, is it down? In many cases what the problem is, is that the server on the other end is down and there is nothing wrong with the computer on the end of the cashier. In this case there is nothing you can do but wait until the server comes back up. Many times a patient is asked to come back another time. This is the annoying part.

But what if the server isn’t down? This is easy enough to check out by simply putting in a call to the main location. In this case, the problem is most likely in the wiring to the server. In this case, a technician is going to have to be called in to find out where the break in the cable is. Of course, it can always be a bad network card.

What if the connection is good though and when trying to scan in the item, it doesn’t show up in inventory and no price can be gotten? In this case, it can be one of two things. Either it is a new item and the item hasn’t been entered yet into the database, or the label on the item itself is wrong. This actually goes back to the barcoding issue of printing out bad data. In either case, the item will need to be looked up manually. Make sure you have manual price sheets.

Other times, you can’t find the patient to see if they’re covered for the item. In this case it is either that the patient was never entered into the system or the patient gave you the wrong information at the counter. Either have the data center put in the patient info, or double check that they gave the insured name and not the patient name, if they are different.

Yes, retail sales in the medical billing world, with all our technology, can be a royal pain. Hopefully, these few tips will get you through most problems.

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Michael Russell

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Tags: medical billing and coding courses, medical billing and coding software, billing home medical specialist work, medical billing home based business, medical billing business opportunity, medical billing and coding schools, medical claim billing software, billing computer medical software

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Medical Billing Software

If you think the following scenario is uncommon, then you haven’t been in the medical billing industry long enough. What follows is a sample of what can go very wrong when billing Medicare for somebody’s, well, whatever it was supposed to be.

You’ve just got your DME software all setup. The patients are in, the inventory is in, the doctors and facilities are in, the insurance carriers are in and you’re ready to start billing.

And this is what happens.

John Doe pops up on your computer. He’s a recent patient at Doctor Jones. It appears that he has been treated for some disease of the lungs and he has prescribed an oxygen concentrator for the patient and several months of oxygen to be given to the patient. The medical billing person goes through the procedure and bills Medicare for the oxygen concentrator and oxygen for the first month. This goes on for about 11 months.

On the twelfth month, the patient dies and the equipment needs to be picked up. Mind you, Medicare has been paying for this item for almost a year now. The maintenance men go to the patient’s home to pick up the concentrator and find, not a concentrator, but a wheelchair. You can imagine their confusion. Well, they call up the DME company and tell them what they found. The DME company says, Well of course there is a wheelchair at the home. John Doe had his legs amputated.

Oops. To say the least anyway. Now, we’ve got a real problem. For starters, we’ve been collecting money for an item that is a heck of a lot more money than what the patient actually got. That’s fraud and a serious crime. Second, Medicare obviously doesn’t know about this or they wouldn’t have paid on the item. So what do you do? Do you tell them?

Here is where it gets sticky. Medicare IS going to find out, first of all, that the patient is dead and then they’re going to find out how the patient died. And then they’re going to put two and two together and realize that this patient never had an oxygen concentrator. That’s when the investigation begins.

Can you see where this is going? At best, the company is going to get charged back for the misbilling. At worst, they’re going to get charged with fraud. Somewhere in between there are other things that can happen but we won’t get into them. None of them are pleasant.

Where this is all going is simply, as soon as you find out about the error, report it to Medicare immediately. If you report the problem, the chances are that you will simply be charged back for the error and paid for the wheelchair instead.

The truth is, this happens more often than you realize. Computers make mistakes. People make mistakes. So if you should find out that you have billed an insurance carrier for the wrong item, report it right away. The alternative is a lot of trouble that you don’t want.

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Michael Russell

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Tags: medical billing and coding courses, online medical billing jobs, billing electronic medical software, medical office billing software, medical billing and coding class, electronic medical claim billing, medical insurance billing software, medical billing certification

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Medical Billing Companies

In the world of medical billing, there is a lot of red tape. The government itself has so many regulations that they’re enough to strangle a billing company to the point where they can just about do business. And just when you thought that this problem would at least end with the software that you buy to do your billing with, you get hit with more red tape and regulations. In this installment, we’re going to discuss the issue of software registration, both on the end of the manufacturer and the biller.

A company can’t just decide it wants to make a piece of medical billing software. Well, it can, but selling it is going to be another issue altogether, at least in the United States. See, the good old USA has very strict guidelines that have to be followed when doing your medical billing. That’s why, if you’re sending claims electronically, there are a zillion record specifications that need to be transmitted. Forget to dot one I or cross one T and you’re looking for trouble. Because of this, insurance carriers, especially the government-controlled ones, require that software be registered. If you look at your records’ specifications you will find that one of the records requires the biller to send over the software version that they are using. If this version isn’t on the carrier’s list of approved vendors, your claim will not be processed. So, how does a software vendor get their software approved?

Well, it’s one heck of a tedious process. After the software is made, they have to send a copy of it to every insurance carrier that they want to bill. This usually includes every Medicare and Medicaid agency in all the 50 states. So we’re talking about at least 100 carriers. The good news is that if you send to just one to start and you’re rejected for whatever reason, you probably won’t be accepted by any of the others and therefore can save yourself the trouble of sending your software out to those other carriers. Once you’re approved by one, most likely you’ll be approved by them all.

To get your software registered is actually simple. You make a sample claim file of fictitious names and transmit the claim file to the agency. If the file passes, you’re registered with that carrier. If it doesn’t, you’re not. It’s pretty much the same thing with the medical billing company as well. They also have to send a test claim in order to get approved to submit claims to that particular carrier, even if the software itself was already approved. I told you there was tons of red tape.

Ultimately, it is rare that a piece of software doesn’t get approved, unless of course it is a total piece of junk, in which case nobody is going to buy it anyway. Still, this process must be followed to the letter. Once your software is approved by the carrier, you get a certificate of some sort. It makes nice wallpaper.

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Michael Russell

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Tags: medical billing and coding, billing insurance medical software, medical malpractice bill, medical claim and billing specialist, online medical billing jobs, medical billing training, medical billing education, medical billing software company

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Medical Billing Services

The things that medical billing people take for granted. Open up your software, push a button, login. Push another button, get a patient menu. Push another button, pull up a patient. Click, click, click and the process goes on and on. Medical billers have no clue what is actually going on behind the scenes of their software. In the following installments and this is mainly for you tech heads, we’re going to show you exactly what goes on behind the scenes with your medical billing software with the main parts of the system. To cover everything would take a lifetime.

We’ll be covering how patient files get put into the system and how they are ultimately access by a biller and placed into a work order to be billed. While this seems like a very simple process, it is actually quite complex and requires a lot of indexing and cross-referencing.

Another thing we’re going to cover is how a claim gets sent electronically. This is one of the mysteries of medical billing as this whole process is actually invisible. While you can see a patient being pulled to a page, you can’t see a claim file being transmitted. How does it go? Where does all that data come from when you have so many record specifications? How does the software know to interact with your transmitting device, which is usually your modem? These and other questions will all be answered.

We will also discuss how forms are printed. How does the software know exactly where to place that patient name and address? How do you choose a form, as there are so many of them? Where does the data get pulled from when all you see in front of you is a patient name?

If you’re curious as to how security is set and how the software knows to lock somebody out of a certain part of the system, we’re going to cover that too. The many options that you have to security systems make this part of the system mind boggling to say the least. We’ll do a detailed walk through of a DME security system and show how it works.

Wonder how your software knows how to read those automated posting files that come from Medicare with all your money tied up in them? No problem. We’ll dig deep into the auto posting system so you can see exactly what is going on behind the scenes there.

What about those add-ons? How does the system know that you even have them or not? Remember, they are not part of the standard package and have to be added later. So what is actually done by the software maker to let your system know that an add-on is there?

Finally, we’ll show you how the software manufacturer can tell if you have a valid copy of the software and when it’s time to pay your maintenance fee on it. This gets into some really low level programming.

The above topics will all be covered in future installments. So get a box of lightly salted popcorn and enjoy the show.

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Michael Russell

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Tags: medical claims billing, medical billing college, medical billing business plan, electronic medical billing, medical billing practice management software, medical billing and coding class, internet medical billing, medical manager billing software

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Medical Billing Specialists

In a previous installment of medical billing goofs, we discussed what happens when you bill the wrong item to a carrier and how you can be charged with fraud, but what happens when you send a bill to the wrong carrier. What follows is a genuine story. It’s kind of funny when you read it, but the truth is, it’s far from funny. This is some serious stuff.

A medical billing company, we’ll call them XYZ company, was sending out a claim for a patient, we’ll call him John Smith, to Medicare Region A, which is in the New York area of the United States. Now in actuality, the name of the patient was a common name so there could have very well been many people with that name.

Anyway, the bill makes its way to Medicare Region A and the response from Region A is that they are not going to pay the claim because the patient that the company was billing was dead. Well, to make a long story short, the medical billing company gets on a conference call with Medicare Region A and the patient. On the one end, the patient is screaming at the carrier, How can I be dead? I’m right here. The carrier simply responds that according to their records, the patient is dead.

Well, this back and forth goes on for quite a while with quite a few phone calls. Finally, Medicare Region A decides that they’re going to go over the patient’s records with the patient and the medical billing agency. So they begin the questions starting with name, address, etc. Well, when the patient gives the carrier his street address and state, the carrier responds with the following. Sir, Texas is not in our region. Well, it turns out that the patient had the same street address as another patient in New York. Everything was exactly the same except for the state, which nobody bothered to check. So what happened was that the patient had his claim sent to Medicare Region A when it should have gone to Medicare Region C.

Everybody had a real good laugh about this, but the problem still wasn’t solved. Now the claim had to be forwarded to Medicare Region C. The problem was that the medical billing agency was not licensed to bill Medicare Region C. They only had a package to bill Medicare Region A. So now they had to see if they could get Medicare Region A to forward the claim to Medicare Region C. Well, they could, but there was a charge for this. Well, the medical billing agency said no way. So what did they do?

They got a hold of another medical billing agency that did bill Medicare Region C and arranged to do a swap. They’d bill one of their patients for them, thus incurring the cost, if they’d bill Medicare Region C for them. The company agreed and sent the claim. The problem was finally solved.

You can’t make this stuff up.

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Michael Russell

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Tags: medical claims billing, medical billing from home, medical billing specialist, medical billing training, medical billing school, medical billing companies, medical billing agencies, medical billing coding

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Medical Billing Systems