2 of 10 MEDICAL BILLING AS A BUSINESS | STARTING YOUR OWN MEDICAL BILLING BUSINESS

which is you charging patients or writing off charges that cannot be collected, so sometimes once everyone pays their share you will need to pay off the remaining balance, which is part of

your

contract, so you agree in

your

contract write Sometimes you cancel some things and cancel them just so your accounts are free and clear. Now the patient owes a zero. You can continue receiving care. Your doctor's books are rocking. So is that whole process of cleaning records? your practice, so these are not part of the actual cycle, but are additional steps of the cycle. Okay, analytics and accreditation, and I guess you could say that analytics is part of the process because it involves reporting, but what I'm talking about is not just going. through the reports and read them as a general revenue cycle manager or biller, but analysis so that a healthcare analytics specialist can handle the automation of internal and external reports, create executive level dashboards and present information to help clients. hospital executives and others understand the operational impact of data now. there is a specific certification for this you can go to ahima or aapc and get certified to become an analytics specialist they make very good money we are all analytics specialists in our own way when we are in the

medical

billing

industry but this is more of a specialized training to really tell the story of what's happening in an organization and that's something you can now do separately as a separate

business

credentialing.

Credentialing is something that happens before something happens. Credentialing is the process of verifying a provider's qualifications to ensure they can provide care to patients. Most healthcare insurance companies require this process, including cms medicare and medicaid and commercial plans, and hospitals definitely do the same. Just like in surgical centers, this is a time-consuming process, which is why in my

medical

construction

business

I don't even offer to look for it elsewhere, it takes a long time, but the good thing about it taking so long is that it is a business opportunity for you to offer this and charge a good amount, so this will need to be done before medical care can be provided.

Now the credentials are very broad, you must obtain all the credentials if a person wants to start a clinic that you have. to have personal credentials and your staff has to have credentials they need contracts with insurance companies they need contracts with medicare they need contracts with medicaid so before they can start providing care they need to get their credentials now let's talk about the pros and cons of separating your services for your new business. Many of your potential clients will already have a

billing

department and suppliers may be reluctant to change the entire department, giving you the opportunity to make your services and your business unique. as an assistant or temporary addition to help the current team and take pressure off the existing team.

This is something that, if done right, you could use to your advantage to be able to say, "Hey, we're not here to take over, we're just here to help your team that's overwhelmed, this is what we offer, we can clean it up, okay so it's a great way to get in the door because it's a very low pressure situation for the group and just being able to add your services as a provider and you're just there as someone who's there to help, that could be very easy to get sometimes, that can be an easy contract for you if done correctly, now the disadvantages arise when you don't adequately explain what you will and won't do, many practices will hire you and think you are taking over a portion than you actually are, then you will find yourself in a situation sometimes I know I have done it and I know I explain it I think I do a good job of explaining, but I have found myself in certain situations where a new, potential client or current, he thought he was going to do more than that.

I agreed so they will hit you with things like hey why are my claims being denied? um because there are no proper authentication checks and then they may think, well, you said you were doing eligibility and benefits checks, so why are my claims being denied? without authentication, those are two different things, so you need to make sure it's clear and that can be a big con for you if you don't make it very clear to your potential clients, so your marketing, your writing and the contract should Be clear so as not to make practice problems worse due to misunderstandings so you can easily make six figures doing credentialing, collection and cleaning, coding, billing and analysis, for those, you could easily make six figures if you want to split up and do something different like publishing of pay, benefits and eligibility, you're not going to make that much money, six figures probably isn't in your near future, but you're going to have a good life like you're making probably thirty dollars, forty dollars an hour, that's probably where it's at.

It will be if you offer some of the smaller sections of our parts of the cycle, but when it comes to credentials and coding, billing and analytics, if you just offer any of those things, you can definitely make six figures, so you'll want to understand that. If you offer these services separately you should know that you are paving your own path because many billing companies offer everything well, they are RCM, they offer RCM and analytics, consulting and retraining, many of your competitors will offer everything. If you're going to go a separate route, know that you're blazing your own path and you'll have to figure out, in terms of marketing and presentation, why a company should come to you for this separate help. of going to a bigger company to get a bigger solution, so for companies to use you for this, you have to create your original marketing, your proposition, you have to get in front of these. people because they're going to do something that's very different, a lot of their competitors offer the full package and a lot more that doesn't really include medical billing, they offer consulting, retraining, analysis and all kinds of things so you're going to pave your own path here. and as long as you're ready to do it and understand that you need to make it very clear and create the reason why they should use you as a standalone unified messaging service. from another company that could use a full suite, then you will be prepared for the challenges that await you if you separate these services, it will allow you to get many more clients than if you offered full services properly, so it is a good one you will get many, many more because you are only doing one thing and that is always an advantage, it allows you to become an expert in that area.

Well, now that you know what the steps of the billing cycle are, you can decide. what services do you want to offer I recently received a message through LinkedIn from a certified medical coder who was interested in

starting

a coding business and I'll show you what he wrote and what I wrote in response, so I received this message on LinkedIn. and basically he wanted to know how you could start a medical coding business and I pretty much told him you can do it separately but make sure you don't poke holes in your clients' accounts because they don't realize that you're just going to code for them make sure that in your marketing, in your language, and in your agreement with the partner, all I'm doing is coding.

I'm not doing anything else, so make sure all those holes are plugged. The most important thing I can say. Guys, don't make things harder for your clients by not communicating what you are and won't do for them. Now let's talk about what you could do by doing this. Remember that all this is subjective. I'm not everywhere. country so I don't know how much everyone is charging but this is just a general idea of ​​what you can charge for these services and of course always try to do the best job possible so you can increase your prices on pickup.

It's a source of income, you can actually make more money by specializing in and I would say that 98 of the healthcare practices in the United States need help and they will lose that money in due course. 100 are going to lose most of the money that is in their accounts every year, that time ticks and disappears, I say about 98, okay, so if they don't get help from outside, they can't collect that or they can't clean it up because Your internal billers are already there. already overwhelmed, they don't have time to go back and fix this problem because they are just trying to deal with the flood of complaints and daily problems that they face every day, so I would say they can collect between 10 or 15, 10 to 15 collections because It's a very tedious, high effort job and it includes correcting and resubmitting claims, so you're going to have to go in and collect them, correct those claims, resubmit those claims you're going to have to do. the appeals process, which means writing appeals and collecting records and reasons why it should be paid, and that appeals process can be done one, two or three times, so you will have the first level of appeals, the second level of appeal, you have to talk to nurses, all kinds of things, then once you get the money, you have to pay, you have to record the payment and settle the account, cancel the extra payment, delete it and anywhere you can wait between five and fifteen phone calls per problem. to clarify and if you are in the medical billing industry you know those phone calls can be 20 to 1 20 minutes to an hour trying to figure it out so it is a very time consuming process that is why I can charge so much money coding so I can code for a doctor at a flat rate okay so you can say you know I would normally make about 25 an hour as a coder so I'm going to charge all my clients probably thirty forty dollars an hour. because I don't have to pay my insurance and then I have to pay my employee taxes and then I'm going to have several clients working that way where I charge an eight-hour day at forty dollars an hour and that's on their monthly bill, you can offer them consulting of coding and finding out if they are using all the codes that they can use, so that is a separate consulting service that you can offer to you as a coder.

Hi, I know for this particular procedure I could probably add this this this and this and they'll pay me double for this appointment and obviously it's just you suggesting it to the doctor and the doctor deciding if it's okay or not. I can add this treatment to my normal plan and that will increase my income. Because you understand the codes they might be using, you are a valuable asset to inform physicians. Hey, I see you're just doing this and this, but did you know that if you added this tracking or this type of service or If you just did this, you could increase each claim by 75 so that all of these things that you can do with coding can be offered in a package or you can offer them separately so you can have new customers every day when they first come in. for a and uh so you can analyze their logs and see if they're using all of their correct code, then you just charge them a flat rate or you take the coding and add all of that for a flat hourly price and you charge them monthly for it, they would offer an analysis of the codes that they use and what they should add, so if you offer the consulting service, it will just go through all your records and review all the codes and say Hey, you're actually missing these codes, you should remove them, you should add them now Obviously, it depends on the doctor who must administer this treatment and he must make sure that the treatment is what he wants to do or what it is. appropriate so they can say no or yes, all you are doing is just giving them options to say hello, if you just add this extra part of the treatment that you are missing, you could add more income to each appointment and the doctor can consider that suggestion and say no it's not necessary because I don't feel like it's necessary for what I do or they may say wow I really should have added that anyway so it's up to you and I think each of these packages are each of these services consulting where you do this analysis of what their coding looks like and what they should be doing.

You can charge between 1500 and 3500 per analysis depending on the size and specialty of the practice because at the end of the day, if you fix, add or adjust your coding, that increases your income which is 1500 to 3500 per analysis for the practice Of a doctor, nothing understands that he is dealing with many foreign competitors who can charge between two and three. maybe four percent of the fees, but as an American company I suggest that you charge between 7.5 and 10 percent anywhere in the middle of the fees for your client when you offer billing, so understand that when people sign a billing contract in your mind they are thinking about rcm so be prepared to deliver rcm which is revenue cycle management in the whole thing, that's pretty much what you will actually haveto deal with in terms of the need or requirement of many of their customers.

Do you understand why I say I'm alone? I can make more money doing AR alone than billing and don't get me wrong, you're not going to work less doing AR, so what do I mean by that? How can I not work less when all I offer is? ar, but you're telling other people that when they offer billing services they pretty much offer rcm, well this is a little hard to explain, but I'll do my best. ar is something that overwhelms almost every practice in America. If the billing department is going to work on your ar they will literally need to double their efforts, so what happens is a lot of people just don't do anything with their ar, most clinics will find that their ar is suffering, it isn't. are working, they can't because the billers are overwhelmed, so when you take over you're not doing less than the billing company, most likely the billing company or the internal billing department just billing.

They are neglecting the area they are in. I don't do it at all because they are overwhelmed, so when you take over an AR, you go to work all day, eight hours a day, you work non-stop, no matter how long the contract lasts, six hours a day. months to a year to clean it. you're literally not doing less work, you're just doing work that the internal billing team simply isn't doing at all because it would duplicate their efforts, so when I say you're doing about the same amount of work as if you had a billing contract, you're um because it actually just leans for most clinics in America and that's why I say you're not going to do less work, you're going to do the same amount of work, you're just doing different things, but Because AR is very tedious and time-consuming, and that money is almost certainly 100 because the internal team can't even work on it.

It's easier to collect that amount of money 10 15 10 to 15 in collections because they are going to lose it anyway modes, so they could also charge you, they could also pay you 15 and analytics, so healthcare analytics refers to the use of a large amount. of data collected to provide organizations with actionable insights so that these insights are developed through analytical disciplines that drive fact-based decision making, so basically it's just a matter of reviewing the numbers, analyzes and reports and then tell the practice what it should be doing. using those numbers to improve your practice, okay, so this is something that there is a separate certification for.

You can go to ahima or aapc and get analytics clerk certification. Healthcare analytics representatives earn between 75,000 and 100,000 a year, depending on the city. if you're making that as an employee, you can actually double it if you're doing it as a consultant, so if you're just jumping from clinic to clinic and you're actually teaching them how to do this or analyzing their numbers for them, you can do it independently or you can get a good job doing it as an employee. I truly believe analytics is your world, it really is your world and you can charge whatever you want for that skill set, literally billions of dollars are lost. in the healthcare industry, so if you can translate that analytics career into a consulting career, it's your world boss, it's your world now that we've gone over medical billing as a business and how you can make money from it and how you can branch out. these services you guys know the drill you can schedule a private call with me if you want to get private tutoring so my links are on the YouTube page and in the description box as well as on my website which is thejadenmedicalbiller.com as well they can look. in my tree linked in the description box for links to courses if you want to become a certified medical biller or if you want to start your own medical billing business and take their medical billing business starter course which will have marketing and sales tips . and scripts, and it's just going to go over how to completely start your own medical billing business from scratch, so this is going to be the year 2022, let 2022 be the year of your independent financial journey and remember in my next video we're going to talk about camera compensation. and the emr, mainly billing systems that you should really use when you are

starting

out and what is the best option for your new business and it will look at different prices and what these systems offer because you will need a system to start your own medical billing business so Don't forget to like this video because that really helps me with the algorithm, I appreciate it and I'm subscribing so you don't miss any of the updates, ciao.