Medical Billing - The Stress Can Kill You

For those of you who are medical billing persons and deal directly with the public, you'll know exactly what I am talking about in this eye opening look at the industry. And the truth is, it doesn't really matter where you fall in the food chain. There is stress at every level. In this installment, we're going to look at a typical day for a medical biller.

For starters, you probably work in shifts. So you get in at one PM and you find that from the morning to that time, there are already about 40 bills that have to be sent to various agencies such as Medicare, Medicaid and even private insurance companies like Prudential. So right out of the gate you're behind the 8 ball. You have two hours work ahead of you already.

Then your supervisor comes in and tells you that there is a problem with one of the patient claims that you submitted last week. It seems that the carrier is claiming that the claim is fraudulent. So you have to immediately get on the phone with the carrier, the doctor and the patient to find out what's going on. The conference call lasts about one hour until the error is straightened out. But your day of horrors is still not done.

Turns out that it's the new quarter and you have to do a HCPCS update before you can even do the days billing. So the next thing you need to get a hold of is a computer with a modem or a direct Internet connection. Well, there are no modems and you find out from talking to tech support that for some reason their Internet connection is down, even though the IIS server is working fine. So now, because you can't do a HCPCS update, you can't get your morning bills out because you don't know if all the procedure codes in the system are up to date.

Then there is an emergency meeting that is called. It turns out that there is a new billing procedure with New York Medicaid that has to go into effect immediately. All the paperwork has been printed out for you, all 40 pages of it, that you have to read ASAP and assimilate even quicker. If you need any help understanding it, don't bother going to your supervisor because he doesn't know anymore than you do.

Finally, the Internet is back up just as your meeting ends. You're able to do your HCPCS update and finally, after your day is about four hours old already, you're actually able to do some medical billing. You now have about 80 claims to process, maybe more.

This may not be a typical day at a medical billing company, but it is not as uncommon as you might think. The number of things that can go wrong, from computers going down, to patient complaints, to carrier complaints to just the sheer volume of the number of claims processed, especially if you are a clearinghouse, can just about kill you.

Source by Michael Russell