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Summary
Summary
For anyone interested in entering into the medical billing field or professionals currently practicing within it. Written by the founder and Executive Director of the National Electronic Billers Association (NEBA), the largest medical billing organization in the country, this book is a comprehensive and authoritative overview of medical billing as a business. Merry Schiff, a renown teacher of thousands of students, brings her understanding and teaching skills to the market. Medical Billing Handbook leaves no question unanswered. A comprehensive approach provides information on all aspect of the business including; policies, procedures, manual and electronic processes, HIPAA, and managing the business.
Author Notes
Merry Schiff, C.H.R.S.
Certified Healthcare Reimbursement Specialist
Founder and Executive Director NEBA
Merry Schiff is a Certified Healthcare Reimbursement Specialist and is the Founder and Executive Director of the National Electronic Billers Alliance (NEBA). She has been in the medical billing business for over 40 years. Early in her career, there were no electronic claims, few medical insurance companies, dental insurance did not exist, and no one had heard of the words "managed care." Over the years, the medical billing field has grown and changed exponentially.
As a medical reimbursement specialist, Merry has been installing computer systems for medical and dental providers since 1978. For two years in the mid-1980s, she was IBM's only authorized installer for its medical software. She has helped design several medical claims packages and has been selling and training in this specific market for many years.
Many people were entering into the medical billing business, and once they had completed their training, they were lost as to how to make the transition to a successful business. Ongoing support was lacking and people did not succeed. NEBA was founded by Merry in 1996 to assist people who were entering the medical billing industry or who were currently working in the field. NEBA offers certification examinations for both medical billers and HIPAA, and offers the business expertise to those who are starting up their own businesses and need help establishing business and financial goals.
Excerpts
Excerpts
Back in the 1970s, I was a single young mother with four children, working many hours to help take care of my family. Health care had always been an interest of mine and becoming a nurse or a social worker would take, in my mind, too much time, so I got involved in the financial management of the medical office. I figured that if I could show a physician how to bring in more money, that I could "make it" as a medical biller and consultant. However, I needed to work from home, and very few people were doing that in those days. I bit the bullet and started my business and admitted to people that were interested in my services that I was "working from home." My business grew very rapidly and still, years later, there were very few people "working from home." Then, all of a sudden, medical billing became a popular business, especially for moms and dads who wanted to stay home with their children. With the experience that I had setting up my own business, I decided to help others learn from my experiences, and so I started training others in this field. As managed care plans started to overtake the health care industry, there seemed so much more need for outsourcing the medical billing functions of a medical practice. We soon found out that managed care produced MORE paperwork. Then, in 1.992, the government agency that handled Medicare at that time announced that all physicians had to submit all Medicare claims for their patients. The choice to do this or not to do this was no longer going to be left up to the physician. What came from this decision was MUCH MORE paperwork, and many more jobs for people to work in offices. At this time also, many healthcare providers started to think of taking all of this paperwork and outsourcing this to others who could handle this better than the overwhelmed staff. And so, a new business was started, one that has continued to grow over the years. Medical billing has continued to be a big business nearly 20 years later. This book is for the person who wants to be trained so that he can work in a medical office, or for the entrepreneur who wants to set up her own medical billing business. Whatever venture you choose, please be aware that this industry changes very rapidly, and that your biggest responsibility will be to keep updated with the latest information. Excerpted from The Medical Billing Handbook by Merry Schiff, Deena Strauss All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.Table of Contents
| Preface |
| Acknowledgements |
| Guide to Medical Insurance ICD-9-CM Coding E/M |
| Guidelines Medicare Billing |
| Guide Collecting Medical Claims |
| Information Processing Claims Manually and Electronically |
| Credit Policies, Billing Procedures, and Making Collections |
| Ancillary Services HIPAA and Privacy Regulations |
| Setting Up Your Own Business |
| Marketing Your Medical Claims-Billing Service |
| Appendix A Abbreviations, Acronyms, Combining Forms; Prefixes and Suffixes |
| Appendix B The Billing Expert Says |
| Appendix C Insurance Departments |
| Appendix D Collection Letters |
| Appendix E Web Sites |
| Appendix F Miscellaneous Forms |
| Appendix G Glossary |
| Appendix H Answer Key to End-of-Chapter Questions |
| Appendix I Coding Exercises |
| Index |
