Medical Billing Guide

stethoscope sitting on top of a stack of medical bills
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According to the Bureau of Labor Statistics, industry demand for medical records and health technicians—such as medical billing and coding professionals—is expected to grow 15% between 2014 and 2024. This growth makes these positions a viable home business option.

Medical billing and coding lend itself well to working at home. Many in the field have been able to do just that, setting up a home business and working for themselves with independent client physicians or working from home in jobs with larger healthcare tracking billing firms.

Medical billing and coding professionals may also be hired by insurance companies, pharmacies, and related companies and even the government for their expertise.

Medical records specialist earn a median pay of $35,900 per year, which isn't bad for a profession that requires little education or training.

Pros of Medical Billing and Coding

  • Can be done from home as a business or a telecommuting job.
  • Healthcare is a trillion-dollar industry that is always in need.
  • Help with billing and coding continues to grow as health facilities and workers move toward electronic billing and filing.
  • Doctors are happy to outsource medical billing to free them up to do what they do best, provide services.

Cons of Medical Billing and Coding

  • It can be difficult to break into the industry as most medical and health facilities have a source for their medical billing and record-keeping.
  • Most sources of work will want you to be certified as a medical biller and/or coder.
  • There are medical billing job and certification scams you need to watch out for.

Required Skills for Medical Billing and Coding

Currently, there are no set educational standards for the medical billing profession. Many employers who offer work at home medical billing jobs look for some level of formal medical billing and coding training through an accredited vocational or career training school, along with actual experience in a medical billing office. Formal accredited programs may take from as little as nine months to as long as two years or more and may also offer assistance with career placement.

Educational Requirements

Medical billing requires a fairly strong knowledge of medical terminology, anatomy, knowledge of how to properly complete various forms, and industry coding for medical procedures. If you don't have that type of experience, you can take a course and get certified as a medical biller and coder. You just need to be sure you choose a reputable program.

Other needed skills include a strong level of computer skills and a typing speed of at least 35 words-per-minute, as well as good customer service skills to deal with patients who may be under stress, physician and hospital billing staff, and other medical personnel.

Beware the Scams

Medical billing expert, Paul G. Hackett says:

Almost 80% of people end up choosing the wrong types of online medical billing courses.

In addition to knowing what to look for when you're researching medical billing and coding training programs, you also need to know what to avoid when you are shopping for an online medical billing study program.

Because of the growing popularity of medical billing home businesses, the industry is loaded with scams like "You Can Earn $50,000+ Processing Medical Claims From Home. No experience necessary!" Scams also try to get you to purchase training, software, marketing materials, and lists of doctors. Additionally, some scams try to sweeten their offers with discounted clearinghouse services if you buy medical billing software from them.

Any of these scams can cause you to part with your hard-earned money and waste your time getting established in the medical billing and coding profession.

Medical Billing as a Home Business

Medical billing professionals are usually able to work independently from home since medical billing software can easily facilitate electronic billing of patients, health insurers, and government health agencies like Medicaid and Medicare. However, most of these opportunities are for experienced medical billing professionals only. 

Billing or coding home businesses could have the potential for success and have grown in popularity. One of the reasons for this growth is the wide availability of online training and medical billing software. There is also the need to transfer medical records into digital form.

Like any home business, starting a medical billing and coding home business is much easier if you already have some experience and you have full training before you decide to go it alone. Additionally, you will probably have gained some contacts during your medical billing employment that will help in establishing your customer base. Other things you need for medical billing business include:

  • A business license. Check with your local Chamber of Commerce and with your state officials about licensing requirements.
  • A computer, printer, and fax, as well as accounting and billing software and fast Internet connection
  • Medical billing and coding software, which ranges between $500 and several thousand dollars. Much of it should be geared toward processing HCFA 1500s, the standard claim form used by health plans.
  • Medical billing and coding reference books. The recommended ones are the ICD-10, CPT and HCPCS Expert 2000, plus the CDT-3 for dentists.

Like any service-based home business, getting your first clients may be your biggest challenge. If you're coming from a medical billing background, you can ask your former employer to be a client or network with the people you know in the industry to find work. Visiting or calling local doctor's offices, clinics, and hospitals can be another way to find work.

Don't forget that many mental health professionals, as well as alternative health practitioners and medical cannabis offices, may also need billing services. Since some of these alternative medicines are not covered by insurance, they will not usually require medical coding.

Medical Billing Clearinghouses

An electronic medical billing clearinghouse acts as a middleman that takes electronic medical claims information and then submits it electronically to insurance companies the medical billing clearinghouse contracts with. Many who run medical billing businesses, however, fail to take advantage of this time-saver in their medical billing and coding practices.