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Hostel bill format for Healthcare

okay so let's get started I like to just give you a little bit of information about me so my name is Kiana Craig I was born and raised in New York I have 21 years of health care experience and 14 years of medical billing experience I have an Associate in Applied Science in medical administration and I'm a certified billing and coding specialist by Nha I am the owner of express medical billing & Consulting LLC which I formed in 2008 and I have worked in the following specialties emergency medicine urology plastic surgery internal medicine dermatology speech language pathology breast surgery psychology obstetrics and gynecology and medical billing has changed my life it gave me everything I was seeking my priority was flexibility I wanted to be able to set my own schedule and be present for my children it has also been very profitable I've been earning six figures consistently since 2006 and it's very convenient I've been able to work from home which I've been doing for the past six years since 2014 okay so what is medical billing medical billing is a process of creating and submitting a claim to an insurance company for a healthcare provider to receive maximum reimbursement for services rendered in simpler terms it's translating a medical service into a billing claim it's very easy to learn and does not require a college degree you can work on site at the providers location or remotely from home there are many different types of providers to name a few MD medical doctor LCSW licensed clinical social worker SLP speech-language pathologist DC chiropractor or Doctor of Chiropractic NP nurse practitioner it consists of a lot of data entry and follow-up calls you have to be very comfortable with computers and talking on the phone skills that will help you succeed are being organized and detail-oriented okay so this is a revenue cycle which is the life of a patient account from creation to payment we're gonna start at the top of the black arrow and it begins with patients scheduling and registration so right now if I were to call my doctor's office they are going to register me over the phone if I were a new patient or even established every time I call now to make an appointment they're going to verify your full name date of birth address email address phone number and your insurance they're going to want all that information up front so that they can verify that you have the active coverage before you even come into the office okay so that's the next step insurance verification then once you arrive to the office they should be collecting the copay at the time of service after you will see the provider whether you have the patient exam or consultation and then after that the provider will complete a super bill it's also called an encounter form or fee ticket and that is where they will mark off the charges so they should be selecting procedure codes whether they're CPT or hick pick codes and diagnosis codes okay so that will be given to the biller the biller will do a claim review and make sure that all the codes are correct and add any necessary modifiers and then submit the claim after submitting the insurance company will receive the claim process to claim an issue an EOB an EOB is an explanation of benefits and it just breaks down the way that the claim processed so if the claim paid and you would post the payment if it denied you would research the denial reason normally it is on the EOB it'll tell you why but if you have any questions you can contact provider services and inquire about the reason they will assist you and you can submit a corrected claim or possibly file a Daniil I'm sorry possibly file a an appeal if necessary the next step is a our follow-up and a R stands for accounts receivables you want to run your AR report every 30 days and that's just checking for any outstanding claims you want to follow up on those claims and any outstanding balances by the patient and then patient statements you want to issue these statements to the patients after you receive the EOB or er a and that just lets them know what their responsibility is what their outstanding balance is and those can be sent by mail by email or even text ok so this is the life cycle of a patient account from creation to payment ok this is an example of a demographic sheet so this is what I was referring to before right now if you call probably most of your providers offices they're gonna collect a lot of this information up front but once you're physically in the office they may have you complete this demographic sheet and again it's your name date of birth address phone number email address your emergency contact they may ask for your primary care physician information and your insurance information okay this is an example of a health insurance card okay on the front of the card they will have the member ID and some of them also have a group number it'll have the member name it may have the PCP or primary care provider primary care physician it may have that on there as well and then there should be an area where they explain the copay for a regular office visit specialist er possibly for urgent care but that will be listed on the front as well and then there's the payer ID the payer IDs electronic number for each insurance company and that's needed so that you know where to send the insurance claim okay and then on the back of the card you would pay attention to provider information and that's going to give you the provider services phone number if you have any questions about benefits or claims and also the pedo box is on the back if you ever need to mail a claim or any correspondence you would send it to this address on the back of the card this is an example of a super bill also called a fee ticket or encounter form and at the top it's going to have the provider and the practice information it may also have the patient name date of birth their insurance it should have the date of service that they're being seen and then again the provider will complete this form and they'll mark off whatever codes are appropriate so it should have again a CPT or HitFix code and a diagnosis code on here okay some super bills had the diagnosis codes listed on here if not in this bottom right corner the provider will just put the code there or write the diagnosis there this is a paper version but a lot of software's now that are cloud-based do you have an electronic version okay this is an example of a hicfa 1500 claim form this is used by professional providers okay this is a sample and the information that you're inputting into the practice management software it's going to look like this on paper okay so again it's the patient information name date of birth address and over on the right it's the guarantors information the member ID number in this section here it's the diagnosis and date of service place of service and those cpt or HIPAA codes modifiers would go here total charges rendering provider NPI and the billing provider's information goes down here so everything that you're inputting all the data entry that you're putting into the system is going to generate on this form you're going to submit claims electronically nine times out of ten but if you need to print it on paper this is what it would look like okay this is an example of an explanation of benefits also called a OB or a OMB explanation of medical benefits and this is what the insurance company is going to issue after they process a claim so it's going to have the provider or practice information at the top and then it should have the patient information as far as name or member ID and it will breakdown the way that the claim process so it'll have the date of service the charges that were billed it will tell you the allowed amount the paid amount and any patient responsibilities okay so patient responsibilities could be a copay deductible or coinsurance okay and then also on the e o B's there are remark codes so if there are any denials or anything that they want to inform you about there'll be a code and on the bottom of the EOB or the back there's normally like a glossary it'll tell you what each code means okay but again if you have any questions you just contact provider services and they'll explain the processing of the claim this is an example of a patient statement so again at the top it's going to have the practice information and the patient information where the statement is going and it will break down the charges what was submitted to the insurance company what was paid and any patient responsibility okay so we're gonna move on to medisoft practice management software I'm just gonna share my screen just confirm when you can see that okay it's a blue screen and at the top it says medisoft network professional okay great thank you so we're gonna go into everything from beginning to end so we're gonna create a patient account we're gonna enter charges we are going to create a claim submit a claim we're going to receive the EOB and post the payment and send a statement to a patient okay so I'm going to create a new patient and their name is going to be Mary go let it put in her address gonna put in her email her phone number I'm gonna go down to her date of birth and with this software they make you select two providers will select a provider and put in the D okay then we're gonna save okay so that was all the demographics we're just gonna also add her insurance here they make it create a case I'm gonna put GYN because she's a gynecology patient I'll select the facility and her insurance she is Oxford so we're gonna put in her member ID and her group member and see okay so we entered all her demographics now we're going to move on to charge entry so let's say the provider gave me these super bill and let's just say in the scene today she's a new patient so just we're gonna give her a 99203 which is a new patient level 3 visit and we're gonna make the four hundred and fifty dollars we're gonna give her a diagnosis code we'll just choose anything and then the second line item is going to be an ultrasound and for the ultrasound we're going to say it was 315 and okay so with this claim we're going to add a modifier to the e/m code evaluation and management code which is the office visit code okay this is going to prevent that office visit code from bundling with the ultrasound code if we were submitted without this modifier some insurances would process the claim and bundle the office visit with the ultrasound and just pay for one code but we don't want that to happen so we'll add the modifier 25 and in less than no this is a separately reimbursable charge do not bundle it and they should process both codes for payment okay so we created our claim or we entered our claim now we're going to create the claim okay so the data service was today and our patient is married Oh okay so this is the claim right here okay this is a tutorial account so it's not going to let me do the next step but the next step would be to have the claim scrubbed and that's just checking to make sure that it's clean and a clean claim means that there are no errors everything looks correct there's nothing missing it's ready to go out to the insurance company so the next step I would have just pressed the button it would check the claim and let me know if it was clean or not if it came Matt green that means it's clean you can submit it and if it came back red or yellow it would give me the reason why I would go back and make whatever necessary corrections scrub it again and then once it's green I would submit it so let's just say I submitted the claim it went out couple weeks later we received the EOB from the insurance company and okay so we're going to select that it came from the insurance it's a check we'll put in the check number I'm sorry put in the check number here and let's say the check amount of $600 from Oxford that's our insurance company okay this account doesn't default these codes let's see let's just choose one and see what happens okay so we have our Oxford payment for $600 we're gonna apply it to our patient again her name is Mary Jo will select Mary okay Sonia have Mary's account open so I have to close her account first and then we'll go back in okay here we go so this is the claim we have our a OB and we're gonna go line item by line item so the first one again is an i-9 203 that's the office visit we submitted a charge for four hundred and fifty dollars the insurance company allowed three hundred and fifty dollars and they paid three hundred okay so we're gonna enter that they paid three hundred but allowed three hundred and fifty and we're just gonna tab over it leaves a remaining amount of fifty dollars okay the fifty dollars is actually her copay which she didn't pay at the time of service so when we're done we're gonna create a statement for her the next line item is the ultrasound we build three hundred and fifty dollars they paid three hundred and also allowed three hundred so there's no remaining amount - okay our only remaining amount is that $50 copay so we're going to go ahead and save and create that statement we're going to select the statement I want we'll bring up her account again Mary Jo this was the date of service and this is what the statement would look like again at the top it's gonna have the practice information and then the patient information and it's gonna let her know what charges she's being billed for and the reason why okay so she owes $50 for her copay okay so that's the entire process we created a patient we entered a claim we submitted a claim we posted a payment from the insurance company there was a balance and we created a patient statement okay so I'm just gonna switch over back to the presentation just let me know when you can see that screen okay we should be back at where it says Metis thaw and it's a picture of the practice management software just let me know if you can see that yeah yeah okay perfect thank you okay with that now let's talk about the equipment that you need okay to get started if your medical billing from home it's going to do the same equipment that you're using in the office so simply you just need a computer it could be a desktop or laptop either one it doesn't matter most software's are internet-based or cloud-based so you just need the internet the type of computer and all the specifications don't really matter that that was used like years ago when you have to download actual software and programs onto your computer so as long as the software is internet-based it doesn't matter what type of computer you're using you're going to need a phone the landline or cell phone either one is fine and a multi-function machine you're going to need to be able to print copy and an X okay so let's talk about what's next and what you would do to get started after here okay so if you're interested in learning more about medical billing if you have any further questions you're more than welcome to schedule a free 15 minute consultation okay if you were interested in actually getting started and maybe looking for providers or starting your own billing company from home you can schedule a coaching call okay you can schedule 30 minutes or 60 minutes and you utilize this time however you like if you want to discuss you know how to start a business how to find clients maybe you want to do a resume audit maybe you're not getting any responses and you want to go over your resume we can discuss interview tips or even train on practice management software okay I do offer a six-week online medical building course it's called biller bootcamp it's 999 dollars this bootcamp is a live online course that teaches you everything you need to know to become a medical billing expert okay during this affordable six-week course I will guide you through a number of interactive lessons and discussions to prepare you for the certification exam and for a successful career in medical billing soon to come our ebooks and some of those topics are going to be key medical billing terms what is medical billing and how to submit a claim how to start your own medical billing business from home it'll be a step-by-step guide and how to find medical billing providers resumes samples and interview tips will be included ok this is all of my contact information I am ask the biller on YouTube Facebook and Instagram my website is just ask the biller comm and my email is ask the biller at gmail.com if you're looking for a group to network with I have teamed up with the amazing two major Alston and we formed a group called billers and coders you made it so that is on Facebook if you're looking to work from home or take a certification course maybe you're looking for career coaching you want to start your own billing company or again just to network you definitely definitely want to join our group ok so now I'm going to open it up for the Q&A if anyone has any questions feel free you can put it in the chat and then I can call on you you can take yourselves off mute and I'll be happy to answer any questions it's yeah can i buy hello hi hi how are you I'm good my name is hameed so thank you thank you very much I know so I'm new to billing so I want to ask where do I start well if you have never done billing before you'll need to take a billing course ok you'll definitely need some instruction and some guidance on you know everything in regards to medical billing you're going to have to learn ok so once you get through that course then you can start with maybe an entry-level position you're going to need you know some experience so you could look for an entry-level position a good position to try to get is maybe with an actual billing company they are willing to hire new grads because they will train you and that's that's something that you're looking for it's hard to secure position right after you take a program so starting with like a billing company or an internship or even volunteering those are ways that you can get into the field so that you can gain some experience and it won't take you very long it's like I said it's easy to learn but you'll need some experience I mean even six months experience should be enough for you to get a good handle on it and then you know if you're interested in working remotely you can start to look for your own providers to do billing for okay thank you you're welcome and so doesn't so does the you do not need to spend tens of thousands of dollars on you know really expensive program although you know you will you met you will make an immediate return on your investment once you get a job you know you will make the money back but I would advise anyone to spend you know the amounts of money that I've heard programs are charging so I've made it very affordable and it's also you know a short accelerated program so that you can get out there sooner than later if anyone is interested in starting today I will send them a coupon code a discount code so you can get a discount off of the course but it is nine hundred and ninety nine dollars okay so if the cash did you do you have to pay my cash cash you have to pay it you know rather than there before you well if you want to make a deposit the next course doesn't start until the week of July fair so if you want to make a deposit you can do that as long as the course is paid in full halfway through the course you know I'm willing to work with you that's fine okay you can send me now you're interested you can definitely send me an email at ask the biller comm I'm sorry ask the biller at gmail.com okay just let me know you're interested I'll send you a discount code and you know that'll take a little bit off of the price you can make your deposit and then you know just make your payments towards it okay thank you okay so so within this next week so so within the six weeks you'll be able to understand and know how to do billing absolutely yes let me clarify medical billing is not medical coding medical coding something completely different you know they work together but medical coding is something different that's when you'll need you know more extensive training you'll need to learn medical terminology anatomy and physiology that's when you're actually going through the medical records and you are deciding the the most appropriate codes medical billing is when the codes are provided for you so it's mostly data entry okay so I just want to clarify medical coding is something completely different but medical billing yes you can learn that relatively quickly in the 6-week program and at the end you will be ready for employment okay so if I'm certified with you I can get a job it's like like like your certification can qualified me to get a job no I do not have certification the certification you prepare for the certification exam and that's going to be one of the companies like AAPC or you know Hema one of the other companies but I do not provide certification I'm preparing you to take the exam miss Craig I have a question okay thank you go ahead Natasha yes thank you this was actually really informative and very insightful but my one question our medical billers are they required to be certified or does that kind of vary you know I wasn't really sure about that I get that you know of course you need you know the understanding and all of that but are you required to be certified no you do not have to be certified now it depends on the type of position that you're applying for I work for professional providers I work for doctors therapists you know private practices vote that type of billing does not require certification now if you're going to be looking to work in a facility or a hospital they are definitely more likely to ask you for certification on it okay so you so you do work for them so you and you have your own business yes okay got it thank you you're welcome no problem yes I have a medical billing company it's called Express medical billing and consulting and under that company that's where I do the billing for five different practices what it is the other company that you're probably thinking of is asked the biller that's where I do training I do medical billing training and coaching got it okay and do you outsource any of your work or have employees under you or is this something were you I merely do it on your own because I know I said you've been doing it for about six years home etc yes I do not outsource I do have one full-time employee okay yes thank you thank you for your questions thank you yeah yeah yeah thank you she is we should relax a great question because so you can work so you don't need a certification if you don't have to work in the bigger company right if you're not working for a facility or a hospital those are the type of writers out there gonna require you to be certified but if you're simply working you know maybe you find a small group a small you know I don't know an internal medicine group or essentially you know those type of providers don't require certification no okay thank you you're welcome any other question No okay good yes this is Alicia I have a question how many notified coder so if I wanted to be certified and billing what I have to take that certification again or with my coding certificate be sufficient no it's not sufficient you would have to take the certified professional biller exam that's what AAPC but whatever company you would go through you would take their billing exam so coding is very different from billing okay that's why you different certification okay all right you're welcome you're welcome so again if anybody's interested in taking the six-week bill or bootcamp course you can send me an email at ask the biller at gmail.com and if you sign up today I'm happy to send you a discount code to take you know some money off of that course and if you have any questions feel free to reach out to me I would appreciate any feedback about the webinar if you don't mind leaving that on social media on Instagram or Facebook if you want to leave a brief review about the webinar today I would greatly appreciate it if there are no other questions I'm miss Craig I have one last question I'm just I'm just out of curiosity how did you get into it I know you stated earlier that you know you had flexibility and whatnot but you know like how did you get into medical billing like what kind of prompted you for this so I started my healthcare career back in 1999 I was working my first job in healthcare was an emergency room registrar so back then they called it the emergency room I know now they call it the emergency department but I was an ER registrar I worked there for a couple years and I fell in love with health care after that I moved on to a couple different practices neurology neurosurgery just doing you know front office authorization office management and then I moved on to an OBGYN group who was outsourcing their medical billing but the medical billing company wasn't doing a great job they were having a lot of denials for untimely filing which is unacceptable because you have at least 90 days to submit a claim so if they weren't getting the claims out within 90 days that means that there was a serious problem so I used that to my advantage and I went to the doctors in the group and I offered to do the medical billing for three months free of charge so I had no billing experience but I have had six years prior of Health Care Administration experience I knew that medical billing was relatively easy and then I could probably learn so I just took a chance honestly and I just offered the three months free because I knew what they were kinda like paying that billing company that billing company was making several thousand dollars every month so I knew what they were paying them I said let me offer it free so that they had that savings and they give me that opportunity and they actually said yes so ever since then in 20 what was that 2006 I've been doing medical billing that's how I got into it I taught myself I didn't take any course or anything I taught myself so thank you you're welcome you're welcome so it is I mean it is very easy to learn it's not difficult I do want to stress like I said that it's not coding coding is something completely different where you definitely need education and certification okay but billing is relatively easy it can be very profitable okay I'm making the six figures because I have multiple providers not to say that you can't make it with one provider I mean maybe if you find a very large group or facility to do billing for you can but I'm you know I am juggling a couple different providers and working comfortably from home so it's definitely a possibility especially now with everything going on with the virus there are a lot of physicians online specifically advertising for remote medical billers they're telling you that you can work from home okay a year ago you would definitely not see that but now it's very common okay so the opportunities are definitely there do you work for providers on nationwide or just in your state I work for providers in two different states I'm definitely open to other states but so far just New York and New Jersey but you can work for any type of provider in any state across the country so you don't want to limit your searches when you're trying to find them okay any other questions one last question so the providers that when you say that those positions are out there online where you have when you can work from home the remote position positions do they require certification or is it just basically working from home it depends but again everything that I've seen that I look at online or professional providers okay that means doctors there that sort of thing they're not facilities not hospitals nothing like that I have not seen any ads that state or maybe a few but it's not common that they want you to be certified as long as you have experience you know that's okay okay thank you you're welcome you're welcome anything else any comments any questions anything else if not thank you so much thank you thankful thank you thank you if you would leave a review online if you follow me on Instagram and leave a review on my post today I would greatly appreciate it okay I will yeah yeah you have out follow in a minute so a screenshot your your Instagram and your Facebook info I'm gonna stop following you yes please do ask the biller that's my name on Instagram and I'll just tell you somehow I was on Instagram the other day and I guess you must have put an ad or something and it like popped up and I was like okay so then I just started following you and Here I am so that paid off to some extent thank you I appreciate you letting me know the ads are working thank you absolutely and I'm nowhere near New York or New Jersey so thank you guys I appreciate it Aaron pan everyone I appreciate your time Alicia I can't see who else is on here that's why I just mentioned those names but everyone who's on here I appreciate your time thank you thank you probably welcome thank you take care enjoy your weekend you too all right thank you back