Let me give a little recap… (this is about the medical billing issue I’ve been seeing – please continue to read!)
I am a mom and for years I enjoyed casual blogging for fun. I recently decided that I wanted to get into it again, but more seriously this time. So… I hopped on my laptop and started a new “Welcome 2018” post. It went well, I enjoyed it and hit Publish.
Then I thought to myself, “You know Cat, you’ve been away for quite some time. You should reach out to each one of your followers, say hi and give a few of their posts a read.” So I started to do just that. But, with each click of the mouse and swipe of the screen, I kept finding accounts that haven’t been posted on in months – in some cases more than a year. 😦
So, I decided to look for some new friends to follow. I went to the main WordPress page and thought about what to search for. Aside from occasional art and hanging with my kiddos, my 3 favorite things to work on are my 3 businesses. Two of them are hobbies, first, selling children’s books for Usborne Books & More and second is Photography. The third is my profession: Medical Billing. For whatever reason, I chose the latter.
I typed “medical billing” in the search box expecting to find another soul that is as intrigued by medical billing as I am. (I know I am a giant nerd, but I am totally cool with it.) The very first thing that popped up – was quite the opposite. It was an article titled, Billing and Bullshit (I will be happy to link back to the original article once given permission) complaining about a recent medical bill. Or a set of them actually. One where the patient was charged $86 for a procedure and then $43 for the exact same thing. Also, $22 for a different procedure and then again $12 for the same one. What?!
Now, without actually reviewing these bills and the procedure codes associated with them, I can’t say that there is an error. What I can say is that all of that is confusing as hell, especially to someone who doesn’t do medical billing.
Then I came across another article titled Dollars and Senseless. (Again, I’ll be happy to link back if given permission.) This one was also frustrated with their bill. One specific irritation was the “adjustment” amount of nearly $30,000. I actually do understand that one without having to see any coding. And when this person called to fight their bill, some charges were removed, but others were not. When medical records were requested for review, it was going to cost $4 per page for over 40 pages. So, since the original costs were less expensive than $160, they just paid them to avoid the higher cost of the research.
Not only is this an injustice and unfair to the patient, but also, if those charges were indeed incorrect – the insurance company now has incorrect information as part of that patient’s medical record! And if the procedures were listed incorrectly – what about the diagnosis codes?! What about the medications (which in this case was specifically what it was). That could affect the patient’s overall healthcare! #Unacceptable!
One follower posted a comment stating that a doctor once told them that medical billing is more difficult to understand than medicine. That is probably true in some ways. I left messages for both authors and for a few commenters on both articles. I told all of them what I often explain to other people. Doctors are amazing!! They go to school for years to learn how to save our lives!! They are not taught specifically how to bill for it. Sure, they learn a little along the way on coding and billing, but it just isn’t the same.
Coding and billing guidelines change quarterly – that is every 3 months. Doctors are busy saving lives and learning the new technologies and sciences behind how to do it better every day. There are some that do get certified in coding so that they understand this side of things better. Most do not. That is why they hire coders and billers. There are a lot of crooked people in the world – some of them are doctors. But honestly, that isn’t the biggest problem. The biggest problem is the staff that is not trained properly to know the best practices for coding and billing!
I have been certified through the AAPC (American Academy of Professional Coders) as a CPC – Certified Professional Coder, CPB – Certified Professional Biller, and a CPMA – Certified Professional Mecial Auditor. I am sitting for my CEMC – Certified Evaluation & Management Coder certification in 2018 and eventually my CPC-I – Certified Professional Coder – Instructor certification. THAT is my passion!! I want to educate!! I want to help audit physician’s offices and educate them and their staff on the proper coding and billing guidelines. More importantly, I want to help educate… YOU!! Anyone reading this that is not in the billing industry!! I want to help explain medical billing and the “mysteries” behind it.
So, in 2018, with my fun little hobbies and hopeful vacations – I really truly want to open my own medical billing education business. I’m just getting started, and it may take a minute to find all the moving parts and get them all put together, but it will happen – and I can’t wait.
I know I can’t save the world and fight every crooked doctor out there and I can’t train each person that is currently billing incorrectly. But, I can help educate other people and together we can make a pretty good dent in it. And I can help educate people in general – so that they can be their own patient advocate. No, it’s not saving the world – but it’s a start.