Avoiding Medical Coding Software Scams

You need more than just medical billing and coding software to start a career.

What to Know Before Buying Medical Billing Coding Software

You may be wondering why you should spend your time and money on a medical billing degree or certificate program when you see ads every day that claim you can install medical billing coding software and earn thousands of dollars per month working from home as a medical billing and coding specialist.

As you may have suspected, the vast majority of these “business opportunities” are scams. According to the Federal Trade Commission, which has filed charges against many of these companies, “few consumers who purchase a medical billing business opportunity are able to find clients, start a business and generate revenues—let alone recover their investment and earn a substantial income.”

Medical Billing is a Skilled Profession

While many companies will want to convince you that starting a medical billing business is as simple as installing some software on your computer and letting local doctors know you’re open for business, you should know that medical billing involves much more than simple data entry. As a medical billing specialist you’ll need to have the following knowledge and skills:

  • Ability to fill out several types of complex insurance claim forms
  • Knowledge of insurance guidelines, procedures and claims submission process
  • Ability to analyze Explanation of Benefits (EOB) forms to ensure that insurance companies have properly assessed and paid for charges
  • Ability to follow up with insurance companies and patients to ensure that bills are paid in a timely manner
  • Ability to generate accounts receivable reports for clients

Get an Education in Medical Billing and Coding

In addition to the above skills, you should strongly consider enrolling in a program that will educate you in both medical billing and coding. It’s common for schools to combine both skill sets in one program, given that medical coding—the process of translating the information in a patient’s charts into a set of coded, billable items—is essentially the first step in the billing process. Although it’s possible to specialize in either medical billing or medical coding, you’ll be far more marketable if you know how to do both.

Medical Billing Business Requirements for Success

Medical billing specialists are responsible for getting doctors paid. This being the case, there aren’t many medical practices willing to hand their accounts receivable over to an individual with minimal expertise. With a degree or certificate in medical billing and coding, a year or two of experience under your belt, and a list of personal contacts in the industry, you’ll be prepared to start your medical billing business the right way.