Medical Billing Frequently Asked Questions

A.There are more than 1.6 million healthcare providers in the United States. As recently as the turn of the century about 27 percent of medical claims were filed electronically. There are some businesses that compete for the large accounts (large corporate practices). However, offering the service to smaller practices is where the focus of this opportunity should be. The market is wide-open for someone who wishes to establish a Medical Billing Center.

Electronic claims filing as a service in itself was a new trend in the mid 1990s similar to electronic tax filing in the 1980s. The market started to change in the late 1990s however with the demand focusing on “practice management” as complete service. Electronic claims processing is only one element of the big picture today.

As such, the medical billing business is no longer dictated by supply-demand relationship. It has become a real full-fledged business based on comprehensive services. In today’s economy, superior comprehensive services coupled with superior products is what the buzz is all about in the medical field. Those who can consistently provide top-notch services and solutions are the winners. Doctors are busy professional and in general they are not experienced business people. They prefer to deal with a few dependable vendors who can offer several viable services.

As far as statistics go, from communicating with our existing clients and a variety of healthcare associations. We see that at least 35% of the market still on strictly paper and many of the clinics filing electronically are doing so only partially. This means that they could be submitting to Medicare electronically but not to commercial carriers (or vice versa). Additionally, great deal of health care providers are still using old systems and paying heavily for support, training and upgrades. As a new ClaimTek-trained billing service equipped with the latest solutions and technologies you can create an attractive edge for your new company. Like any other real business, you enter the field ready to provide the best and take on the best.

To help understand the concept of this type of increased need for independent medical billing service companies, let us give you a couple of examples from other industries that fit the same scenario:

• A Chef or a Restaurateur wants to open up his own restaurant in town. He/she researches the neighborhood and finds several restaurants already in place. If this business person is confident of his/her ability to provide great/unique food, good price and excellent ambiance & customer service, should he/she be discouraged by the presence of other restaurants?
• Another close example is the electronic filing of taxes that started in the 1980s. Some people thought that many accountants may go out of business as a result. That was a false assumption. Similar to Medical Billing, accounting is a full-scale service not controlled by supply and demand of a single factor.
• Health care is a vast and complex industry. Due to population growth and the aging of baby-boomers more and more insurance claims are being filed. This business is recession-proof. People get sick regardless of economic conditions.

A. ClaimTek Systems offers billing, collections and complete office automation services to doctors; networking, hardware setup and software installation. Through this association we have developed a vast understanding of the healthcare environment. Also, we have access to the lowest prices possible on computer hardware. If you need a personal computer we will be glad to give you an estimate and when you compare our price to your local retailer you will notice our price advantage.

ClaimTek Systems offers more business solutions for you and your doctor clients. With our system you can offer your clients three ways of processing their claims or handling their entire billing, depending on their needs. You can process claims and handle other billing functions using the traditional method (picking up the claims information). The second method, the advanced method is by using our MedOffice® software. The third method, which is not very common or recommended, is by using the Claims Converter software.

ClaimTek Systems has researched and developed a unique software; MedOffice®, specifically for billing claims centers to install in doctors offices. This program works in conjunction with the billing center software that transmits the claims to the central clearing center. The MedOffice® Software has tremendous benefits for the doctor. s medical practice. No other "Electronic Billing" seller can match the ClaimTek System, which includes this unique, most advanced software, private one-on-one training along with our sizzling marketing package, free customized MedOffice® software for your doctor clients, and all the one-on-one counseling and support you need to make you successful.

Our system is designed to make your business as automated as possible so you can do more work in less time. With our company you have great potential of turning your Billing Center into a Medical Management Consulting firm offering a wide array of products and services. Our software systems are easy to learn. You will be assigned a personal trainer to walk you through the applications and answer any questions for you. ClaimTek Systems is constantly developing programs that can help you enhance your new operation and run a successful business of your own.

Investigate before investing your money. Compare our program to that of other companies. Look into the software solutions, the quality of the marketing materials and the training setup. You will find that our company offers the most comprehensive program packages. We are not just saying this or biased...It is true!

A.The problem in healthcare offices is not limited to purchase of software. Doctors can buy software and initial training for a few thousand dollars but their problems won’t go away forever.

In addition to ongoing expenses for IT issues, upgrades, training and support, the main problem in a healthcare office has to do with human resources. Turnover in medical offices is high especially with positions that deal with front office and billing functions. On average staff in billing positions come & go every 3-6 months! The frequent changes in staffing create potential income gaps between filing claims. When new staff members are hired they’re under pressure to learn the software and collect on past claims.

Billers are initially hired to strictly handle the billing function but soon they start handling all sorts of duties. As the phone rings, they get pulled & pushed into so many directions that they do not get to concentrate on their main job description. Additionally, their pay is historically low and this is probably one of the major issues that cause high turnover. Healthcare providers mostly look at in-office billing staff as “billing clerks” with “Fill-in-the-blanks” duties. Medical (or dental) billing truly needs more professional and dedicated people who know how to handle the intricate details in order to reduce or eliminate rejections while maximizing reimbursements. To a degree, it is a “corporate culture” issue. A similar comparison would be the way Banks look at tellers. While there are differences, the similarities lie in the fact that both are important positions but not well paid generally.

Overall, doctors end up paying much more for in-house staff than to hire a professional reliable outside billing service. When calculating staff pay, you have to take into consideration all the additional costs other than salary, such as taxes, benefits, vacation, etc.

Your goal as a professional medical billing service is to bring awareness to doctors that this area of their practice truly needs much-needed attention and stability. As a ClaimTek professional billing service you’re equipped with advanced tools and provide better cash flow solutions, lower costs and bring stability to their practice. Additionally, their staff gets too busy to keep up with changing regulations. By having ClaimTek’s programs you can bring so many benefits to the table.

Let me add one more thing relative to what ClaimTek offers you in establishing your service. We provide you with the tools to offer numerous additional services to doctors, such as Electronic Funds Transfer, Collection Services, Remote Backup Services, Well-Care Services, and Digital Scanning of Medical Records. These services are often needed by healthcare providers, and clearly office staff cannot provide them since they require specialized tools and knowledge. Our web site provides detailed information about these extra services that we set up to offer you.

From what we’ve seen in the market place, the trend to outsource is growing. However, there will always be segment of the market (doctors) that prefers to handle their billing in-house. It is a matter of timing, experience and management style. As a ClaimTek licensee you can help both segments! When you sign up with the Preferred or the Principal program you become a reseller of our software earning 40% and 25% discounts respectively. Sometimes, relationships with doctors start from this angle (buying software for in-house use) but when they lose their reliable staff and go through instability in this department (which makes their A/R spiral out of control), they may consider outsourcing. This is especially true when they already have a positive and established relationship with you. Switching a relationship with a client from software sale to billing is very easy because you can transfer data without conversion problems.

A.Medical Claims opportunity provides the ultimate in flexibility. This is a work-where-you-please, when-you- please-business. The amount of time you invest in your business is up to you. You can operate from your home or a small office. Many of the people who take up medical billing are accustomed to a full-time work load because they want to maximize the high earning potential of this business. With the high profits that are possible, it's easy to see why. You can find work anywhere in the U.S. where medical services are offered.

Our experience proves that one person can handle 4-5 accounts working full-time using the traditional method and between 7-9 accounts if these accounts use the MedOffice® system. With the advanced MedOffice® method you work around one hour per account every day. The MedOffice® system provides flexibility. You can perform the download/upload routines daily, twice or three times a week. With some small accounts, once a week may be sufficient!

A.If you have previous business experience it will certainly be an asset. However, we have designed our programs to fit your needs. For the first-timers, we offer a complete program that makes it easy to start up and be successful in their business. And for the experienced entrepreneurs, we offer a package that provides the necessary ingredients to be up-and-running and to succeed without having to pay for what they already know. If you are goal-oriented and determined to succeed, then this opportunity and our programs are tailor-made for you.

A. When you have an emergency or just need a few days of vacation. We have the answer and solution for this very important problem of a one-person business. Our answer for this problem is called our Emergency Support Service, or ESS. This service is available if your doctor clients have the MedOffice® system. When you need to leave, let us know and we will take over by modem and do the processing of your claims. This great benefit to our associates is available for up to a full month! remember we are here to help you. So rest assured you are not alone, but you always have someone who is competent, reliable, experienced, and available on short notice. This is your insurance policy. You can't buy it or find it elsewhere!

A.The codes needed to process medical claims are provided by the physician. s office staff. Our training program and materials include a Medical Coding and Fees Manual that explains the format and use of ICD-9-CM, and CPT4 codes. You will quickly learn the basic principles of medical coding. When you come across a term you are not familiar with, you can simply look it up in one of the reference books we provide you with. If you are determined to succeed you will learn these details in no time.

A. We are in the computer and electronic age, as are most other businesses. ClaimTek is on the leading edge of the advances for "Electronic Billing" systems. Our company is ahead of the pack in this fast moving electronic age and has spent the money and time investment to develop new and innovative software. We want to give our clients the very best and also stay ahead of any competitors. We furnish you with all the premium up-to-date software programs and any future advancements. When you start, you will be furnished the MedOffice® system among other things, none of the competitors have anything like it! This program was designed and developed from scratch. You may hear of other programs that the seller say can do a few similar things. But it is like GM when they tried to catch up to their competition by using a gasoline engine block to build a diesel engine. It was a disaster for their company and a greater disaster for the buyers. What ever you build or develop, to be a good product, has to be done from the ground up . . . no shortcuts. MedOffice® is the only program available in this niche market, and it was built from the ground up! No other company has a superior software program like this . . . only our clients and associates! When you have the very best of tools, you will find building your business is exciting and profitable. Additionally, You will enjoy a wining edge over your competitors in finding new clients.

A.They generally fall into two groups; some say they cover everything needed by having you read their materials while others hold a group training seminar at their office or in a hotel meeting room. Both methods cost the program seller far less money, effort or time. What is far more important to us is what happens to you. To become successful in any endeavor it is easier and faster to learn if you have one-on-one private instructions. Think of group golf or dance lessons and you know what I mean. Further, I would compare this to flight training; you must have individual training with your hands on the airplane controls to fly. That is why we designed a training program with you at your computer keyboard, watching what takes place on your monitor. The trainer is on the telephone with you and through the online access program the trainer can see your computer screen. Both parties view every step-by-step instruction procedure. Mistakes can be explained and corrected immediately. This training method is far more costly for ClaimTek in terms of money and time than 2-3 day seminar. We want you to be a success. You will truly be a real professional. Your trainers are experienced professionals with billing, business and marketing experience, which means you are actually with an expert mentor. We could go on-and-on with this answer, but lets say there are more positives for ClaimTek training and more negatives if someone hands you some materials or gives a group seminar at some fly in costly hotel meeting. Please read our training section to see how we help you gain the most knowledge through a 3-step hands-on training process.

A.There is a common myth of a pushy, arm waving, aggressive person required to sell . . . This is not selling! When you Explain your ClaimTek System package, with all the benefits, to doctors you'll get their attention . . . Sales and marketing experience is usually acquired through a learning program and proven tools. We will provide you with sizzling marketing tools and complete training! ClaimTek's MedOffice® software will sell the doctors on its own when they see all the benefits they will receive. But then, you will explain all the other benefits they will receive to run a very efficient and much more profitable practice. Read the section on marketing and you will see all the tools that will make your presentation easy and professional. Doctors are always looking for ways to be more profitable and have office efficiency. They would see the profit advantages of your comprehensive services.

A.It is vital for doctors to inspect and update their CPT codes annually. We encourage our licensees to offer this service for FREE to doctors as part of their marketing strategy. We have found among our ClaimTek licensees that doctors appreciate this offer and most accept it.

A.Our software is programmed to work with the best dictation software out there, which is Dragon's Naturally Speaking Medical Edition. This is an optional module. Dragon's software has received the highest rating for dictation transcription accuracy and speed. The New York Times Technology section reviewed the software in early December 2004 and gave it astonishing kudos. A doctor can speak at a fairly normal rate and the software transcribes it with very high accuracy. It can replace manual transcription, but it still requires doctors to take some time to review the transcription and correct errors. This is, however, no different than the time it takes a doctor to review transcriptions provided by outside transcription services, since they too require doctors to review the transcriptions for accuracy. Speaking of transcription, you actually could consider this to be an opportunity for you to provide an outside transcription service. Here's how. When doctors dictate and they are in a hurry, they can dictate into a sound file. You can then download the sound file and do the transcription yourself -- or hire outside transcribers to perform this transcription while you remain solely the business generator, keeping a percentage of the fees.

A.Usually, we have a software version upgrade every 12 to 18 months. The cost is usually starts at $499 for upgrades. Like any software, it is not always mandatory that you get every single upgrade; you can continue to work with a version over several upgrades if you prefer. We leave the upgrade choice to you to decide.

A.This argument is in itself obsolete and absurd. We've heard this argument since the mid-1990s and it's always been proven wrong. Medical billing is a detailed and involved process; it simply cannot be treated as if claims were simple banking transactions. There are so many laws, regulations, and constant changes that it is impossible to automate the claims billing process. In fact, the most successful billing services are those that provide personal attention to the needs of their doctor clients - precisely because their needs can be specific. The truth is, the healthcare industry is chaotic; there are few simple standards when it comes to health insurance and claims reimbursement. Those who bring expertise and solutions to providers are the ones who succeed. We help our ClaimTek licensees to provide the most comprehensive, highest quality services to healthcare providers. We have been in business for 11 years now, and we know this profession inside and out.

A.Medical billers have no significant additional liabilities than any other service business. In general, you won't have clients coming to your home or office, but like any business, if you do, you may want additional liability insurance. However, if you end up performing coding for your doctor clients (which requires you to become a certified coder), you will need to have Errors & Omissions (called E&O) insurance.

A.When you buy the Preferred program you become a ClaimTek authorized “Preferred Reseller”. With the purchase of the Principal program you become ClaimTek authorized “Standard Reseller”. Preferred resellers receive 40% discount on future purchases of the MedOffice® software. Standard resellers receive 20% discount. Here’s how this great feature benefits you:

Let’s say you go out on 10 appointments pitching your billing services to healthcare providers. Chances are a couple of your prospective doctor clients could be contemplating keeping the billing operation in-house because they may feel they have reliable staff for the time being. In such cases, they would need to buy software along with training and support. We feel that it is important for you to be able to satisfy their needs at any level so that you could build a relationship with them. You can offer to sell them the MedOffice® software along with training and support. There is good money to be made in this area. Let’s explain first why this is a viable service to offer...

The main problem with the billing operation in doctor offices has to do with the ability of their staff to perform the billing functions professionally and with consistency. The average turnover in doctor offices is about 3-6 months and new employees always require training and support. If doctors feel that they have reliable and stable billing person for the moment, they may feel they could handle their billing in-house. If this is their choice, why not help them get what they want? Try to build a relationship with your prospect in any way you can. By selling them software, training and support, you guarantee a professional relationship going forward and you make good money too! Software sales to healthcare office typically entail training and support. You can charge somewhere between $55-$125 per hour for training (depending on your geographical location and area demographic) and about $1,000 for annual support or you may charge for support on a per call basis. There are many people nationwide making great revenue as software resellers. What is important here is that you retain professional relationship with your doctor clients. Their needs may change in the future when their reliable billing person is no longer there. At some point they may realize that outsourcing their billing may make better sense especially that they have a working relationship already established with you.

With most software companies out there you pay a premium of several thousand dollars to become a dealer. With ClaimTek, you are ready to benefit from this fantastic benefit as soon as you get started. ClaimTek assists you in turning your startup medical billing business into a viable medical billing corporation with comprehensive services!

A.There is no industry standard for medical billing at all, so among all various agencies that are offering certification, no single one means more than another one. The certification is as good as the company that is offering it. We believe that our ClaimTek certification is top-notch. Our certification reflects the fact that we have been in business for 11 years and are the developers of the MedOffice® software system, the most advanced medical practice management software available. In other words, you are working with one of the longest standing companies involved in medical billing with a solid reputation for professionalism.

A.We charge $2.50 per claim to take over your billing on a temporary basis in the event an emergency prevents you from doing business. Our support is based on helping you maintain your clients, while you recover from an accident or illness. The support is limited in duration and is not intended for us to make a profit, but to help you stay in business. We are interested in a long-term relationship with our ClaimTek licensees.