Buying Medical Billing Software


While we cannot make any recommendations on which medical billing and office management software to to use we can give you some examples of those we have used, and indicate which ones we liked. I liked Lytec, Web MD's Medical Manager, and ZirMed.

We don't know anything about the rest of medical billing software that's out there, but we know what to look for! (Much!) more tips on selecting Medical Billing Software that works:

* It has to produce AR reports on demand
* Individual insurance reports
* Individual account report
* Monthly payment report
* Monthly overpayment report
* Monthly adjustment report
* Monthly time payment report
* Debt collection report

It's important to ask about clearinghouses!
  • When selecting a clearinghouse, make sure you find out how many insurance companies they send claims to
  • Are you required to use their software, or one of your choice?
  • How much will it cost you per claim to send to the clearinghouse?
  • What reports will you get?
  • Will you get a confirmation of receipt of claims not only by the clearinghouse, but also by the carrier?
  • Will you get a claims adjudication report?
  • If the claims were sent to the clearinghouse and the insurance company says the claim is not on file (NOF), what will the clearinghouse do to rectify this?
  • Do they resend for free, or do you get a refund?
  • Make sure your contract has a no-penalty termination clause and you can terminate for any reason without penalties.



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Medical Billing Done From Home - HIPAA and CMS

Ever changing and new federal laws, such as HIPAA, and those regarding electronic claims submission make it a bit more difficult to take medical billing work home. However, many have overcome these unique challenges as they arise, and are following their dream working in a career they absolutely love.

What About HIPAA Rules?
As long as certain safeguards are in place, and there is a data backup plan, disaster recovery plan, and emergency mode operation plan, HIPAA has no objections to medical coding and billing staff working from home. Another important consideration in the medical coding and medical billing realm concern CMS (previously HCFA) and the Office of Inspector General (OIG) regarding healthcare provider's in-house compliance plan.

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Clients Who Default on Payment for Medical Billing Services


Clients that won't pay...


Here is a situation medical billing freelancers, business owners, and consultants will likely encounter sooner or later: defaulting clients.

How can you protect yourself and the business?

Here are a few tips:

1.) charge a retainer
- a retainer gives you part of the money up-front, and keeps the client involved

2.) mile-stone payments (at commencement - mid-way - completion)
- even if the client defaults at the very end, at least you have most of your money

3.) never hand files over until payment is received
- let the client know ahead of time what is required, what is expected, and when the final payment is due

4.) Offer many methods of payment (cash, check, money order, various credit cards, PayPal...)
- consider a payment plan for those who need it

5.) Offer a discount for early, or pre-payment
- a special coupon, 2-5% off, or free magazines (whatever you can offer)

6.) chase a payment the moment it is due
- make your clients understand that a 30-day invoice is exactly that

I hardly do 30-day invoices any more, except as a courtesy for super reliable, already established clients.

Why??? Because Bby the time 30 days have gone by and...

* you have given it a couple extra days to make sure
* you have contacted the client
* the client has checked their records
* a new check has been issued and
* and the mail man finally delivered it

...it could easily turn into 60 days late, and another invoice due. After learning my lessons, all my invoices are due upon receipt, or no more than 15 days.

What else? Huh
Tips about Starting a Medical Billing Business of your own.



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