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Nurse Practitioner (NP) and Physician Assistant (PA) Programs for Military Vets

On August 8th 2011, Bob Blumm of the American College of Clinicians (ACC) sent out a public statement regarding medical personnel returning home from combat duty wishing to further their education to join the allied health professional work force. Many of these war veterans are facing a rough economy and tough job market when they return and are seeking employment as civillians.

"Very few realize that many of the allied health professionals they encounter in medical offices and healthcare institutions, from medical assistants to phlebotomy technicians and physician assistants to nurse practioners, have learned their skill while serving in the Armed Forces and have a strong military background."

It served as a reminder that the ACC did in fact publish a white paper to honor and make a special pathway for those who served in the miltary and upon returning to the USA desire to further their education and become either nurse practitioners (NP) or physician assistants (PA).  ACC feels strongly that those who have given a part of their lives to serving in a time of war deserve special consideration when applying to programs of advanced practice clinicians. The college asks all PA and NP programs to look favorably on these veterans if they apply to their training programs.

"ACC serves nurse practitioners (NP) and physician assistants (PA) as an advocate for the professions scope of practice. The following is a joint effort of the executive committee 2-3 years ago demonstrating what we feel would best serve both professions as a thank you for a job well done.”

In another white paper published just one day later, Lisa P. Shock, MHS, PA-C President/CEO of Utilization Solutions in Healthcare, Inc. emphazises the value physician assistants (PAs) add to the medical office as a business. In the paper she explains: 

"As healthcare reform is implemented, the expansion of healthcare industries will require an emphasis on cost containment. Here are five ways a PA can make your business more profitable."

Physicians and healthcare institutions are expected to employ more PAs to provide primary care and to assist with medical and surgical procedures because PAs are cost-effective and productive members of the healthcare team.

According to the Bureau of Labor Statistics, employment of physician assistants is expected to grow 27 percent from 2006 to 2016. According to the American Academy of Physician Assistants, median income for physician assistants in full-time clinical practice was $80,356 in 2006; median income for first-year graduates was $69,517. Income varies by specialty, practice setting, geographical location, and years of experience.




Kim's Advice: "Get Your Medical Biller On!"

Medical_billing Kim V., Certified Medical Biller

Medical Billing—Find Your Calling!

This is a good time to become a medicalbiller, a career in which you can be trained quickly and where you can grow professionally and as a person. This site is designed to help you find information you need to become a medical biller, find local schools for medical billing training and quickly locate job opportunities in your state for medical billing and coding employment.

What Medical Billers Do:

Medical billing is versatile and rewarding. To understand medical billing you must know what medical billers are and aren't,for example medical billers are not medical coders (although they understand certain aspects of coding).

Medical Billers have one goal: billing for medical and healthcare services, medications, equipment, supplies and consultations. It is a systematic procedure of billing and collecting professional fees for medical and healthcare services provided to patients. That means we send a claim to an insurance company, we post payments, we respond to outside information requests that relate to the claim, we follow up on a claim with no response, we communicate with the patient or their insurance company about a claim that is denied, in review or pended. We send statements to the patient and we turn over delinquent accounts to the providers debt collection agency. Doing it right requires a broad range of knowledge and understanding of the medical billing process and health insurance company rules.

Exclusion Due to Disability in the Medical Office

Most positions in the allied health and healthcare industry are conditioned on the applicant passing a medical examination (the so called pre-employment physical). If a job requirement excludes a healthcare worker, including a medical assistant working under the direct supervision of a doctor, from a position due to a disability, the requirement must be job-related and consistent with business necessity. Some requirements will obviously meet this standard, such as licenses required by state and/or local governments for doctors and other healthcare professionals. In other instances, however, an employer may need to consider whether the standard that is excluding an individual with a disability from employment accurately predicts the individual’s ability to perform the job’s essential functions. For example, a medical assistant in a wheel chair could work in the front desk recepition area.

female worker with disability does dataentry work

Many states and localities have disability and anti-discrimination laws and agencies responsible for enforcing those laws. A leading national health care staffing firm in Pittsburgh, PA violated federal law by withdrawing an offer of employment to a certified nursing assistant because she was HIV-positive. The U.S. Equal Employment Opportunity Commission (EEOC) charged the firm with discrimination in a lawsuit.

In EEOC v. LA Weight Loss (D. Md. Dec. 1, 2008) , EEOC alleged that a chain of weight loss counseling centers with facilities in 21 states had a companywide policy of refusing to hire men into the positions of medical assistant, trainer, sales counselor and various management positions.

Both applicant flow and census data showed that men were not hired consistent with their availability and employees were told by managers that defendant was not interested in hiring men because management believed that female clients responded better to female counselors.


Healthcare job applicants, or hired employees, who believe that their employment rights have been violated on the basis of disability by a private sector, state government, or local government can file a Charge of Discrimination proceeding with the U.S. Equal Employment Opportunity Commission (EEOC). The charge must be filed by mail or in person with a local EEOC office within 180 days from the date of the alleged violation.


EEOC refers to these agencies as “Fair Employment Practices Agencies" (FEPAs). Individuals may file a charge with either the EEOC or a FEPA. If an Americans with Disability (ADA) charge filed with the EEOC is also covered by a state or local disability discrimination law, the EEOC will “dual file” the charge with the FEPA but usually will retain the charge for investigation.


Questions and Answers about Health Care Workers and the Americans with Disabilities Act


Medical Billing from Home

The following question was posted today in our active Medical Billing Community forum where this question is not new to us. We get questions revolving around how to start a medical billing business from home quite often from new individuals in this field. I say new, because seasoned medical billers and their medical coding counterparts already figured out that doing medical billing from home requires certain distinct steps; however, here is where this new medical billing and coding graduate who asked is right on the mark--she, too realizes that this goal takes time. She states she hopes to achieve it within the next five years.

Re: Medical billing/coding from home
I've just received my billing/coding certificate and I have a while before I even want to try to take on a home business. But I've looked everywhere and can't find any information on how to do this work from home. Can anyone give me steps to how to begin this process? Do I go to the provider and ask to be hired but say I want to work from home? Or ... I'm just so confused with all this. ANY help would be nice. I want to start preparing myself for the years to come, because doing this from home is one of my short term (within 5 years) goals.

Danni R. responds:
« Reply #1 on: Today at 08:14:51 PM »

We have discussed this topic a few times, here at the forum. For most who eventually started their own medical billing business from a home office it was not something that happened overnight. They have been in the field as an employee with trusted employer relationships for years, and have made contacts with doctors and clinics who have earned their trust. This would be the point where one could say: "Doctor So-and-so, I am looking for opportunities to do this job from my home office. Would you allow me to take some of your billing home."

So, in a nutshell, your education counts, experience counts, employee relationships count, and trust and references count. Then, when you have all this under your belt make sure your resume is updated and shines, also make sure you have researched and know local and state laws as to what is required via city ordincane and zoning, and such, to run a home business. Find out how to incorporate your business. Although you could "freelance" it, an LLC provides you with a certain amount of protection.

May be our Steve can add a couple more tips. In the meantime, try our forum's search function for older discussions around this topic. Good luck.
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What Happens When a Patient Can't Pay Medical Bills

Protecting Assets from Unexpected Risks

A new article by San Diego attorney Robert J. Mintz of the Asset Protection Law Center, examines the legal and practical consequences to the patient of unexpected medical bills, far beyond what the individual is able to pay. What happens if the patient has some retirement savings or some funds tucked away for a child’s education? Will medical bills from an injury or illness wipe out everything that has been saved over the years?

An issue of increasing importance in the legal field addresses the question of how to protect accumulated savings from medical expense related liability risks, according to an article by attorney Robert J. Mintz in the August edition of the The Asset Protection Newsletter. The problem, according to Mintz, is that a brief stay in the hospital may cost tens of thousands of dollars and a serious injury or illness lasting weeks or months can exceed almost anybody's ability to pay. Is there any advance planning available to protect individuals and families from unexpected medical bills?

The potential for financial disaster is well known and obvious to those who are uninsured. But even for those who are lucky enough to be insured under private or employer plans, the financial risk remains significant. Uncovered medical expenses due to lifetime policy caps, large co-payments, coverage exclusions and outright denial of claims can result in unexpected medical bills that would financially stagger even the wealthiest individuals.

"What happens if a patient has uncovered medical bills from an accident or illness?"

"Is the family home and savings in jeopardy from these bills?”

"Is there any way to legally protect accumulated savings from uncovered and unexpected medical bills?"

In the Auguest 2011 issue of the Asset Protection Newsletter, Mr. Mintz answers these questions and addresses the legal issues of asset protection against medical expense risks. A complete copy of the article can be read at What Happens If You Can’t Pay Your Medical Bills?

Author: Robert Mintz
Phone:(760) 758-4748
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Medical Billing and Practice Management Tips: How to Handle Overpayment and Refund Demands

What constitutes an overpayment? An overpayment is when your medical office receives money, or payments from an insurance company, patient, or both, that exceeds the amount of charges that are produced for a visit or medical services. For example, the patient had an ear-lavage with removal of impacted cerumen, the charge is $100. The doctor is reimbursed a total amount of $150 from the health insurance company. The $50 is the amount that was overpaid.

There can be many reasons for an overpayment. The patient may have multiple insurance plans. Plan A pays $50, Plan B pays 30 and the patient pays $70.

The doctor cannot keep the overpayment. An investigator or auditor could consider the action of keeping overpayments as possible fraud because his medical billing misrepresented the charges. If the insurance company says that the patient had other insurance, you might have the right to demand that they provide proof of this (laws may vary from state to state).

Some insurance companies use professional debt collection agencies to perform refund demands. Some of these companies can be very aggressive with trying to collect the money.  With some debt collection agencies, the agent calling makes their money based on what they individually collect, so some debt collectors can be abrasive and downright abusive. It is always best to not get involved into any detailed discussions over the phone.

Instead ask for details of their claim/demand in writing and also respond in writing sent by Certified Mail/Return Receipt, which prevents the "we never got your letter" excuse.  In addition, if the office needs to file a complaint or lawsuit, there is proof that a response was sent and it was received.  This is important, because it shifts the preponderance to your side to make the case. Now, the insurance company or debt collection agency can no longer state the office never responded.

Steven M. Verno, a highly experienced Certified Master Medical Coder and Certified Master Medical Biller and Medical Coding/Billing Instructor in Florida, who also serves our Medical Billing Community Forum as a volunteer forum moderator has elaborated in great detail on medical billing and coding issues, challenges and common misconceptions and given examples and tips to remedy some of the unforeseen issues that can arise in medical billing and practice management.

Anyone in the medical billing discipline can join the forum and read Steve's comments and training primers for free, including training primers on overpayments, refunds, deductibles, uninsured and self pay, however, a username and password registration is required to access the "deeper" parts of the forum. If you have questions, please post them into the Medical Billing Community Forum. We will see you there.

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Managing the Medical Office in Tough Economic Times

7 Tips on How to Manage the Medical Office in Tough Economic Times

 Gen Wright

One of the most commonly mentioned advice for coping with tough economic times, is to cut costs. There are many different ways you can cut costs for your businesses. So where do you start? Office management seems to be a good place to start. You can make some changes easily and quickly because you have full control over how you want to run your office.

For example, if you are running a medical practice, now may be a good time to start looking at medical office software to help manage the office more efficiently and more effectively. Consider the functions that a great piece of medical practice software can perform for you:

1 - Check patient eligibility with insurance company to make sure the patient is covered for insurance.

This is a repetitive task that may be taking up too much of your employee\'s time. Have the software do this for you.

2 - Check patient balance when they are calling for an appointment and remind them of any outstanding balance and ask them to bring a check or credit card with them to appointment to pay.

This is an important aspect of the business. The software will help generate healthier revenues from the more efficient payment collection processes.

3 - Collect patient deductible and co insurance at time of service. Offer different payment options.

With the software, you can offer different payment options. Deductible is the amount payable by the patient and cannot be claimed from the insurance company. The software helps to track that to ensure prompt collection.

3 - Followup on all insurance denials or rejections, don\'t let the insurance companies cheat you out of revenue.

Many practices simply give up on insurance claims because they find it too tedious to track the claims. The practice thus ends up losing money. With the software in place, a practice doesn\'t have to lose money due to rejections or denials anymore. Simply follow up with the claims, correct the problems, and rake in the cash.

4 - Schedule efficiently to fill up your schedule efficiently.

Your practice depends on your patient appointments for revenue. So it\'s important to have powerful software that will manage all your appointments for you.

5 - Doctors, be sure to submit info to office staff for hospital and nursing home visits and rounds.

Doctors, being busy and heavily stressed professionals, sometimes forget to submit info for office staff. They can now submit the info through the software.

6 - Immediately bill any claim to patient if insurance company denies.

Sometimes, you may have legitimate denials from insurance companies. Have your software bill patients immediately if an insurance claim fails (e.g. insurance policy expired).

7 - Send patient statements at least monthly - hire a temp if your staff complains about not having time to print, and stuff and stamp the statements. Consider an electronic statement service. For about the cost of stationery, envelopes, and stamp, a service can serve this crucial function.

Monthly billing statements take up a lot of time and the work is not just repetitive but also builds up over time. With a medical practice management software program, you can hire a temp staff to perform such tasks and free up the time of your full time staff. In the long run, you will be saving more money due to better use of your staff\'s time, and declining staff turnover.

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