We can talk all day about training, support and marketing — and we usually do — but here’s the bottom line when it comes to medical billing:

You need the best software.

No ifs, ands or buts. The other things are valuable resources, but if you don’t have the top software then you have about as much chance of success as a one-legged man in a butt kicking contest.

Now everyone swears they’re the best, but we can prove it. And we do prove it beforehand.

ClaimTek Systems offers MedOffice, which essentially handles every possibility you can offer. But instead of talking about it, here’s the link to how you can try it out. After you see for yourself, we’ll talk about it.

Free trial offer of MedOffice

Sometimes you gain insight by being the patient.

I had two root canals yesterday. Yeah, I know, ouch. They were in teeth close together so it made sense to just go ahead and do them at once. While waiting for the numbing to kick in, the office manager came in and collected my share — $560. Frankly, I thought it would be more but my wife is a federal government worker and our health insurance is probably as good as it gets for everyday people.

But the real shocker was getting a copy of the bill that showed the insurance company was billed $2,741. Combined with my $560, that’s $3,301. Not sure where the $1 came from.

Wow, $3,301 for an hour’s work. Quite the gig there. And, I noticed the schedule was filled for the day so that’s maybe $20K coming in for a day’s work.

Again, no lesson here, just an observation — somebody’s getting rich. Then again, you’ll pay anything to make the pain go away so it is what it is.

A teacher many years ago told me people learn three different ways: audio, visual or doing it. Some people learn mechanical skills by grabbing a wrench. Some read the manual first. Some people need to be told how to do it.

There’s no right or wrong way to learn — it’s just how you do it. That’s why ClaimTek has both audio CDs and video DVDs to supplement its instructor training and manuals. They’re also handy for refresher tips.

Click the link before and see which one works best for you.

Audio tapes and DVD lesson plans

It’s always about the training.

For many, the thought of returning to a classroom after decades away from high school seems a little scary. You wonder if can you learn all this technology.

OK, calm down. It’s not so bad. We don’t have nuns hitting you with rulers for incorrect answers. In fact, ClaimTek doesn’t have mass classes. We don’t make you fly anywhere for training. You don’t need to spend days away from home while spending hundreds or thousands of dollars to attend.

No, ClaimTek’s training is all about making it easiest for you. That’s why we have one-on-one tutors . . . via the phone . . . while you sit at home . . . at the schedule of your choosing.

Doesn’t get any easier than that. We even have recess.

Ready to talk? Call our staff at 1-800-224-7450 to learn about training for your success or click the link below.

Train with ClaimTek

It was one year since HIPPA rules were introduced on Feb. 17 as part of  President Obama’s stimulus package. It was a long list from soup to nuts.

Just wondering — did you get everything changed in the past year as it went into effect last week? Here’s a comprehensive review to ensure you’re compliant.

Hitech Act

Medical Economics.com has a great story on how billing practices are changing with doctors. It used to be the last thing doctors brought up with patients, and now it’s the first said one health care provider.

Obviously, doctors are worrying the recession is cutting back on patients and thus cutting back on cash flow. They’re starting more direct billing, using credit cards and trying to figure out how to stay profitable.

So our question to you is are you doing enough to meet your clients’ needs? Are you winning the race against technology? What more could you do in the final days of 2009 to make 2010 more successful? ClaimTek Systems has the answers. Give us a call to see how we can enhance your billing options at 1-800-224-7450.

Physicians Practice.com has a great chart on what people are charging.

What’s that to you? Many medical claims billers work on a percentage basis so if your health care professionals are underbilling, so are you. Help them out. Help yourself out. Check out the chart.

90210.

If you’re older than 30, that number makes you think of the evening soap opera from the ’90s that returned last year in its second generation.

Ironically, it’s almost the billing code for the H1N1 swine flu shot. Go figure. Somebody has a sense of humor. If only Tori Spelling would give me the injection.

The new billing code is 90470. We checked –it’s also  a zip code for Finland. Hmm, Finish actresses on a soap opera. Maybe we can pitch Hollywood that idea

• 90470—H1N1 immunization administration (intramuscular, intranasal), including counseling when performed
• 90663—Influenza virus vaccine, pandemic formulation, H1N1

Physicians Practice has a long Q&A about the biggest problems facing health care providers. I laughed as I read it. All their problems largely center around medical claims and a good processor would solve so many of their ills.

Read the article because chances are you’ll have the same conversation with prospective clients. This will better prepare you for that talk and make you sound even more convincing.

The American Medical Association’s 2009 National Health Insurer Report Card tells us the following:

* Insurers did a better job in accurately reporting the contracted rate to health care providers. It was correct 72 percent to 93 percent of the time in 2009 versus 62 percent to 87 percent in 2008.

* Insurers still have problems with wrong denials. The report showed the widespread reasons makes standardization even more vital.

* Transparency (don’t you love that word?) has improved. Insurers are doing a better job disclosing vital policies and information to physicians through web sites.

* The money is coming quicker. New prompt payment laws are forcing insurers to move quicker. Five of eight insurers reduced their median response time.

Inefficiency in the claims process is costing Americans $200 billion annually, according to the American Medical Association’s National Health Insurer Report Card.

The report used a random sampling of 1.6 million electronic claims in February and March 2009 to Aetna, Anthem Blue Cross Blue Shield, Cigna, Coventry Health Care, Health Net, Humana, Medicare and the UnitedHealth Group.

“Each insurer uses different rules for processing and paying medical claims that results in confusion and inconsistency,”  AMA board member William A. Dolan, MD. said. “Simplifying the administrative process through standardized processing and payment requirements is needed as part of comprehensive health reform legislation this year. It will reduce unnecessary costs in the health system and eliminate the variability that requires physicians to maintain a costly claims management system for each health insurer.”

Duh, we could have told him that and saved the money spent on the report.

The American Medical Association releases its second annual National Health Insurer Report Card that rates claim denials, timeliness, accuracy and transparency. The top eight showed improvement, but still need improving.

Aetna offered the lowest claim denial rate of 1.8 percent while Anthem Blue Cross Blue Shield was the highest at 4.3 percent.

Here’s the link for the entire report — National Health Insurer Report Card

The Healthcare Billing & Management Association (HBMA), a non-profit educational resource and advocacy group representing third-party medical billers and billing professionals, revealed findings of its June convention.

* 46 percent reported less than 60 percent of insurance companies transmit denial information using HIPAA-standard codes
* 68 percent of member said 60 percent or more of all denials are ultimately paid by the insurance company after appeal or intervention
* 69 percent reported cumbersome protocol for filing appeals is the most challenging aspect of handling claim denials

“HBMA is committed to its ongoing outreach efforts and is focused on securing cost reductions that will ultimately benefit all stakeholders, including payers, providers and patients,” said Brad Lund, HBMA executive director. “As part of HBMA’s efforts, we will also be reaching out to individual health insurance companies to identify practical administrative simplification solutions.”

With so many workers getting layed off and seeking new careers, medical billing has never looked better.

According to the Ocala (Fla.) Business Journal, health care is the nation’s fastest growing industry. It’s now 16.7 percent of the gross national product. Florida alone has 56,000 health care providers billing more than $100 billion annually.

With 78 million baby boomers now in or closing in on their AARP cards, medical billing will continue to grow. Indeed, the American Medical Billing Association has grown by 33 percent in the last three years to 1,200 members.

The story’s worth reading, and using in your next sales presentation.

Ocala Business Journal

It used to be you were competing with someone in your town for the doctor’s business. Maybe someone a state away, but it was usually a regional competition.

Well, outsourcing medical billing is now among the many jobs being sent to India. Here’s a story on how one firm expects to hire 200 people to process U.S. claims.

India in the news

How important is health care to the U.S. economy? The Rand Corp., a non-partisan think tank, has some startling stats showing medical billers will be even busier in coming years.

Health care spending is growing faster than the overall economy. Americans spent $2.1 trillion in 2006 and $2.25 trillion in 2007 with an expected annual growth rate of 6.7 percent. By 2017, nearly one-fifth of all spending will be on health care.

Sounds like a growth industry for medical billers.

The federal government paid for one-third of healthcare spending, largely through Medicaid and Medicare. Private companies paid 34 percent while individuals paid 14 percent. The remaining 20 percent was paid by state and local funds.

More than half of Americans have health insurance supplied by employers, but one in six have none. The average American spends six percent of their after-tax income on health care.

The U.S. spends more than other countries using single-payer systems. The U.S. spends 7 percent compared to 1.9 percent by France.

Private insurance companies spend 14 percent on administrative costs compared to 3 to 5 percent for public insurance programs.

Think we’re frustrated over the bureaucracy of medical billing? Think about the civilians who enter into our world not knowing a code from a cow. It can be maddening.

A Boston Globe reporter recently wrote her first-person deal with the seven circles of hell (I mean medical billing). You’ll get a chuckle at times because the story strikes a nerve. Maybe it will make people better appreciate what we do for a living, too.

My mom, Dianne, is 76 and lives in an assisted living facility in Newton. Over the years, she’s had a variety of conditions needing occasional treatment, and the trips to her doctor were getting to be a nightmare. We’d battle our way through traffic into the Longwood Medical Area and park in a dark, crowded lot. It was tough for my mother, who uses a walker, to get to the elevator. And the doctor had all the bedside manner of a Filet-o-Fish. When medical issues arose, such as a painful rash or bruises from a fall, Mom would be sent off to specialists. But none of these doctors seemed to be in synch. They didn’t even talk to one another.

Read the rest here The Sick Truth