This is Why Starting a Medical Billing and Coding Business Was The Best Decision For Me
Medically reviewed by:For over 20 years, Barbara Young has worked in the medical billing and coding profession. She’s become a standout in the field by opening her own business, Barbara Young Medical Billing Services. Her business is certified by the Better Business Bureau. Young, who is an expert of the minutia, acts as a necessary go-between amongst healthcare providers and patients. She and her business make sure procedures are paid for properly and the high level of expertise her slice of the medical field demands is met each and every day.
Young has a tough job as a Medical Biller and Coder. It’s tedious and, at times, convoluted. Yet, for Young, it’s a calling and is totally worth it. She loves her profession, finds joy in the meticulous nature of it, and can even handle the occasional yelled complaint over the telephone.
We caught up with Young to find out how she found herself in the medical billing and coding field, how she started her own business and what she thinks about moments before she starts her workday.
You just celebrated 20 years in the business. How did you first get started in medical billing and coding - where were you before that?
I became a certified medical biller when I was 19-years-old. Medical billing is and always has been my life and passion. Before that, I was accepted and enrolled in the Math and Science Institute in high school and selected for paid Biology internships starting my freshmen year. I graduated high school six months early and was awarded a scholarship to the College of Staten Island.
When and why did you know you wanted to work in healthcare and start your own medical billing and coding business?
I definitely knew I wanted to be in the medical field in high school - if not before that - with my love of science and, more specifically, biology. That’s where my love of medicine began.
I didn’t know I was going to start my own medical billing and coding business, it wasn’t something I had originally planned when I first became a medical biller. I’d worked at a local medical billing job for about 6 months, and my boss suddenly announced she was leaving to be a supervisor at another hospital medical billing office in Manhattan. I was so ambitious and committed to advancing my career, I asked her for her job.
She ended up offering me a position to go with her to work for her in the Manhattan billing office due to my hard work and ambition. I accepted and worked there for 2 years and absolutely loved it and have always missed the good times and people at that job. I decided to start my own medical billing and coding business because, at that point, I felt I already possessed the extensive experience that I needed to be successful.
I had people that believed I should do it before I even knew it would be possible. I worked my way up from data entry to eventually medical billing for the practice’s top orthopedic surgeon. I was extremely dedicated, always staying late at the office, going in on days they were closed, working during my commutes to and from Manhattan. I was even given a laptop to work at home on nights and weekends.
I loved everything about working there but eventually, the commute became too much. At the same time, several people I associated with were telling me I could bill on my own. With the encouragement of these people, whom I will always be forever grateful for, and what had to be fate, I put in my resignation and left my job with hopes to start my own business.
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What were some of the challenges you faced and overcame with your business?
My first challenge starting out was actually getting clients. With my perseverance, determination and experience I was able to obtain clients right away and was promptly featured in my local newspaper’s business section.
Another major challenge was the medical billing software. The software I originally started out with was very inexpensive and I quickly realized I needed the dependability of a more reliable software program. I contacted Advanced Data Systems because I had used them at both hospitals, and it was so expensive I had to lease it. It cost more than my car, but I knew I was in trusted hands.
In 2018 I only just first launched my website as we had simply relied on word of mouth. That was a huge challenge for me and is an ongoing project.
What is medical billing and coding?
Medical billing and coding are both related to receiving insurance payments for provider services rendered but are actually separate.
- Medical Coding is taking the doctor’s notes or operative report and having the knowledge to accurately interpret and assign the correct CPT (Current Procedural Terminology) procedure code and ICD-10 (International Classification of Diseases) diagnosis code to go on to medical billing. There are over 10,000 CPT codes and 70,000 ICD-10 codes.
- Medical Billing is the process of taking the codes to prepare and create an insurance claim in a timely manner, which is then submitted to the insurance company, and then tracking the claim until the provider receives reimbursement. Without medical billing, providers would suffer because they would not be reimbursed for the medical procedures they perform on their patients. A medical biller is an essential part of any medical practice.
What do medical billers and coders do?
We take the information from the provider’s visit and then bill the correct CPT (Procedure) and ICD-10 (diagnosis) codes electronically to the insurance companies for the healthcare provider. The dr is then paid electronically in as little as 7 days.
For example, in my business, we maintain a nearly 100% success rate on first attempt clearinghouse claims and follow up on all rejected and denied claims immediately.
If you want to learn more about a career in medical billing and coding, check out nurse.org’s awesome medical billing and coding career guide! It talks about requirements, job outlook and salary.
Why do providers hire independent medical billers and coders?
Outsourcing medical billing saves providers time and money. Medical billers go to school and learn how to code and bill and then become certified. Hiring a medical biller in the office, you would always have to train each person that comes and goes and a provider can lose a lot of money that way, in addition to paying someone by the hour with benefits.
- To save time - Time is one huge issue to think about. I guess it's up to a provider to decide if they are willing to spend the time and money on being their own medical biller. Will a provider have time to call an insurance that closes at 4pm because of a denied claim or because an insurance made a mistake and suddenly dropped them in error (yes this actually happens) or will the provider be busy attending to patients?
- To save money - The next huge issue on why to outsource is the money a provider will save. I currently pay for the billing software itself - billing software and hardware support fees, clearinghouse fees, tech support, secure internet access, online backup in additional to external hard drives to be HIPAA compliant, document destruction, etcetera. Then you also have to consider the hardware I go through constantly including computers, printers, fax machines, scanners, copy machines, and postage meters. On top of that is general office supplies including paper, cms 1500 forms, special statement paper and envelopes, regular envelopes, ink and toner cartridges, postage, pens, and just about everything in between.
Where do you work as a medical biller and coder - what type of setting and where is your office?
I work in an office located in Staten Island, New York. I have a ridiculously huge desk with the main server next to the phones and printers and copy machines and scanners and a fax machine that you would find in any other typical office. I have both my original “Barbara Young Medical Biller” desk engraved nameplate and hospital photo ID tag proudly displayed on my desk.
The only difference from any other office would be the huge bookshelf that contains all of our coding books. We have separate conference rooms in the building to meet with clients/potential clients to maintain client privacy and always remain HIPAA compliant.
Some medical billers and coders even work from home. This career comes with lots of flexibility and perks, learn more by reading the medical billing and coding career guide.
What skills do you and your staff need for this role - what makes a person a good fit for a job as a medical biller and coder?
As with any profession, medical billers and coders possess skills that they have learned through their education and on-the-job training. But, it’s also important to make sure that your personality and personal qualities align well with the role.
Most valuable skills include,
- Computer and typing
- Good figure aptitude
- Understanding of anatomy and physiology
- Understanding of medical terminology
- Knowledge of Microsoft Word and Excel, CPT coding, ICD-10 coding, medical billing system experience
Most important personality traits and personal qualities include,
- Good phone voice
- Excellent people skills
- Being extremely detail-oriented
- Be able to sit for long periods of time
- Being a self-starter
- Having a good memory
- A strong customer service background
- The ability to multitask and effectively handle multiple customers at once
If you feel that your personality will fit well with this career, you should read the full medical billing and coding career guide to learn more about requirements, career outlook and salary.
What training was necessary for you to become a medical biller and coder - and would you recommend this same training?
I took a Medical Billing, Coding, and Recordkeeping course in-person. I remember taking a test every single class and still have all my notes and tests saved.
Nowadays, they offer classes online, which I think is very convenient.
I would recommend both in-person courses and online courses and I think it depends on the individual person’s preference. You also then really learn a lot more from experience because taking a course is not the same as actually working.
How long does it take to start a career in medical billing and coding - what are the requirements?
The duration of study for medical billing and coding is dependent on many factors,
- Whether or not you are going to take classes in-person or online
- If you are looking for a certificate or a degree
- If you will be attending classes full or part-time and what level of expertise you wish to achieve at the end of the course
The American Academy of Professional Coders (AAPC) offers courses online for Medical Coding and Medical Billing, which are four months (80 hours) each. They also recommend taking Medical Terminology and Anatomy courses first, which are also four months each. AAPC is the world’s largest healthcare training and credentialing organization.
What advice would you offer someone looking to join your team, or just get started in the field - pros and cons of the business?
If they want to join our team, they should be hardworking, dedicated, trustworthy, a team player, enthusiastic, a fast learner and exhibit leadership.
- Pros of the business are that it’s very rewarding, especially when dealing with happy clients.
- Cons of the business can be getting yelled at by patients that don’t want to pay their bills!
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How convoluted can the medical system be - is it a maze, a jungle, outer space?
It’s constantly changing. There are new healthcare rules, laws and updates all the time. I remember days before HIPAA compliance existed and when paper claims were the norm and those were considered the big changes of the time.
The anticipation of ICD-10 was much worse than the actual change itself, and I have learned to just always be ready and to expect change.
I am a very active and dedicated member of the Manhattan Local Chapter Chapter of the American Academy of Professional Coders AAPC and by being so involved I am always learning the latest, most up-to-date information available. I have memberships with medical billing and coding groups that are only available to certified medical billers. These groups offer ongoing education, training, networking and I am always able to have access to information on the newest billing regulations.
What was it like to be certified by the Better Business Bureau and what does that mean for you?
Honestly is a very important quality for me personally and being certified by the Better Business Bureau was so exciting for me to be part of such an elite organization so that potential clients will know that they will be working with a company that stands by honesty, integrity, and trust. Trust is so important in this business because we are put in charge of our client’s income and the Better Business Bureau is a great way for potential clients to know that we are a trusted, ethical company.
Right before you walk through the door to work, what do you think to yourself?
I am thankful every day to be able to do what I do!
Get in touch with Barbara!
Website https://www.bymedicalbilling.com
Instagram @bymedicalbilling
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