How much money can I make?
A: According to the industry standards, starting salary is about $35,000 per year, higher in some areas of the country. A typical coding firm charges $17 per outpatient report to code, and the average per report time involvement is two to ten minutes.
How far you go with this expertise?
A: Once you become proficient in coding many opportunities exist. Coders often
undertake auditing functions. Independent fraud analysts are also in demand and often are paid a percentage of what they save insurance companies. One of the most common uses for fraud analysis is in state-sponsored Worker’s Compensation Funds, where fraud is rampant, accounting for a burgeoning percentage of America’s health care costs. Many consultants and fraud analysts set up their own businesses and work at home. Consulting is a great field for nurses looking for a change in career.
undertake auditing functions. Independent fraud analysts are also in demand and often are paid a percentage of what they save insurance companies. One of the most common uses for fraud analysis is in state-sponsored Worker’s Compensation Funds, where fraud is rampant, accounting for a burgeoning percentage of America’s health care costs. Many consultants and fraud analysts set up their own businesses and work at home. Consulting is a great field for nurses looking for a change in career.
Gate keeping is another interesting job potential requiring terminology and coding. The gatekeeper is contacted when a policy holder needs a medical service for which the gatekeeper’s intervention is required to determine the lowest possible costs without jeopardizing care, such as a surgery procedure, or a series of visits to a physical therapist. The gatekeeper refers to the policy’s coverage and limits, refers to the appropriate code or codes, and determines what the payer (e.g., insurance company or employer) will pay for it, or determines whether the service is excluded. Depending on the health care plan, the gatekeeper then tells the patient which provider in the network
is prepared to accept what the payer offers along with deductibles or copayments. If the patient decides to go outside this recommended network of care providers, then he or she will be responsible to cover any differential of the predetermined amount the payer is willing to pay. Gatekeepers commonly earn $60,000 to $100,000 a year. Many nurses fill these jobs.
is prepared to accept what the payer offers along with deductibles or copayments. If the patient decides to go outside this recommended network of care providers, then he or she will be responsible to cover any differential of the predetermined amount the payer is willing to pay. Gatekeepers commonly earn $60,000 to $100,000 a year. Many nurses fill these jobs.
Many employers are self-insured, which means that they establish a reserve account (like insurance companies) to pay for the medical care of their employees. “Third-Party Administrators” (TPAs) contract to manage the process. Gatekeepers perform the services to get the best economic deal possible for patients and payers.
How do I get paid in medical billing?
A: That depends on your objective. If you decide to go to work for the business office of a care provision facility, you’ll likely be salaried (and this isn’t a bad way at all to get more experience). Entry level pay is generally $20K to 30K per year, with incentives, fringe benefits, bonuses, etc. If you decide to set up a billing operation, you typically charge a percentage of the collected revenue. If you decide to get into electronic claims submission, you charge by the claim. Remember that you must also pay the clearinghouse a fee to process that same claim.
