Medical Billing “Opportunities:” Worth a Second Opinion
If you’re looking for a home-based business that can help you pull in $20,000 to $45,000 a year using your computer, a work-at-home opportunity doing medical billing may sound like the perfect choice. But before you part with your money, consider this: The Federal Trade Commission (FTC) has brought charges against promoters of medical billing opportunities for misrepresenting the earnings potential of their businesses and for failing to provide key pre-investment information required by law.
Medical Billing Scams.
Ads for medical billing business opportunities appear on the Internet and in the classified sections of local newspapers and “giveaway” shopper’s guides. In the “Help-Wanted” classified sections, the ads may appear next to legitimate ads for hospital medical claims processors, leading consumers who respond to think they’re applying for a job, not buying a business opportunity.
The ads lure consumers with promises of substantial income working from home full- or part-time – “no experience required.” They direct consumers to call a toll-free number for more information.
If you call, a sales representative will entice you to sign up by telling you that the processing of medical claims is a lucrative business, that doctors are eager for help with electronic claims processing, and that you – even without any experience – can do this work from the comfort of your home.
Medical Claims versus Medical Billing.
First, let’s clarify the difference. Medical Billing is a system with people who review every patient encounter, figure out what the services rendered were, then post the charges on a computer software system. The insurance processing (and statements) are then cycled with either a hard copy printed or an electronic version of the claim form sent to a clearing house. The clearing house then “pre-audits” the claim to make sure there is no missing information which could pend the claim (keep the payer from paying it). Once the audit is complete, it is then sent on to the payer.
What the companies who sell these “medical billing opportunities” are doing is trying to get people to enter the arena of only the claim processing, not the billing service. Since most providers have software which already provides the electronic processing, those who sell only that element of the medical billing process fall far short of a realistic home business opportunity.
Medical billing scammers charge a fee of $300 to $500 or more. In exchange, they claim to provide everything you supposedly need to launch your medical billing business: the software program to process the claims and a list of potential clients. These “clients” are simply lists of existing physicians in a given state.
But the reality is that few consumers who pay for medical billing opportunities for processing claims find clients or make any money.
Promoters of fraudulent medical billing opportunities are not interested in helping consumers, either. They only want their money. Many times, the client lists they provide are based on out-of-date databases of doctors who haven’t asked for medical billing services. The software they send may not work or may not have been properly authorized and so is useless. And the money-back “guarantees” often prove worthless. Even after making repeated calls to the promoter or complaining to their credit card companies, government agencies or consumer groups, only a few people actually get refunds.
How to Protect Yourself & Where to Complain:
To avoid losing your money to a bogus medical billing business opportunity, the FTC advises you to:
How to Protect Yourself
* Ask the promoter to give you the names of many previous purchasers so that you can pick and choose who to call for references. Make sure you get many names from which to choose. If the promoter provides only one or two names, be careful: The contacts may be “shills” – people hired to give favorable testimonials. Interview the references, preferably where the business operates, to get a better sense of how the business works. Ask for the names of their clients and a description of their operation.
* Consult with organizations for medical claims processors or medical billing businesses and with doctors in your community. Ask them about the medical billing field: How much of a need is there for this type of work? How much work does medical billing entail? What kind of training is required? Do they know anything about the promotion or promoter you’re interested in?
* Check with the state Attorney General’s office, consumer protection agency and the Better Business Bureau in your area and the area where the promoter is based to learn whether there are any unresolved complaints about the business opportunity or the promoter. While complaints may alert you to problems, the absence of complaints does not necessarily mean the company is legitimate. Unscrupulous companies may settle complaints, change their names or move to hide a history of complaints.
* If the medical billing opportunity sells another company’s software, check with the software company to find out whether company representatives know of any problems with the medical billing promoter.
* Consult an attorney, accountant or other business advisor before you sign any agreement or make any payments up front. An attorney can review the promoter’s contract and advise you on how best to proceed.
Where to Complain
If you think you’ve been defrauded in a medical billing business opportunity scheme, contact the company and ask for your money back. Let the company representatives know that you plan to notify law enforcement and other officials about your experience. Keep a record of your conversations and correspondence. If you send documents to the company, send copies, not originals. Send correspondence by certified mail – and request a return receipt – to document what the company received.
Medical Billing Training for Real
Here at Meditec, we train you to become a medical biller (not a claims processor only, though you will learn how all of that works). The training will provide you a good background to apply for a job in any medical provider setting. Adding insurance specialist training (included in the billing course) or opting to add coding and medical office specialist training to your learning process will dramatically increase your skill level for marketability. With experience, you may certainly look to management positions in medical arenas, go for consulting services to providers, or even set up a home-based business.