How to File Claims for Doctors From Home

Instead of employing a full-time medical biller, many private physician offices choose to outsource their medical billing to private contractors. The outsourced, independently contracted billing specialists often provide these services from their own homes, after obtaining all necessary information from the physician's office by email, fax or pick-up. Anyone with knowledge of current medical coding and laws has a chance at a successful career filing medical insurance claims from their own home.

Things You'll Need

• Computer
• Internet access
• Fax machine
• Printer
• Medical billing software
• Medical billing clearinghouse subscription
• Paper 1500 HCFA forms
• Copier
• Current ICD-9 and CPT Coding Books or Software
• Patient information and charge forms from individual doctors' offices
• Individualized contracts

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Instructions

• 1

  Obtain a signed contract from the physician's office stating the rates and terms of the billing services. Arrange with the physician's office the means by which the patient charges will transfer to the billing service.

• 2

  Using the individual patient charges, enter each charge by use of the correct CPT and ICD-9 code into the medical billing software. Be sure to enter the correct information into the appropriate section in the program to prevent rejection by the insurance companies or clearinghouse.

• 3

  Submit the completed charges to a medical billing clearinghouse. The medical billing clearinghouse will scan the program for any problems and will reject any billing not acceptable by the insurance companies.

• 4

  Using a printer and paper 1500 HCFA forms, print and mail any charge forms for insurance companies that do not accept electronic submission of claims. Most insurance companies accept all or most of their claims by electronic means. Additionally, some insurance companies, as well as Medicare, accept only electronic submission of claims and will return unopened paper claims to the sender.

• 5

  Check the rejected claims folder for any claims rejected by the clearinghouse. Some clearinghouses will specify the reason for the claim rejection, others will not. Note the reason for the rejection, correct the problem with the claim and resubmit it to the clearinghouse for processing. If the clearinghouse does not specify the reason for the rejection, carefully double-check the patient and charge information for accuracy before resubmitting the claim to the clearinghouse.

• 6

  Obtain information regarding any secondary insurance to bill from the physician's office. Use a printer and paper 1500 HCFA forms to print the necessary secondary insurance claims. Copy the original primary insurance explanation of benefits, attach it to the secondary claim form and mail it to the insurance company.

• 7

  Bill the physician's office for your services, according to the terms of your contract.