Medical Billing is a legitimate profession, but behind it lurks an unsavory element of con-artist software companies who want people to believe they too can easily run their own Medical Billing business. Medical Billing essentially consists of book keeping and accounting for a doctor's office. Every time they see a patient, a claim is filed and they are either billed directly by your agency, or the claim is sent to be processed and paid for by an insurance company. I have direct, personal experience with the shady side of the industry, as I allowed myself to be duped into wasting about $500 total during a period where I really could use the money. I had just recently been laid off from a tech-support job when I saw the ads in the paper. "Make $25-60 per hour doing Medical Billing at home. Must have computer with modem. We train. Call 1-800-XXX-YYYY." I had seen plenty of similar ads before, I don’t know why this one looked any different. I wasn’t really desperate; I was entitled to unemployment compensation, so for the next six months I had some degree of guaranteed financial security.

It was very easy to get excited about this, because I knew that such a job would be merely data entry, and if it were self-paced and paid by the claim, great! Doing this from home would be the ultimate convenience – no driving expenses, no wasted hours spent stressing out behind the wheel. No winter driving. I decided to call the number, and the song and dance began. I wish I remember the name of the bitch who swindled me; she convinced me that this was a no-risk thing (of course) where I could easily get a refund within 30 days if I decided not to participate. For a mere $400 or so, I would be given a software package that would allow me to process medical claims and send them to a clearinghouse via modem. It sounded great; she told me that the average pay was $3-7 per claim, and that a claim could be processed in less than five minutes. Best of all, the company provides all of the training material, and would even get you started with one doctor’s office from the beginning. In fact, she spent most of the call convincing me that I would essentially be working for them, but that I had to pay for the privilege to work at home.

So I stupidly bought the package. I’m usually not this dumb, but it was so damned appealing. It seemed bulletproof. I type 100+ wpm on average, so I anticipated $30 an hour, no problem. All done at home. Piece of cake! But when I got the package ("Kwic-Claim(tm)"), I soon realized that this was a "start your own business" kind of thing. I wasn’t working for anybody but myself. I had to actively go out and find doctors, and convince them to sign a legally binding contract to work with me, even though I had no experience in the industry. The company would not assign me a doctor, as their sole purpose was to sell the software and collect a nominal fee (about $0.50) for every claim I sent to their clearinghouse. The ad in the paper made it sound like a legitimate "work at home" job. Not a "make your own business from the ground up" deal. The woman on the phone convinced me that everything would be taken care of, yet here I was with a poorly written database program and little more.

But I refused to think I’d been duped, even when I realized there was absolutely no training material on how to actually use this software, or how to process claims in general. No, that had to be bought separately, in various packages running around $100 each. Rather than cut my losses, I decided to go for it anyway and bought the basic training kit, which was worthless. I learned quickly that this would be an insanely easy job if I could actually recruit some doctors. That was the hard part. As I read the training manual I noticed typo after typo, along with countless grammatical errors. It was written at a seventh grade reading level, if not worse. I seriously considered offering to correct the shitty grammar for them, and even sent them an e-mail requesting to be given the opportunity to do so. After a couple weeks I decided that this wasn’t worth the effort, so I called to get my 30-day refund. "Does the software work?" "Yes, it works, but I was basically conned into buying it without being told exactly what I would have to do. I was even told I would be assigned a doctor, which is a total lie." "Well I’m sorry if we told you that, but if the software has been installed, and is functional, we can’t give a refund. So how many letters have you sent so far?" *click*

The program came with an outdated list of doctors in my area, and a cheesy form letter generator that could print out letters to be mailed out. I think I mailed thirty or so (writing my own far superior form letter), all in all, mostly to small-time doctors who I figured would be less likely to have an office staff. I got one response. The doctor who called me wanted to know how much I charged to process claims. "Well, the average claim is $3-7, but it’s negotiable, and I’d be willing to go lower if guaranteed a certain number of claims per month." I felt so cheesy pretending to be a salesman/businessman over the phone. "Well, my software only charges $0.30 per claim." "Well, my job is basically to provide the software and plug the information in. If you have it and are willing to do it yourself, you have no need for my services." In other words, any doctor can buy the same damned software and pay the same cheesy nominal fee that I had to. All they really have to do is input the patient’s basic insurance information one time (forever stored after that), and put in a few searchable code numbers in to represent whatever services they were providing.

For a doctor to pay me even $3 to do one claim would be absurd. A receptionist making $8-10 an hour could easily file the claims, and if the doctor wasn’t above it, it wouldn’t take him/her more than five minutes out of every visit to plug in the information. What a cheesy scam. I know it’s possible to actually pull it off, but the company ("Medicor(tm)") makes every effort to convince you that you simply pay for the software and they do the rest, including training. "We train" my ass! So I complained to the Better Business Bureau of Nevada (where they’re located), and got a form letter back. The BBB had contacted them and had their response – "We will contact the complainer and straighten things out." I wanted a full refund. Instead, they had some customer service lackey call me to inform me that this was a real legit business and that if I would only send a few thousand letters out, I’d be rolling in the dough. By this time I had a real job again, and didn’t feel like expending the effort. The BBB is still awaiting my response to the question – "Did you receive a satisfactory response?" I’ve been too embarrassed to even reply as of yet, but now that I am capable of noding the subject, I should be ready to respond.