We know: All About Medical Billing

What's medical billing?

Medical billing is a commonly advertised job opportunity that is also often associated with scams and fraud.

Ads for medical billing business opportunities appear on the Internet and in the classified sections of local newspapers. 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.

But the reality is that few consumers who pay for medical billing opportunities find clients or make any money, let alone earn the promised substantial income. Many doctors' offices process their own medical claims. Doctors who contract out their medical billing often use established firms, not individuals working from home.

How do the scams work?

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.

Medical billing scammers charge a fee of $300 to $500. 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.

How to protect yourself

To avoid losing your money to a bogus medical billing business opportunity, the Federal Trade Commission advises you to:

  • 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.

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