How to Start a Medical Billing Business

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Image of a person in a medical smock standing near a desk

A Quick Overview For Starting A Medical Billing Business

Medical Billing Business Overview:

A doctor’s attention should be on patients, not money matters. Help medical professionals focus on their core competencies with a medical billing service.

Despite the fact that the healthcare industry is alive and well in America, most doctors and other healthcare providers have no idea how to get paid quickly and efficiently.

Instead, doctors are overwhelmed by the maze of complicated claim forms and insurance policy procedures. As a medical claims biller, you can earn a good income managing claims for doctors and other healthcare specialists, plus startup costs are minimal.

Working from home involves working closely with doctors to help them complete their claims with both insurance agencies and patients. It involves keeping track of different insurance claims as well as sending out bills and collection statements.

You can easily do this job from home using a computer and a phone line, as well as special software, designed for this purpose.

Once you have taken the classes and gotten a certification for understanding the basic language and coding, you need to start finding clients. References go a long way toward building a client base who will trust you to handle their billing for them.

This is a good business opportunity. It is getting harder and harder for medical providers to keep their billing in-house.

There are many changes in billing procedures and many insurance carrier requirements. It makes sense for them to have an “expert” to handle the billing for them so they don’t have to deal with the changes and requirements.

Skill Set:
  • Stay updated on terminology
  • Data entry
  • Preparing claims to insurance companies
  • Accurate record keeping
  • Mailing patients’ statements
  • Following-up on all unpaid insurance claims
  • Resolve Appeals
  • The ability to collect on unpaid bills
  • Handling all patient billing inquiries
  • List of Common Business Skills
Employee and Job Consideration During The Start-Up Phase or In The Future:
Approximate Daily Hours Needed:

You should be available to work during the general business day from at least 9:00 a.m. to 5:00 p.m., as you will be spending a good portion of your time on the phone with different doctor’s offices, insurance companies, and patients.

Equipment, Supplies, & Services During Start-up OR In The Future:
Monthly Expenses and Operating Costs To Consider:

See our list of common business expenses

Licenses:

See Our Page On Licenses and Permit

Approximate Minimum Startup Cost:

Bare essential – Counting the education that you will need, your startup costs could generally run between $3,000 to $5,000. Much of this depends both on the level and quality of education that you pursue and on the type of software that you decide to purchase for your company.

Tips & Considerations:
  • This service requires knowledge of both complex medical terms and the software used by different hospitals and insurance agencies. Certification programs are available for anyone who wants to get into this business.
  • Have a plan when you meet with your clients. Know what you are going to offer them, how you are going to help their business and most of all how they will save money and receive the best service possible.
  • You may ask your own physician’s business office manager if he/she would allow you to sit in and observe what is required. Most will agree to do this because it shows their employer that they have the ability to train others!
Pros and Cons:

The Pros:

  • This job is something easy to perform from the comfort of your own home.
  • The market for this job is rapidly growing, giving you lots of opportunities to be successful
  • Once the basics are mastered, this is a job which can be easy to perform and enjoyable.

The Cons:

  • Usually requires classes to become familiar with the different medical terms used on the job.
  • It can also require considerable startup costs with computer software and licenses.
  • Finding clients can be difficult
Type of Customers:

Medical facilities, private physicians, hospitals, dentists, and anyone in the medical field.

Statistics:

With a growing number of providers and the increasing patient pool, the healthcare industry just keeps growing. According to a recent study, national health care costs were over $1.5 trillion in 2002, and Medicare spending was over $240 billion of that amount. There’s no doubt that health care is big business.

Resources:

Certification In Medical Billing:

Medical Billing and Coding

Related Sites:

ClaimTek

Forums:

Advantage Forum

Franchises:

Medical Billing Franchise Listings

Associations:

AMBA

Books:

Amazon Books on Medical Billing

Other:

Medical Billing Opportunities: Worth a Second Opinion