Ready to Start a Medical Billing Service?

You’ve learned medical billing and considered the pros and cons of starting your own business in the field. Chances are you’re ready to take the plunge if you can answer “yes” to each of the following questions:

  1. Can you bill and code with your eyes closed?
  2. Are you the go-to person in your office for medical billing questions?
  3. Are you proficient at managing multiple projects and people?
  4. Can you manage yourself and your time well?
  5. Are you comfortable with ambiguity?

Most successful business owners have mastered both people and processes before striking out on their own. They are visionary, self-motivated problem-solvers with the courage to step outside their comfort zones. They’re passionate about contributing, and they possess the patience and communications skills to motivate others.

Most successful medical billing business owners have long ago mastered the technical aspects of medical billing. They’ve learned what mistakes a medical biller should avoid and gained speed and accuracy in the process. They’ve transitioned to ICD-10 without batting an eye. They’ve worked in the industry long enough to trust their instincts about managing and interacting with others at many different levels.

Who We Are

The Healthcare Billing & Management Association (HBMA), serving some of the nation’s largest medical billers, estimates there are about 2,000 medical billing companies in the U.S. They range from freelance medical billers who moonlight to multi-million-dollar players.

“The average HBMA Member has 40-50 employees, uses commercial software, has been in operation over five years, has company revenues of $2.5 to $3.5 million and processes about 350,000 to 400,000 claims per year,” according to HBMA.

What We Do

“The (medical) biller typically assembles all data concerning the bill,” the American Association of Professional Coders (AAPC) says. “This can include charge entry, claims transmission, payment posting, insurance follow-up, and patient follow-up.”

To start a medical billing company, you must understand the importance of the business of healthcare. You must know that managing the revenue cycle is more than just sending out claims and calling on the status.

As with most industries, today’s medical billing world thrives on technology, so technophobes need not apply. There’s still a lot of paper in healthcare today, but medical billing is now much more about electronic filing and remittance than about paper claims and faxing. And industry experts stress that electronic claims generally get paid in half the time or less of paper claims.

How to Get Started

If you answered “yes” to the five questions above, you’ve probably taken the foundational steps toward starting a successful medical billing business. You understand medical billing — the daily drill and the larger industry. You’re confident that you have the focus and discipline to deliver for providers who entrust their reimbursement to you. You’re ready to make a living at this!

Plan Your Work. First you must strategize and plan. Most successful business owners develop a business plan before hanging out a shingles.

  1. Articulate measurable goals.
  2. Conduct market research on the target geography and customer population(s).
  3. Estimate start-up costs and ensure access to funds and other resources to carry them through the months leading to profitability.
  4. Set up a dedicated work space. If it’s at home, they check local zoning laws and apply for a business license to avoid disturbing neighbors or violating the law.
  5. Map out a marketing plan.

Work Your Plan. After you’ve done your homework and laid a solid foundation for your medical billing business, it’s time to get out there and find clients. You’ll want to send out marketing materials and follow up by phone. However, networking in person often works best. Consider personal contacts, professional organizations and even medical-billing freelancing while getting yourself established.

There’s no right or wrong way to start a medical billing business. However, understanding what you’re getting into and planning how to manage it increases your opportunity for success exponentially.

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