Start your Own Medical Billing Service

Start your own medical billing service

An aging American population and changes to Medicare regulations in the early nineties have produced a booming medical billing industry. Medical practices simply can't cope under the strain of increasing paper work and client enquiries. If you are looking for a skilled work at home career with the potential to pay the bills and much more, the medical billing industry is for you.

What exactly does a medical billing service entail?

Medical practices outsource all of their billing responsibilities to private medical billing services. Your day to day activities could any of the following:

• Preparation of insurance company claims, both electronic and hardcopy


• Maintaining a practice's patient database


• Invoicing patients, both electronic and hardcopy


• Collecting co-payments from patients


• Tracking overdue accounts


• Answering patient enquiries


• Submitting reports to practices i.e. number of patients, bottom line etc.

What is required to start a service - experience, qualifications?

The medical billing industry makes use of a complex and ever changing system of codes. If you don't have any experience in the industry, its time to take a course at your local college or through a recognized home study program. When enquiring about courses or doing research, remember that the course you are after might be under another name than medical billing. Purdue for instance runs a Medical Specialist course which includes a module on medical billing.

Beware of scams, anything that sounds too good to be true usually is. Experience or a qualification is always required to start a medical billing service - all services take time to grow and attract clients. Any companies that advertise "no experience required" or "guaranteed client list" are scams.

What your medical specialist course should include

Make sure the course you take includes at least the following basic elements.

• Basic medical terminology


• The insurance claims process


• Processing forms


• National diagnostic and procedural system


• Training for medical billing software


• Methods to handle denied claims


• Soft collection techniques


• CPT codes

Don't necessarily choose the cheapest course option available. Doctors are very weary of who they hand control of their billing too. A qualification from an established and recognized institution will go along way to created trust and increasing the reputability of your service.

Getting your service off the ground

To start your service you'll first need to setup an office, the following will be required: a computer, high speed internet connection, printer, medical billing software and a CPT coding manual. Most of your work will be done online so a high speed internet connection and a good billing program are essential. Also consider spoiling yourself with an LCD monitor, your eyes will thank you later! Don't forget to compile a basic business plan before setting up your service. Good planning can often mean the difference between failure and success.

There are numerous software packages available on the Internet, expect to pay at least $500 for your software and around $3000 to $5000 for the total business setup, depending on the course you take and equipment you purchase. Search online forums and social network sites like Digg.com for honest consumer reviews before purchasing a software package, the number of unresolved forum posts or negative user reviews will give you a good idea of each programs usability and features.

Marketing your new service

To be successful in the industry you will need at least six medical practices in your employ - typical monthly fees range from $800 to $1,500 per client. The good news is you'll only need to market your services in the beginning, once you have a full roster of medical practices marketing is no longer required. (This lack of marketing expenditure later on is part of what makes this career very profitable).

Market your services initially through direct mailers to doctors, cold calling and networking in the medical billing community.

Final word

Budget for occasional and ongoing education - medical billing is constantly changing so its essential to stay current with changes in the industry. Be on the look out for seminars in your area.