Start Your Own Medical Billing Business with Expert Tips

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A medical billing company is a boon to the doctor as it is the key to getting his payments. Although the healthcare industry is very much active and doing pretty well in the USA, most doctors, as well as, healthcare providers are clueless as to how to get their payments efficiently and quickly by either the patients or the insurers. Needless to mention medical claims processing service is a significant aspect of the healthcare industry. HMOs, insurance companies, and some other health organizations apparently make it really tough for doctors to get their payments for the services already rendered and also time spent in an attempt to collect all their debts. Medical claims processing services would be letting doctors receive their dues without having to worry about collection anymore. Here are a few tips for starting your own medical claims processing company.

Identify Your Target Market

Your target market could be diverse. The clients you are targeting would be from diverse fields of healthcare and medicine. You have to pursue healthcare providers including family practitioners, specialty providers from pediatrics to geriatrics, osteopaths and chiropractors, oncologists and obstetricians, podiatrists and proctologists. You could even pursue mental health professionals, psychologists, and psychiatrists. Your target audience should ideally also include social workers, dentists, ambulance services, nursing homes, home-health practitioners, pharmacists, medical equipment providers and bionic body parts providers.

Estimation of Startup Costs

Startup costs for your medical claims processing company are relatively pretty low. You could operate your business and work from your home. This would save a substantial amount that would have gone into leasing a proper office space. There is practically no inventory involved. Whatever expenses are involved, they comprise expenses on software and office equipment. Moreover, you already seem to have access to most of the office equipment. Here are some of the things to arrange before you get started

  • Clearinghouse
  • Computer system including a printer and of course, the internet connection
  • Fax machine
  • HCFA 1500 forms
  • Office supplies
  • Postage
  • Reference material
  • Software
  • Telephone
  • Voice mail

Practice Particulars

You have to structure and organize your services. According to the way you have structured all your services, you would be performing specific activities during the peak hours. Most Medical Billing Specialists are best at performing complete practice management for the concerned clients. They would be handling all accounting activities of the doctor right from electronic claims to even billing patients to even tracking both payable and receivable accounts. Most MIBs are savvy businesspeople so they would be taking charge of whatever seems necessary to land their client. A professional medical billing company would take care of all the accounting services involved in a medical practice.

Reference Materials

You should learn more about the business and the technicalities involved. Your reference materials must include good coding books like CPT, ICD-10, CDT-3, and HCPCS Expert 2000. You must pay undivided attention and take utmost care while choosing clearinghouse and software. These would be the most expensive and useful tools.


Software packages would come with different features right from the minimum bare-bones to the comprehensive business opportunities that would be providing effective training. Do ample research before getting any software. Pay only for those services and features you would need. Always check the credentials of the software provider.


The clearinghouse is actually the firm that would be receiving your claims, scrutinizing them for any errors and transmitting them back to you. You need to do a complete background check of this company. Be careful while choosing clearinghouse as you would need to interact with them for a reasonable period of time.

Finding Work

Create a wonderful network of contacts in this industry. Communicate and interact with people you know, your friends, family, and acquaintances. All of them surely know some doctors and they could tell you if any doctor would be requiring your services. They could, at least, talk to their physicians about you. You could visit and give your proposals to all the doctors known to you. Get in touch with other professionals such as real estate agents, accountants, lawyers and even insurance agents who could be having contacts in the healthcare industry.

Getting Paid

Medical claim processors usually use one of the basic three ways for billing their client. They could be paid in terms of the percentage of the total amount collected, or as per claim basis and often they could be charging hourly rates for their services if the bill happens to be very low.


With low costs and high demand, a medical claims processing service could be a successful and profitable business for you. Remember successful people are those that never ever give up. You must have the grit and determination to succeed. Only then you could run a successful medical billing business. Do not be daunted by failures or lean patches. Perseverance and patience are the keys to success for any startup medical billing company.

This article is presented by Jonathan Berkley, he is an expert healthcare professional with invaluable experience in medical coding and the medical billing industry. He operates a blog where he enjoys sharing expert tips on medical billing collections and recommends professional medical billing company to his fans and readers.

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