How to Start a Medical Billing Company

Starting a medical billing company takes careful planning and preparation.

As the liaison between health care providers and insurance companies, medical billing companies are responsible for filing claims and processing payments for physicians, allied health care professionals, hospitals, laboratories and government agencies. Third-party medical billing services companies are an important cost-saving, outsourcing option for many industry segments. Successfully entering this growing, competitive market calls for finding the right employees, setting a competitive price for services, delivering strong results and targeted marketing.

Things You'll Need

• Experienced, certified medical billing specialists
• Background checks
• Security liability insurance and bond
• Association membership

Instructions

1. 

   Hiring experienced, certified, home-based contractors makes good business sense.

   Employ only experienced medical billing specialists who have earned certification from an accredited training program. These individuals will have the knowledge and insight to quickly and correctly file claims that generate proper billings. In the medical billing field, many of these specialists will be home-based contractors. This provides the benefit of starting the medical billing company with reduced salary, benefits and equipment costs. Home-based medical billing specialists are paid either hourly or on a per file basis. Signing a confidentiality agreement pursuant to the Health Insurance Portability and Accountability Act (HIPAA) laws should be required of all employees and contractors.

2. Follow the American Medical Association guidelines for medical billing service providers, which recommend that all employees and contractors submit to background checks. This should include all business principals, as well, for security and marketing purposes.

3. Buy an insurance policy and bond that sufficiently covers security and performance liability. Together, they will help protect the business by covering legal expenses and judgments against the company. The policy and bond are also a powerful marketing tool when establishing a new client base.

4. 

   Membership in industry organizations is important for credibility.

   Demonstrate your commitment to the industry by joining the Healthcare Billing & Management Association (HBMA) or American Medical Billing Association (AMBA). These national industry associations set industry standards for ethics, confidentiality and business practices. Membership in these organizations also builds credibility for the new business.

5. 

   Competitive rates help ensure profitability and growth.

   Investigate the rates of competitors in your area. Determining a fair, competitive price for the company's services is a major hurdle to overcome. If the rate is too high, the company will price itself out of the market. If the rate is too low, the professionalism and quality of the service provided may become suspect in the eyes of potential clients.

6. 

   The volume of health care procedures makes medical billing services a good outsourcing option.

   Reach out to all health care facilities and offices in the surrounding area. Remember most business will be handled via the Internet, so do not let geography be a barrier. Pursue opportunities in areas where the going rate may be higher. Many smaller offices look to outsourcing of billing services as a way to reduce overhead costs

Tips & Warnings

• Never take "no" as a final answer. A medical billing company provides a needed service to an often overwhelmed industry. Initiate conversations with office managers, nurses and receptionists in various health care offices. These workers often fill the gaps by taking on billing responsibilities in addition to their regular job requirements. Offer convenience, professionalism and cost savings as the main benefits of the business.

References

• Medical Billing and Coding: Training
• Medical Billing and Coding: What is Medical Billing?
• American Medical Association: Physician Compliance