How to Open a Medical Billing Company

Every medical procedure must be billed as an insurance claim.

Medical-billing companies are a vital link in the health care industry. Serving as the liaison between providers and insurance companies, medical-billing services encompass filing claims and processing payments as outsourced third-party companies. Opening a medical-billing office and entering this challenging and potentially profitable industry is the first step in joining a field that the U. S. Department of Labor reports as growing for the next several years.

Things You'll Need

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

Instructions

Getting started

1. 

   The right contractor brings experience and training to the job.

   Contract experienced home-based medical billing specialists who hold certification from an accredited training program or school. Certification ensures that these individuals have met minimum requirements for accuracy, proficiency and professionalism. Using home-based contractors reduces salary, benefits and equipment outlays, now and in the future. Make sure that every employee and contractor signs a confidentiality agreement that covers all aspects of Health Insurance Portability and Accountability (HIPAA) laws.

2. 

   A thorough background check protects the business, your clients and their patients.

   Perform background checks on all employees and contractors, including company officers and management, per the recommendations of the American Medical Association guidelines for medical billing providers.

3. Secure an insurance policy and bond to cover security and liability for legal expenses and possible judgments. Be certain to mention these in any marketing or promotional materials as this assurance may prove important to potential clients.

4. 

   Set standards for your business and its employees/contractors.

   Create privacy and ethics policies that match those of the Healthcare Billing & Management Association (HBMA) and/or American Medical Billing Association (AMBA). As national industry associations, membership in these organizations builds credibility. Also consider joining the local chamber of commerce and the Better Business Bureau.

5. 

   Geography is not a barrier in medical billing.

   Set rates based on local and regional competition. One important factor to keep in mind is that most medical-billing business is done remotely, which means that geography does not have to stand in the way of attracting business. Locating in a lower-cost market can be a real competitive advantage when looking for business in larger, higher-priced markets.

6. 

   Every health care facility uses medical-billing services.

   Pursue sales opportunities with physician offices, allied health care providers, hospitals, surgery centers, government agencies and medical laboratories. Smaller offices often look to outsourcing services such as medical billing as a way to reduce overall costs.

Tips & Warnings

• The virtual nature of the medical billing industry is one of the great advantages of opening this type of business. Utilizing home-based medical billing specialists offers lower start-up costs and maintains those savings over the life of the business. Use these savings to promote the business at local, regional and national tradeshows and medical meetings.

References

• Medical Billing and Coding:What Kind of Jobs Can I Get in Medical Billing and Coding?
• Medical Billing and Coding:Billing & Coding
• U. S. Department of Labor:2010-2011 Report