How Do I Start a Home-Based Medical Billing Business?

The idea of being your own boss can be very empowering, but as with any new business endeavor, there are things you must consider before striking out on your own. It is important that you understand your options and how a home-based position might fit in with your personal needs and goals. Learning what is involved in starting a medical billing home business is the first step in making the right decision.

Before starting a home-based medical billing business, it is important to learn about the needs of doctors and medical facilities in your area. By doing your research, you can better gauge your chances for success as an entrepreneur. Questions to ask doctors include:

Do you handle your own billing or go through an outside company?
Are there specific software programs that you use or would recommend?
What is your daily patient volume?
If you use an outside billing company, do they only handle submitting insurance claims or also deal with other aspects of your accounting?

Keep in mind, there are many offers available for people starting a home-based medical billing business that sound too good to be true. The Bureau of Consumer Protection offers some valuable advice on how to identify scams. For instance, you might want to contact one of the following groups to find out about any complaints against the company you are researching:

Your State Attorney General’s office
The Consumer Protection Agency
The Better Business Bureau in your area

Additionally, before signing any agreement with a medical billing provider, consult with an attorney and have him or her review the paperwork.

Consider a Specialty

There are many options in the medical billing industry and everyone from family practitioners and psychologists to nursing homes use medical billing. If you are considering starting your own home-based medical billing business, it may be helpful to pick an area of focus. Do you already have a background in one area of healthcare? Then you might want to pursue doctors in that field. Any awareness and experience you can bring to the table will help you as you try to land that initial client, and it will also help as you establish your business.

Focusing on a specific area of health care will also let you eliminate the need to know a larger volume of billing codes. Doctors with more limited, single-specialty practices would be:

Cardiologists
Chiropractors
Dentists
Psychiatrists

The area you decide to specialize in can also determine the volume of work you will be doing in your medical billing home business. Doctors who generate smaller copays must see a higher volume of business to succeed than a doctor who has a higher copay or fee because of his or her area of focus. As a result, healthcare providers who cost less may actually have more work for you than doctors whose cost per visit is higher. If you are seeking a higher volume of work, this could be an advantage. However, if you are just starting out, a large amount of billing and coding may be overwhelming at first.

To your advantage, a home-based medical billing business is a relatively inexpensive one to get off the ground. Because your home is your office, you can bypass the additional overhead you’d need in a regular office. You will, however, need some basic supplies such as:

Clearinghouse (a company that electronically receives and transmits medical billing claims)
Computer with an Internet connection
Phone, printer, and fax machine
Medical billing software
Medical insurance forms
Reference materials (ICD-10, CPT, and HCPCS Expert 2000 coding books)

Picking Billing Software

Assuming you already have a computer, one of the largest expenses involved in starting your own medical billing business will probably be the billing software you select. There are a number of options, and of course a range of prices. To determine which software package is right for you and your business, ask yourself these questions:

Do you want basic software, or a package that includes lead generators and other assistance?
How many years has the software package and/or developer been in existence?
What references can the developer of the software package provide?
When consulting those references, is the program easy to use, and is the technical support convenient and readily available?

Create a Work Environment

One pitfall for many peoplestarting a home-based medical billing business is the fact that they are working from the comfort of their own home. It is imperative to create an environment that works for you. This may mean designating a room devoted to your medical billing and coding, away from any household distractions such as chores or family. Working from home requires, in a way, even more discipline than working in a traditional office. Give yourself time to make the adjustment if you are new to the experience.

Earning an Income

For anyone starting a home-based medical billing business, there are three main ways of charging the healthcare providers you partner with:

A percentage of the money they collect from their billings
A per-claim fee
An hourly fee

The option you choose will depend on the healthcare provider you are working with, as well as the type of medical coding and billing function you are providing to their office.

Growing Your Business

While you may think that working at home wonít require you to interact much with the outside world, the opposite is in fact true. The only way to successfully grow a medical billing business is through marketing yourself and what you offer. Referrals can be an excellent way to expand your business. If you have existing clients, ask them if they know of any other doctors or providers looking for a medical biller. Starting from scratch? Donít be afraid to utilize the contacts you already have, such as your familyís doctors. While it might be awkward to directly ask them for their business, a better route mightbe to mention that you have started your own medical billing business and see if they have any tips or referrals they would be willing to share.