Getting Started
We are going to assume for the sake of this article,
that, after step one, you have chosen the
appropriate means of training/education OR you have
previous billing/medical office experience.
This ultimately should be the first step.
Download a sample
Start--Up Checklist
1.
Research,
Research, Research!
We do not sell
business opportunities or software, so we have no ulterior
motive for telling you the truth! Average start-up
costs run between $3,000 to $5,000. Though we have
seen companies offering business opportunities and/or
franchises ranging upward to $15,000 or more!
In the Subscriber section
of this site, there is an evaluation process that you can
follow if you do not understand what it is that you should
be looking for in a practice management software. When
looking at software companies and/or business opportunities,
Check with the BBB,
FTC and speak with
other's who have purchased or thought about purchasing from
that company. Know how long that company has been in
business. Completely look at what they are offering and make
an informed and educated decision.
2.
Decide how you want to set up
your business
(i.e., sole proprietor,
corporation, LLC, partnership, etc.). Consult with an
accountant or business advisor.
Prepare a Business Plan
(sample plans are located in our Subscriber area).
3.
Choose a name for your
business.
Be sure to choose a professional name. The name of your
business is important! Be creative, but professional.
Check with your local county and/or state for name searching
to be sure you choose a name not already registered
4.
Visit your
local municipality and state tax office to register your
business. If you are planning to work from your home, obtain
the zoning laws/rules from your county/
5.
Research
trademark
for your business name.™
6.
Open a business checking and
savings account
(consult with your accountant for various types of
accounts). It is a good idea to set aside a percentage
for taxes into an interest-bearing savings account.
7.
Research and purchase your medical billing / practice
management
software.
Remember: Do NOT purchase without
an adequate evaluation of the software and research of the
COMPANY selling it. Make sure you purchase a
support contract! Support contracts are vital in our
industry, due to the many changes that take place. Your
software has to be from a company that is committed to
staying on top of industry changes! Don't think you will
learn a program overnight! We have an area with an extensive
list of what you should look for in your Practice Management
software and how
to do a thorough evaluation (demo).
We give you a full area on HOW to demo your software!
8.
Set up your office. Find
space.
Organize that space to fit your needs for both now and in
the future. Picture the growth of the company you want to
build and make sure your space can accommodate those goals.
Make sure your office meets HIPAA privacy standards. Take
every precaution to be sure your clients' Private Health
Information is PROTECTED! Even if you work from HOME!
9.
Purchase office equipment:
-
Printer(s) -
preferably ink jet for your marketing and a laser or dot
matrix for your claims printing.
-
Fax - you
should have a separate fax line, so your clients can fax
you the source documents you need to do your job without
delay. We recommend an onsite fax machine (or fax
software through your computer) and NOT online services
who cannot guarantee the privacy of your incoming and
outgoing faxes!
-
Phone - a
multiple line phone works great so you can have a line for
your home and at least one line for your office. You don't
want to answer your phone "Hello" when it could be a
potential client on the line. Even if you plan to work
from home, you should plan to run a professional business.
10.
Purchase your
supplies.
Ink/toner,
claim forms, envelopes, postage (marketing), paper,
marketing supplies, filing cabinets, file folders, etc.
Remember that you need envelopes for both claims and patient
statements. You should choose the envelopes to match the
format of your patient statements within your practice
management software.
11.
Prepare your
marketing
materials.
You will want to prepare business cards, flyers, postcards,
newsletters and brochures. Decide on a marketing
strategy and track your efforts, so you can find the
strategy that works for you. Our
marketing area
is packed with many different samples for you to look at or
use! Website
marketing is also an
excellent tool. Doctors use the internet for their
research; they use it to find services as well.
12.
Begin preparing your company's compliance plan.
The OIG has put forth
proposed regulations for third-party billing companies, as
well as physicians. Many professional associations (such as
the AMA) are advising doctors to get a billing company's
compliance plan to be sure they outsource to companies that
are in compliance! Our subscriber area has many resources
regarding compliance, as well as HIPAA compliance (which
should be a vital part of your compliance plan - see
below).
We don't
guarantee these are all the steps every business or
individual needs to take or that they are in the right
order for you and your business. Every person and business
is different. All of the above steps and MUCH more
is covered throughout the Subscriber area of our site!
Download
a sample Start--Up Checklist

Additional
TIPS:
Medical
Billing Software
Our site has a listing of reputable
vendors, as well as tips on how to choose a company a
nd
choose software! We make sure
to check our advertisers
and sponsors with both the
Better
Business Bureau and Federal
Trade Commission.
Software alone will run you between $500 to $5,000, so be
sure to do a good evaluation!
Education
The career you are choosing is one
that makes you responsible for your client's income. It
is imperative that you gain the knowledge
to do this correctly and efficiently. Your business will
fail miserably, if you enter into this profession without
educating yourself first and you will do a great
disservice to your clients as well. Not to mention, you
will find it difficult to sell your services if you do not
know what you are doing. Remember that your client's
financial status depends on YOU knowing your job!
The cost of education can range from
a few hundred to thousands of dollars, depending on
experience, aptitude and material. We have a wonderful
learning center, as well as recommendations for reading
material that we have rated excellent. There are also
reputable companies and associations that offer home study
programs and seminars that are very thorough. When
purchasing an educational program or business opportunity,
ask for references and check with the
Better Business Bureau
and
Federal Trade Commission.
Methods for Staying Up to Date
Joining associations, subscribing to
newsletters and attending seminars are great ways to stay
up to date. This industry changes rapidly and one of the
things that attracts clients to outsource their billing is
that we, as professional billers, make it our business to
stay abreast of these changes. Continued educational
resources are a MUST!
You will need to set up with a
clearinghouse. Be sure to find out which are compatible
with your software. We have several listings of
clearinghouses you can contact.
PMRNC subscribers also
receive a discount for
ET&T
clearinghouse and LTC clearinghouse.
Additional information on these discounts are found within
our Subscriber area, under "clearinghouses".
Marketing
You need to develop a
marketing plan tailored to your specific market.
Marketing is a large part of a successful medical billing
business.
Developing Marketing Material
We recommend that you set aside at
least $500 for initial marketing. That is a minimum
cost. A typical "mailing" will run you at least $100.
Our
Getting Started section walks
you through the steps of getting started and provides you
with resources for starting a business - all in one
place!
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Facts &
Myths
#1 myth we
hear from people researching companies:
Q:
A
company just told me that the government is making all
doctors file claims electronically, is this a good time
for me to market?
A:
It
is always a good time to market. However, the company
that told you that the government was forcing providers to
file claims electronic has twisted the truth a bit. The
buzz on electronic claims is derived from regulations in
effect called
HIPAA
(Health Insurance Portability and
Accountability Act of 1996).
HIPAA
Congress and
the health care industry have agreed that standards for
the electronic exchange of administrative and financial
health care transactions are needed to improve the
efficiency and effectiveness of the health care system.
The Health Insurance Portability and Accountability Act of
1996 (HIPAA) required the Secretary of Health and Human
Services to adopt such standards.
National standards for
electronic health care transactions encourage
electronic commerce in the health care industry and
ultimately simplify the processes involved. This results
in savings from the reduction in administrative burdens on
health care providers and health plans. Health care
providers and health plans that conduct business
electronically at one time, could use many different
formats for electronic transactions. For example, about
400 different formats exist for healthcare claims. With
a national standard for electronic claims and other
transactions, healthcare providers are able to submit the
same transaction to
any health plan in the United States and the health plan
must accept it. Health plans are able to send standard
electronic transactions (such as remittance advices and
referral authorizations) to health care providers. These
national standards make electronic data interchange a
viable and preferable alternative to paper processing for
providers and health plans alike.
How
does HIPAA impact the medical billing industry?

MYTH # 2
Q:
A company told me
that as long as I can type 45 wpm, I qualify to start
doing claims for them after I purchase their software for
$399. Is this true?
A:
Absolutely, positively
NOT! Typing has nothing to do
with medical billing! In fact, I am willing to bet that
most of your successful billing companies can't type at
all! Data entry is just a very small part of this
business. You should never have to pay for a "job".
These companies that sell software and promise to have you
working after you buy are scams, PERIOD! Your
success is up to you.
You can have as many
clients as you want and be as successful as you want.