Welcome to Practice Managers Resource And Networking Community

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

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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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We hope this was of some help to you and that you take the opportunity to subscribe to our website at http://www.billerswebsite.com It is the most effective and efficient way to get started.

 

 

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.

 

 

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