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How to Start a New Medical Billing Business:Addressing all your concern

Thinking of starting a home-based medical billing business but reluctant due to lack of information about the process? It’s your lucky day, we got you covered.

In this article we will share pointers on

  1. Introduction about a Medical Billing Business.
  2. Is there a need for a new Medical Billing Business in your target market?
  3. How much will it cost for startup?
  4. Steps to starting your own home-based Medical Billing Business
  5. Pre-requisites for Starting
  6. Selecting an intuitive Medical Billing Software
  7. What and how much to charge your clients?
  8. How to specialize yourself with industry know-how?
  9. How to market and grow your client-base?

Grow your Network in the Medical Billing Industry.

1. What does a Medical Billing Business entails?

Medical centers, hospitals and private medical care professionals bill their clients for services they offer, including check-ups, tests, procedures, treatments, prescriptions etc. This is where Medical Billing Businesses comes in, they help medical practices (big and small) by translating these clients services into billable statements. Not just this, they also send these claims to insurance companies and then follow up on them until collections on these billables are received.

Why are outsourced billing methods used by Medical professionals and healthcare providers for their revenue cycle management procedures?

Complex Medical Billing Software are used by health insurance companies, Medicare and Medicaid to process patient statements/billables. What makes it more difficult, are the ever-changing regulations and strict industry rules that these companies are compelled to abide by. More so, these claims are to be submitted with a number of illness/procedure specific codes – making it an excessively organized process. This whole process includes:

  • Claim Creation Techniques
  • Denial Management and Collection
  • Contracts with Health Insurance Companies
  • Medical Coding
  • Data Transparency and Analytics
  • Administrative and Organizational Hassles
  • Compliance Issues

Medical Billing Companies/ Medical Billers and coders are well versed in all the Revenue Cycle Management Procedures. Its their job to monitor, control, add value and improve every step of the claim life cycle – from patient appointments to final reimbursements of the patient billables. Their job includes optimizing the whole Medical Billing Process through their industry knowledge and experience, helping medical professionals and healthcare providers earn profits proficiently.

Healthcare professionals have a lot on their plates already from taking care of their patients to worrying about denials. Billing is better done by billers and coding specialist. They help create and process medical claims faster and with greater efficiency - meaning higher profits and significantly lower Account Receivables rate.

2. Is there a need for a new Medical Billing Business in your target market?

Market research is essential to starting any business not just Medical Billing. Before starting a Medical Billing Business (from home) its advisable to contact medical partitioners and healthcare providers to inquire about the need for Medical Billing Service in your area. Gaining an insight about the recommended medical billing software/practice management software can save you a lot of hassle and can help optimize the claim life cycle management process. You can ask these questions:

  • Are you handling your Medical Billing procedures yourself or do you have a third party hired?
  • Which Medical Billing Software would you recommend?
  • Which of the processes do you/would you outsource?
  • What is the patient foot-fall in your practice and how many do you bill on daily basis?

3. Startup Costs?

As per market research, a solo-run Medical Billing Business is relatively easy to start and can range between $2000 to $10,000. A home-based medical billing business relieves you of the overhead costs like office rent, space, etc. The only cost that you incur is on a Medical billing Software and that too vary on the size of client’s company, no of employees, software features – ranging from $100 to $10,000.

Further growth from small to medium/large company may cost you up to $50,000. (Training of professionals cost up to $3000+)

4. Steps to starting your own home-based Medical Billing Business

Starting your own medical billing home business can be exhausting. With ever changing industry regulations and strict biding rules, it is highly advisable that you be careful and avoid legalities issues.

5. Pre-requisites for Starting

6. Selecting an intuitive Medical Billing Software

The cost for the Medical billing software varies widely based on features and the size of your company.

AltuMED PracticeFit

AltuMED PracticeFit is a hassle free, cost effective and user- friendly software that allows you to provide your Medical Practices with stress free Billing solutions. It frees you from all the IT hassles. Allowing AltuMED to take your practices to the cloud provides you with paperless freedom with secure access to all the medical billing and practice management features anywhere, everywhere.

CareCloud EHR

A cloud-based medical practice management system with an integrated billing app that features claims processing, claims scrubbing, code & charge entry, health insurance verification, invoice history, and more.

Kareo EHR

A web and mobile-available software that manages patient billing through cloud technology. Billing features include claims processing & scrubbing, health insurance verification, and more.


A simple, efficient, and affordable cloud-based medical practice management and medical billing solution for your third-party billing needs. Billing features include claims processing, claims scrubbing, health insurance verification, remittance advice, and more.

7. What and how much to charge your clients?

Some of the ways to charge your clients in the medical billing process:

8. How to specialize yourself with industry know-how?

Gaining industry know how, especially specializing yourself in one or two fields of the healthcare can significantly enhance your chances of earning profits. The more you know, the more you will be hired for outsourced billing.

  • Cardiologists
  • Chiropractors
  • Family practitioners
  • Dentists
  • Psychiatrists
  • Audiology
  • Nephrology

9. How to market and grow your client base?

Having a rigorous marketing plan is essential to success in this competitive medical billing industry. Winning the first client is the first of many challenges that you might be facing and it definitely helps if you have experience or someone with experience to help/assist.

Having a detailed marketing plan can help bring in leads which mostly translate into clients. More so, you can think about having a website, social presence, printable mediums etc and can also work on creating campaigns offering incentives to simulate market growth and create brand awareness/presence.

While generating leads, consider providing these free incentives to lure in prospects:

  • An analysis of the benefits of outsourcing billing services for their specific medical practice.
  • A code reviews. Analyze which codes are out-of-date or incorrect, and estimate the amount of lost revenue that has resulted from these codes.
  • A free claim process and an estimate of the time your services saved them.
  • An analysis of their Superbill and accounts receivable, and an estimate of why some of their medical claims are rejected.
  • A consultation to evaluate if they comply with HIPAA and OIG.

Grow your Network in the Medical Billing Industry.

Networking helps more than we care to believe. More so, referrals and testimonials are your biggest assets in this business. Do not aim to land many clients but work with a few in the beginning and offer than such extraordinary Medical billing service that they be your advocates in the industry.

AltuMED offers Free Subscription for New Medical Billing Companies, Sign up now to claim your free license !

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