Healthcare

Start A Medical Billing Outsourcing Business | Physician Billing Services

Work From Home

Healthcare providers all over the USA use specific codes to bill insurance companies for medical services provided. On top of that, it is all done electronically. There are 1000s of medical codes for billing, and a certified medical billing and coding company must use the correct code every time to ensure these companies pay the proper reimbursements. Further, Medicaid, Medicare, and all health insurance companies require that all billing be electronic using approved software. Many rules and regulations govern outsourcing the practice of medical billing solutions to prevent fraud. Also, entering the wrong billing codes can quickly lead to an audit, a major league headache.

Certified Medical Billing And Coding Business

The fact of the matter is that healthcare workers no longer have the time to figure out which service codes work. Healthcare workers also have a time limit to bill for their services; there is no reimbursement if the billing is too late. So today, physician billing services are done by certified medical billers. Besides large companies that do medical billing, many individuals perform it online either from their homes or regularly at the healthcare provider’s office. The healthcare field is immense, with many medical and surgical services; hence, there is a significant demand for medical billing solutions.

Medical billers are trained to read medical charts and know which medical codes go with which procedure. They also have a vast knowledge of what insurance companies require. The faster a medical biller enters the billing codes, the earlier the healthcare provider is paid.

However, medical billing does require certification and experience. But for those who can quickly grasp medical terminology and know the codes, medical billing is a great way to make good money. Read on for practical tips on how to start your medical billing business.

Here are some certified online courses

Medical Billing And Coding Certification

It goes without saying that without a certificate, you will never win a contract in the medical billing business. All doctors and healthcare institutions will ask for a billing certificate plus experience. So the first step is to get the certificate, which you can obtain from a college within 9-18 months. After the course, you’ll need to pass the exam to get the certification. Going to an accredited college for your medical billing certification would be best. It will cost you anywhere from $8K- to $15K. Graduating from an accredited college will help you acquire many contracts.

Choose a billing program that covers the below three code manuals:

CPT: Current Procedural Terminology (set by the American Medical Association)
HCPCS: Healthcare Common Procedure Coding System
ICD-10-CM: International Statistical Classification of Diseases and Related Health Problems (Maintained by the World Health Organization)

After completing the course work, you will need to take the Certified Medical Reimbursement Specialist exam – American Medical Billing Association (AMBA)

Here is some valuable information regarding the certification

Become A Certified Outpatient Coder

If you want to open a medical billing business fresh out of college, then it is unlikely that you will receive many contracts. The reason is that medical billing is a delicate branch of the healthcare industry where mistakes are not allowed. The Federal government takes billing errors very seriously and is always on the lookout for fraud. So most healthcare workers will ask if you have experience working in a healthcare setting. If you do not, you should work for a medical billing company first to learn the terminology and the billing codes to perfection.

Medical Billing And Coding Demand

Before you set up your medical billing business, determine a need. You can do this by talking to people in the medical billing business and scanning hospital ads for medical billing jobs. You should also contact healthcare workers in your area to determine who is providing their medical billing services. Many healthcare institutions and clinics do outsource their medical billing. Plus, you also need to find out if the jobs are part-time or full-time. A few places where medical billing jobs commonly exist include newly established health clinics, nursing homes, and solo healthcare providers.

Physician Billing Services Business Plan

To understand the complexity of a medical billing business, you must create a business plan even if you decide to work from home. The plan should contain the following.

Will you be working solo?
Will you work from home?
What are the startup costs?
What type of income will you expect?
What equipment will you need to get started?
How will you obtain billing jobs?

Here are a few online examples

Certified Professional Biller

Obtain a business license
Register for state and federal taxes
Open a dedicated bank account

Medical Billing And Coding For Dummies

Able to enter data on a computer
Computer literacy
Dedication
Focus
Management skills
Medical knowledge
Organization
Patience

Medical billing is not tricky, but it can be frustrating. Healthcare providers do not always fully explain what type of service they perform, and the medical biller is left to read the medical chart and then select the code. For example, the doctor may have performed a breast biopsy but neglected to mention what type of biopsy. A breast biopsy can be completed in several ways, and each of these techniques has a different billing code.

What Are The Startup Costs For A Home Medical Billing Business?

Starting a medical billing business from home will involve the following expenses:

Internet connection
Microphone headset (Logitech, Corsair, Astro, Mpow, Razer, Creative, etc.)
Telephone
PC (e.g., Acer, Apple, Dell, HP, Toshiba). No matter what PC you buy, it must have a least an i5 processor, Windows 10 operating system, 500 GB SSD, and at least 8 GB RAM.
Webcam (Logitech, Microsoft LifeCam, Mevo, Razer Kiyo, etc.)
Billing Software programs compliant with HIPAA (CureMD, AdvancedMD, NextGen, EpicCare, DrChrono, etc
Scanner (Panasonic, HP Office, Brother, Canon, Epson, etc.)
Printer (Epson, HP envy, Canon PIXMA, Brother, etc.)
Fax (Epson, Samsung, Brother, HP)
Hard drive for backup
Computer security
IT support
Reference billing and coding books (ICD-10, CPT, and HCPCS Expert 2000)
Invoicing software (Quickbooks, Scoro, Zoho books, Xero, Freshbooks, Wave, etc.)
Time track software (Clockify, Hubstaff, Harvest, Meister talk, Toggl, Everhour)

For under $10,000, you can start a medical billing business from home. The most expensive equipment required is the required software ($3K-$12K) and security ($300-$1K), mandatory during electronic healthcare information transmission. Since most healthcare information is stored on cloud platforms, you can access the data from home.

How Much Should I Charge For My Medical Billing Business?

The pay scale varies from $18-$25 an hour. Some medical billers who obtain contracts from healthcare institutions may charge anywhere from 5%-7% of the collected claims. So if you bill for $100 000, you will collect anywhere from $5K-$7K.

Try out some of these “free” contract template websites

Medical Billing Process

Do you want to work in a hospital or a doctor’s clinic?
Do you want to work for an insurer, assessing medical billing transmitted for reimbursement?
Do you want to work in one medical specialty- like medical billing only for the emergency room?
Do you want to work in the surgical field?

The key is to do something you like because medical billing can sometimes be frustrating. Rest assured; insurers do not reimburse money on a whim. They thoroughly review each code to ensure it matches the procedure, and rejections are pretty standard.

Medical Billing Solutions – Start Small

If you want to open your own medical billing business, we advise you to start small and work out of your home. The great thing about home medical billing is that no fancy permits or licenses are required. This arrangement will limit your expenses, offer you insight into the industry, and as you grow, you can always build a team that works for you.

Because there is a risk of violating HIPAA rules, some healthcare institutions and clinics will not initially permit work from home but instead ask you to come to their clinic. In such scenarios, transportation and food are the only costs you will have. Once you have proven your ability, reliability, and compliance with rules, you can apply to work from home.

Marketing Coding Companies

First, create a website to showcase your education, credentials, and certificate. Share your experience and contact information.
Physically visit local clinics and healthcare institutions in your area and introduce yourself.
Drop your business card with human resources and the billing departments of hospitals and private clinics
Initially, offer free consultations to review rejected billing claims and difficult or complex billing cases.
Participate in online medical forums and develop a network
Speak to other medical billers and be willing to cover them when they are off sick or on vacation
Teach at the local college

Here are some handy links

Build Your Own Medical Billing And Coding Company Website

Your restaurant domain name protects your website address on the internet. You can register a domain name with any hosting company you choose.

Some of the common domain registrars include:

Here is a list of some options for building a regular website.

Here is a list of drag-and-drop page builders for WordPress.

Medical Billing Scams And Shams

Unfortunately, the business of medical billing is fraught with scams and shams. Some of those include:

Unaccredited medical billing courses that you can complete in 4-8 weeks
Fake medical clients who require upfront money to train you
Bogus online classes
Paying fees for online courses that are scams
Fake certificates

Always speak to others before you sign up for any classes or courses in the medical billing world. Further, search for an accredited college where you can get your education.

Conclusion

Starting a medical billing business at home is demanding but lucrative. But remember, there are deadlines for billing submissions, or doctors do not get paid. So it would help if you had the commitment, organization, and efficiency. If you do a good job, your business will grow because there is a considerable demand for excellent medical billers.