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Here’s How You Can Launch Your Own Medical Billing Startup


The healthcare industry is vast, and ever-growing. And the good thing is, you don’t need to become a doctor or even a medical assistant to get your foot in the door of this lucrative industry. One way to do that is to launch your own medical billing startup and provide your services to clinics, hospitals, or other medical organizations that process billing.

You may not realize it, but medical billing companies are silently processing millions of large transactions behind the scenes, every day. Healthcare providers work with medical billing companies to offset the amount of work that goes into process each payment. These companies help to make sure doctors are paid quickly, and that every service conforms to the rules and regulations of patient plans.

Here are the steps you can take to get started:

Get Certified.

Medical billing is a very unique field. The majority of bills are sent directly to insurance companies rather than the patient themselves, and there’s a vast array of codes and descriptions that you’re required to understand before you can work with specialized software.

Fortunately, there are many certificate programs that can fast track your world into medical billing; these programs typically take anywhere between nine to 18 months to complete. During your schooling, you’ll be trained primary coding manuals, and your studies culminate with the proper certifications to get started with your own business or get your experience in another company.

Set Up Your Business.

Now that you’re certified, it’s time to take care of logistics. Getting your business set up requires several moving parts, but you should think about what type of services you’ll be providing before you make any final decisions. For example, it helps to position yourself as a niche medical billing company. Do you want to focus on radiology billing, or would you prefer to provide services to private practices? Think about how you would like to proceed. Analyze the major business structures and take each into careful consideration. Hire an accountant to help you better understand what you’re getting into from a tax perspective.

Get Your Equipment.

Medical billing companies need specific types of equipment to get up and running. If you’re starting out as a home-based business, your overhead costs are significantly lowered. Your billing software of choice will likely be the biggest cost, as some programs are upwards of $10,000. Complete business suites offer much more than billing features and functionalities, and help you run the marketing and lead generation areas of your business as well. Many of these software options offer free demos; take advantage of this by exploring each demo thoroughly and decide which will work best for you. You’ll also need a clearinghouse membership, which will allow you to pass your claims.

Find Your First Clients.

One of the most troubling aspects of starting any business is finding that initial customer base. Your clients will want to know they can trust you, and it’s difficult to show clout as a new business. In the medical industry, this can be even more difficult because you need to build in-person relationships with your client. Chances are, you won’t be able to reach them by phone, and marketing to this audience can be tricky.

But on the plus side, there’s plenty of potential, and the world is your oyster when it comes to outreach. Essentially, anyone that offers a medical service with private or government health insurance is a potential client. This could be anyone from dentists to podiatrists to nursing homes and pharmacies. Although, as previously mentioned, it helps to think about a niche before you start your looking for an initial customer base.

Think About Payment.

There are several ways medical companies charge their clients: per-claim, hourly, and percentage of collections. Understanding what’s common in your area will help you price your services accurately and improve your chances of getting those early clients.

Your income potential will depend on whether you’re working full or part time, and industry averages encompass a wide gap: anywhere between $20,000 to $100,000 annually. It helps to get involved in your industry and begin networking at meetups, conferences, and other events. Talking to others in your field can help you better understand the local payment scheme for medical companies, and you may even be able to get referrals through those connections.