Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => Topic started by: thomsnat on October 06, 2017, 05:00:57 PM

Title: Starting Medical Billing Business help
Post by: thomsnat on October 06, 2017, 05:00:57 PM
I have read quite a few questions on the forum and they have been a huge help. I am going to start my own business here within the next couple weeks. I have the PM software I will be using along with the clearing house, phone, fax, contracts, BAA, and E&O insurance and I just mailed in the paper work to get my business license. Is there anything I am missing? Also I will not have a website until I can get more established. What is a good way to get the word out. Is it practical to go to the practice and walk in? I was thinking of having a flyer pointing out the benefits of having a billing service vs in house billing? I have been doing medical billing and insurance follow up for 5 years and I am very familiar with most aspects of the revenue cycle and knowing that if you don't know billing a lot of stuff is missed and put to a contractual adjustment even if in reality it shouldn't have been. I just am not sure on how to get their information to my system and if I am posting the payments how do our systems reconcile? Also their pricing for services?  I just want to have all the answers when it is time to get my first client. Also I was thinking of doing my first few clients at a lower percentage rate for full revenue cycle service (billing, follow up, appeals, and patient statements) but will that make me seem desperate? So many questions and I am just eager to get started because I know I can do it and be successful at it. Any advice would be greatly appreciated.
Title: Re: Starting Medical Billing Business help
Post by: williamportor on October 07, 2017, 12:08:29 PM
Your questions are legitimate, and ones that most folks ask when starting their medical billing business. My best advise is to read all the posts on this site, since many of them address your questions. In fact I've gone as far as copying and pasting them on wordpad, separating them by subject matter i.e. marketing, contracts, pricing, operations, posting of payments etc. this will allow you to access the information you need quickly. The most delicate matter is when to launch your business. You want to lay a solid foundation for success, but be mindful of the fact that if you wait until you're 100% ready, you never will be. So do your research here, and when you feel you're well prepared to start, then go for it. Just remember, this is a marathon, not a sprint. Fortune favors the persistent!  :)   
Title: Re: Starting Medical Billing Business help
Post by: PMRNC on October 07, 2017, 03:54:10 PM
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I will not have a website until I can get more established. What is a good way to get the word out.

Why is that? I ask because a website can often be your first impression in today's market. 10 years ago I would have agreed that waiting was a better option. A website can offer you a lot of benefits direct mail can't. A website doesn't have to be just about obtaining clients but rather showcasing your knowledge. Even if you do a blog with basic contact information and services offered. Links can be established to social media pages you setup for your business and reach your target market MUCH faster than direct mail.

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Is it practical to go to the practice and walk in? I was thinking of having a flyer pointing out the benefits of having a billing service vs in house billing?

Absolutely. But you have to do them right. At the right time, make contact with the right person(s) and go there with respect for the practice's time. If you go in there trying to talk to the doctor, don't waste your time. NEVER get around the gatekeeper (office manager) it's the biggest mistake I see new billing company's make over and over again. Never go in to do the "hard sell". Go in, ask for a good time to come back, leave materials and speak with the billing or office manager and make them feel confident that you are not there to come in and try to take their jobs, you'll never get a call back.  Ask questions if they give you the time. Find out what their biggest billing headaches are and take notes. Offer a good time to come back with solutions as to how you can help them. Again, don't try to go past the office or billing manager, you need them and you need to check your Ego at the door. Make them feel as if they will not give up any control. Make them confident that you are there to help THEM.


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I have been doing medical billing and insurance follow up for 5 years and I am very familiar with most aspects of the revenue cycle and knowing that if you don't know billing a lot of stuff is missed and put to a contractual adjustment even if in reality it shouldn't have been. I just am not sure on how to get their information to my system and if I am posting the payments how do our systems reconcile? Also their pricing for services?  I just want to have all the answers when it is time to get my first client. Also I was thinking of doing my first few clients at a lower percentage rate for full revenue cycle service (billing, follow up, appeals, and patient statements) but will that make me seem desperate?


Outlining the benefits of outsourcing vs. in-house billing is a good start, but it has to directly impact the billing staff so that you are NOT making them feel alienated. You have to focus the outsourcing benefits as an "extension" to the staff they have. If your benefits of outsourcing make it appear you are going to take their jobs, the doctor will never see them, so don't waste your time.

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I just am not sure on how to get their information to my system and if I am posting the payments how do our systems reconcile? Also their pricing for services?

This depends on your business model. Some billing companies work within their own system and do a conversion or manual entry for setup to bill from their own licensed software or system. Some, like myself prefer to utilize the clients setup thereby bypassing the setup, ugly conversion and waste of valuable time with reimbursements. You can decide your own business model to work for you. I've found that being able to work on any provider's system allows me to better market myself and show the client there is NO delay in reimbursement, the conversion from in-house to outsource is completely invisible.

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Also I was thinking of doing my first few clients at a lower percentage rate for full revenue cycle service (billing, follow up, appeals, and patient statements) but will that make me seem desperate?

It could, but it depends on how you market. Also keep in mind that there are states that prohibit physicians from entering into a fee-splitting arrangement so a % of collections could violate a state statute. I am in NY which is one of those states so I charge a flat fee but before that when I was in NJ and PA I wish I had charged a flat rate from the beginning. A % of revenue doesn't afford you the ability to be paid for all the services you will be doing. BUT if you can and want to charge a % and want to do it lower, why not do it as an "introductory offer" rather than advertising it as an all exclusive %. I also recommend you research rates based on specialty and volume. As a billing company you never want to go in with a blanket %. Different specialties have different volume, the amount of providers on staff, services performed and contracts they hold all should be evaluated and analyzed to come up with a fee that is acceptable to you and the client and represents the work you will be doing as well. For example, I would never go and do a flat 4% for all accounts. You could find your first client to be a family practice with 3 or 4 physicians to which you will surely lose your shirt in the first month of working for them. Make sure that you analyze EACH practice before quoting rates.

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I just want to have all the answers when it is time to get my first client.

Many of us have been doing this for years, myself almost 25 years and I can tell you we never had all the answers when starting and still don't. <g>