Starting a Medical Billing Business > Starting Your Own Medical Billing Business
Employees working at home
PMRNC:
--- Quote ---I don't have to spend $20,000 on computer software? I can just use theirs? If a doctor always used a clearinghouse does that mean the his computer isn't capable of doing his billing? Does he have to get it upgraded? Any help would be great.
--- End quote ---
If you are going to operate your own business, yes you will need a practice management system. Will you be able to access a clients computer / PM software? Yes if that's what they want, and yes if you plan to make sure you are in full compliance and you have a contract you are set, however for every one client you find that wants you to use their computer/software you will find 2 that want you to take it all.. so that means if you are going into business for yourself you will need to have a PM software system of your own. As a business owner you never charge your clients costs associated with "Doing business" such as attorney fees, insurance, coding books, continued education, memberships, software, etc etc. Any cost that is utilized by the business FOR the business is Never passed on to the client. IF you plan to work as an "employee" there are several things that must be done in accordance with IRS guidelines on both the clients end and your end. The client would need to provide ALL items needed, even the computer, software, etc in order to get any type of employee deduction allowed under IRS guidelines. To give you an example, I had a client that left his practice and instead went into book publishing, he wanted me to work for him but he was in a different state, he went to his accountant who advised him that for an employee status he was better off finding someone inhouse because I would be using all of my own computer, supplies, etc and that wouldn't qualify him for any employee deductions.
Point is that if your going to start a business you need to prepare to pay the start up costs as you would starting any business. If you decide you are looking to be an employee, well it's not advantageous for physicians to hire "employees'' to work from home, they get better deductions and lest out of pocket costs by hiring an outside billing agency/company. I wrote this article from my website which should give you a good idea in weighing your options between starting a business and becoming a work at home employee. http://www.billerswebsite.com/jobvsbiz.htm I hope that helps.
tallmanusa:
From what I can gather, there is a 80/20 rule in this business. (And in other businesses too). That 80% of the business is done by 20% of the companies. All of these medium to large companies outsource their work, some within USA, some off shore. Almost all pay for performance to persons who are sub contractors (not employees). Almost all use web based systems; for the most part web based system has no up front cost. Non web based systems are passe, like horses and bayonets.
The Superbill is also fading, the EHR is integrated, no Superbill is required. Good riddance.
Now how do these companies comply with HIPAA?
To find out who these companies are do a search on Google for " medical billing companies "; the top five companies do most of the business. Their websites describe that they offer web based integrated EHR.
The point is that this business has changed so much that it has not much in common with yesteryear technology. Some people still believe that you have to pay up front for software.
Even a small operator with few doctors has to compete with the major companies; if you have no cloud based system, no EHR, and no sub contractors to offer, I am not sure how far you would get.
PMRNC:
--- Quote ---for the most part web based system has no up front cost. Non web based systems are passe, like horses and bayonets.
--- End quote ---
No way.. I disagree completely.. the #1 most widely sold PM system has been Medisoft for YEARS and it's still the most widely used. Of all my clients total past/present only 3 had web based/ASP based systems.
--- Quote ---The Superbill is also fading, the EHR is integrated, no Superbill is required. Good riddance.
Now how do these companies comply with HIPAA?
--- End quote ---
Ask them how EHR is working out in NY/NJ with the after affects of Hurricane Sandy.. It is my prediction this is going to be postponed, NOT for just that reason but for reasons having to do with Cyber Terrorism. It's already happened in small chunks and the middle east is only getting more tech savy on us. Plus you will have patients who exercise their right to "opt out". Paper is not going away. I have many clients who don't want to lose some of the paper systems in place, they don't trust EHR's. MANY providers are even waiting until absolutely necessary.. most of their fears are based on the exact situation they are facing in the hospitals after the hurricane in NY/NJ, EHR was completely DOWN the entire hospital's came to a very scary stop. Also the government's track record with implementation of these types of things always includes a few years in postponements, they still have NOT ironed out the kinks in security. As for compliance, again. The software companies make their solutions compliant, it's up to each provider to IMPLEMENT HIPAA security.
--- Quote ---To find out who these companies are do a search on Google for " medical billing companies "; the top five companies do most of the business. Their websites describe that they offer web based integrated EHR.
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No disrespect as i know your new, but I think you are putting way too much thought into EHR and forgoing all of the other "more" important aspects of having a billing/practice management company. I've already contracted with a few companies to network with and give referral's (affiliate) because I don't plan to get involved in the EHR stuff at all. I'll let them handle that part :)
--- Quote ---The point is that this business has changed so much that it has not much in common with yesteryear technology. Some people still believe that you have to pay up front for software.
Even a small operator with few doctors has to compete with the major companies; if you have no cloud based system, no EHR, and no sub contractors to offer, I am not sure how far you would get.
--- End quote ---
Again, I have to disagree, even with those solutions the MAJORITY of practices still do not fully trust internet. It's not the technology, it's the security that is the issue. I have talked to many clients with hangups on this issue and rather than try to talk them into something they are NOT ready for, I work with them, they retain the right to the same control, that's actually the number one marketing drawback in our industry, doctors are hesitant because they don't want to lose control. Why should I force technology when I can be an extension and ease them slowly. I've seen too many billing companies lose potential clients because the client wanted to retain some control or use their software, etc.
DMK:
Linda, you're my hero!
PMRNC:
I aint giving up my source documents that Cover my ass.. HELL NO! :)
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