Starting a Medical Billing Business > Starting Your Own Medical Billing Business

Signed my 1st Client!!!!!!

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Thank you to everyone (Michelle, Alice, Linda) and others that have wrote books, created forums and added valuable input to help "us little guys" lol. My client is a "paper" only practice, I am excited to help him move into the electronic world!!

I do have a couple of questions, I have looked here, at PRMNC and googled to see if there is a "list" sort to speak of what to do now. I have my EIN, gonna use that to open an acct this weekend. I have to register in TX as well, oops found that out today.

Here is where I am in my journey, please let me know if I am missing something.

Medicare Part B: I need a submitter ID as a billing company in TX, he needs to apply for electronic billing privileges after my ID comes in.

Aetna, BCBS, Humana and UHC I haven't contacted yet, I'm assuming it's the same deal. I have them on the calendar to call tomorrow.

He needs web access as well to all payers. Or can I sign up for that as a practice management company. I want to be able to see claims online and download the remits. Right now the agreement is his staff to fax or email to me.

I need copies of his contracts, he does not have any on file or can not find them, therefore no fee schedules available to me at this time. Can I call on his behalf to obtain these? Or will he need to?

I'm using a software vender to submit claims, but I am not sure if I have to register with Availity for a submitter ID as well.

He's currently not submitting claims, he's been holding off since 1 April. I just signed him on Saturday.

Thanks again for all of the help and encouragement!!!!!!  ;D ;D ;D ;D ;D ;D

Congrats.. It is very exciting. 
I am going to leave the answers to your questions to those that actively
are doing billing currently. 

Thanks Merry you were a big help as well!!! You answered some of my other ?s. It's exciting and scary at the same time lol! Hopefully the nervousness go away soon

You'll be nervous and you will make mistakes (oh, did I say that?) Everyone does. Remember this client will take you more time than the ones that you get in the future.
What is the specialty of this provider? Are you familiar with the specialty? Hopefully we will be able to continue to help you with all of the "experts" here.

I am concerned about the claims being held since April 1st which will definitely impact his cash flow. Can you send out the claims on paper (remember to use the new CMS forms 02/12). The signing up process can take some time. Medicare can take a  few weeks.

In the "old" days, we could send our Medicare and Medicaid to both carriers. You read that right. We could send our Medicare claims to Medicaid and they would be sent on to Medicare by the Medicaid carrier. And visa versa.  I cannot imagine that happening now but just thought of this while I was typing.



He's Chiro. I have not billed Chiro before, but I do have 7 years experience with PPO's and Medicaid. No Medicare experience though. I am about to buy Michelle and Alice's Chiro billing book so I can start reading and learning about billing for chiro And I've seen a lot of Chiro ?s here and on Linda's site, I plan to read and reread all of them lol. I asked 3 times if he wanted me to send paper, he said no. He wants all "clean electronic" billing. The company he was using is called Inception, I have not heard of them but they are still using the old paper cms1500 form, so his claims have all been kicked back. He's ready to take a loss on the billed claims and just submit April forward. Medicare stated I can submit for him on paper, just not electronically until my ID comes in. So far looking up BCBS, BlueLine, Humana, UHC, Aetna and Cigna it looks like I just have to register with availity. Hopefully that's all I have to do and I can get to helping him bring in cashflow. We bill Medicaid like that at the "real" job I have. Our smaller Medicaid payers do not have portals to direct bill, so we submit claims through TMHP (Texas Medicaid) and they transfer them, man if I could do that with Medicare lol


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