The need for medical billing services is in great demand. Healthcare providers need to obtain payments from insurance companies and patients. With the growing demand of healthcare services, the demand for such billing services has also increased. More and more providers are outsourcing their billing to professionals in the medical billing industry. Most providers have no experience in medical billing, which results in claim denials, reduction in cash flow, and a financial strain on the office.
Unfortunately, entering into the field is easy, but being successful is hard work. Unless you have experience in the medical billing field, you will need training in order to properly code claims, and bill insurance companies. Many companies offer training to assist you in your medical billing profession. Before deciding on your training, be sure to check the company out with the local Better Business Bureau and medical billing associations. Obtaining certification as a professional medical billing coder will assist in making your business more successful.
Another important aspect in your medical billing company is selecting the right software to assist you in managing your business. Select a software solution that provides a cost effective billing system that will help you market and grow your business. The system should support multiple clients, and provide complete security to allow your client access to their data.
The software vendor should support the scheduling, registration and charge entry while you concentrate on the billing and collections. This will provide you a competitive edge, so that you can offer your clients a complete solution from scheduling to collections and collections.
The software should support electronic claim submission. Most insurance companies give priority to electronic claims. Claims received online are paid in 10 to 14 days, as opposed to paper claims, which are set on the back burner for at least 25 days.
Finding a software that is available as an ASP (i.e. hosted solution) will reduce your IT costs and reduce your technology concerns, allowing you to focus on your business!
Another important business decision will be what type of provider(s) you will target and how you will reach your target market. At this point you should consider how you would structure the fees for your services.
There are options on how you can bill your clients for your services. These include a per claim fee, a volume discount, a percentage of billed charges, a percentage of collected charges, along with possible incentives (SLAs) as you become more successful in your business.
As you are considering how to charge for your services, you should do research on specific restrictions some payers have with fees charged. For example, Medicaid does not allow physicians to pay a percentage for billing services. So, if you plan to bill Medicaid, you will need to charge a fee per transaction.
You are now ready to establish your client base. It is important to analyze the multiple types of providers in your area, along with your coding/billing knowledge, to help you identify the market you will target.