Starting a Medical Billing Business

A medical billing service helps physicians obtain payment from insurance carriers and patients by handling insurance claims, and provide information to help physicians to more effectively manage their practice.

Medical billing is a business that can easily be done at home, even on a part-time basis. However, running it as a business takes more than just the technical know-how: you need to know how to manage and run a business, market and promote to get clients, and possess financial savvy to turn it into a success.

It is a business that has grown by leaps and bounds in the past decades. While demand is great, competition in the medical billing market is fierce. While there are a number of large and well-established firms dominating the market, the medical billing business has a lot of room for a small and home-based business entrepreneur.

Knowledge and Skills Needed to Start the Business

As a medical billing professional, you will provide the following services:

• Preparing either electronic or paper claims to insurance companies, such as Medicare, Medicaid, and third party insurance's, such as Blue Cross Blue Shield, Humana, Great West, etc.


• Entering patient information into the software


• Mailing patients? statements


• Posting payments


• Following-up on all unpaid insurance claims, as well as appeals and denials


• Conducting "soft" collection on non-paying patients (e.g. making phone calls and sending out past due statements)


• Submitting reports to the doctor (e.g. number of patients per month, etc.)


• Handling all patient billing inquiries