Gift Guide

How to Open & Operate a Financially Successful Medical Billing Service: With Companion CD-ROM


According to the U.S. Department of Labor s most recent statistical data, the median annual income of a professional in the medical billing industry is $29,000 and, as a business owner, you could earn even more. The healthcare industry provides 14 million jobs and it is estimated that the industry will generate 3 million new jobs by 2016, more than any other industry. If you are detail-oriented, want to be your own boss, and would like to act on the behalf of physicians all over the country, the medical billing ...

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According to the U.S. Department of Labor s most recent statistical data, the median annual income of a professional in the medical billing industry is $29,000 and, as a business owner, you could earn even more. The healthcare industry provides 14 million jobs and it is estimated that the industry will generate 3 million new jobs by 2016, more than any other industry. If you are detail-oriented, want to be your own boss, and would like to act on the behalf of physicians all over the country, the medical billing service business could be a right fit for you.

Whether you will be operating out of your home or you are looking to buy or rent office space, this book can help you with a wealth of start-up information, from how to form and name your business to deciding if this will be a joint venture or if you would rather work solo. Valuable information on forming a Partnership, LLC, Corporation, or becoming a Sole Proprietor, the four types of business formation, is included, as well as the legal implications of each.

A complete list of all of the start-up equipment that you will need is provided, as well as a sample budgeting sheet to allow you to gauge start-up costs. You will learn about potential risks that you take in opening a medical billing service and why it is important to have business insurance.

You will find information on the operations side of running your business from filling medical billing claims to receiving payments, along with privacy information that you will need to know such as HIPPA. Included is a glossary with all of the medical billing terms that you will need in order to knowledgeably run your business, alongside a complete listing of procedural codes and a directory of insurance carriers. You will learn about each of the covered services in the medical field, along with other major medical industries such as, psychiatric, dental, durable medical equipment, and pharmacy.

This complete manual will arm you with everything you need, including sample business forms; contracts; worksheets and checklists for planning, opening, and running day-to-day operations; lists; plans and layouts; and dozens of other valuable, timesaving tools of the trade that no business owner should be without. A special chapter on the different types of billing software that you should buy is included, as well as how much it will cost you and how to set up and use the software to save time and money.

While providing detailed instruction and examples, the author leads you through every detail that will bring success. You will learn how to draw up a winning business plan (the companion CD-ROM has the actual business plan you can use in Microsoft WordTM) and about basic cost control systems, copyright and trademark issues, branding, management, legal concerns, sales and marketing techniques, and pricing formulas.

You will learn how to hire and keep a qualified professional staff, how to meet IRS requirements, how to manage and train employees, how to generate high profile public relations and publicity, and how to implement low cost internal marketing ideas. You will learn how to build your business by using low and no cost ways to satisfy customers, as well as ways to increase sales, have customers refer others to you, and thousands of great tips and useful guidelines.   The companion CD-ROM is included with the print version of this book; however is not available for download with the electronic version.  It may be obtained separately by contacting Atlantic Publishing Group at

Atlantic Publishing is a small, independent publishing company based in Ocala, Florida. Founded over twenty years ago in the company president’s garage, Atlantic Publishing has grown to become a renowned resource for non-fiction books. Today, over 450 titles are in print covering subjects such as small business, healthy living, management, finance, careers, and real estate. Atlantic Publishing prides itself on producing award winning, high-quality manuals that give readers up-to-date, pertinent information, real-world examples, and case studies with expert advice.  Every book has resources, contact information, and web sites of the products or companies discussed.

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Product Details

  • ISBN-13: 9781601382801
  • Publisher: Atlantic Publishing Group Inc.
  • Publication date: 3/3/2010
  • Pages: 288
  • Sales rank: 461,058
  • Product dimensions: 6.00 (w) x 8.90 (h) x 0.80 (d)

Table of Contents

Introduction 11

What is Medical Billing? 11

Chapter 1 Industry Basics and Insurance Industry Overview 17

Working With Patient Information 17

Caregories of Health Services 19

Insurance Options 22

Insurance Verification 27

Medical Ethics and Laws 28

Getting Started in the Medical Industry 28

Chapter 2 Organizations, Codes, and the Daily Duties of an MIB 33

Professional Organizations 33

Training and Certification 35

A Day in the Life of a Medical Insurance Biller 44

Claim Cycle 47

Avoiding Rejected Claims 48

Other Service Options 49

Chapter 3 Medical Billing Reference Materials/Specifics 53

Reference Materials 53

Medical Coding 54

Clearinghouses 58

Start-Up Forms Needed 61

Chapter 4 Software Choices 65

Medical Claims Billing Software 66

Coding and Reference Software 75

Labeling Software 77

Accounting Software 79

Clearinghouse Options 80

Chapter 5 Starting Your Medical Billing Business 83

Diving into the Medical Billing Biz 83

Researching Your Business Options 85

Starting Your New Business Venture 86

Trademark Registration 90

Selecting a Business Structure 91

Making a Commitment 99

Goal Setting 103

Chapter 6 Establishing a Business Plan 107

Drafting Your Business Plan 111

Creating Your Business's Financial Plan 118

Chapter 7 Financing Your New Business 123

Personal Savings and Certificates of Deposit (CDs) 124

Credit Cards 125

Obtaining a Loan to Finance Your Business 126

Equity Investments 135

Home Equity Loan 136

Chapter 8 New Business Basics 139

Work from a Home Office 139

Work from an Office Away from Home 142

Utilities 145

Business Expenses 145

Staying Organized 155

Legal Considerarions 157

Licenses and Zoning Requiremenrs 161

Chapter 9 Operations 163

Hours of Operation 163

Accounting and Bookkeeping 165

Profit Planning 171

Leading the Company 173

Chapter 10 Advertising and Marketing 175

Developing a Marketing Plan 175

Your Business Logo 177

Finding Clients 178

Direct Mail Campaigns 180

Business Cards 187

Cold Visits 188

Referrals 189

Following Up 189

Building a Web Site 192

Chapter 11 Working with Clients 199

Meeting Prospective Clients 199

Charging Your Clients Their Claim Fee 202

Assessing Clients' Needs 205

Handling Complaints 208

Chapter 12 Expanding Your Business and Hiring Staff 211

Hiring Employees 212

Training Your Employees to Serve Clients 219

Insurance Options 222

Employee Evaluations 223

Firing Employees 225

Payroll and Keeping Track of Hours 227

Respecting Everyone at Work 229

Meetings 229

Motivating Workers 231

Conclusion 235

Appendix A Sample Business Plan 237

Appendix B Abbreviations 249

Appendix C Resource Directory 261

Online Resources 261

Book Resources 263

Appendix D Insurance Directory (For Business Insurance) 265

Glossary 267

Bibliography 277

Author Biography 281

Index 283

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Sort by: Showing all of 7 Customer Reviews
  • Posted April 29, 2010

    How to Operate and Open a Financially Successful Medical Billing Service

    Starting a new business in the healthcare system is very complicated task. Currently, the healthcare industry is the fastest job creating industry in the United States. Beginning a new business is always challenging, but planning ahead is not. How to Operate and Open a Financially Successful Medical Billing Service, is an excellent guide for an entrepreneur. This guide explains every specific detail of venturing down the path of Medical Billing service. Not only does it lay out plans for your business blue print, but it describes how the medical field works by processing billing.

    The author, Laura Gater, has written this book with obvious care. She has provided a very detailed overview of the medical billing process. I'd recommend this book to anyone who has an unclear picture of how the medical billing field works. The author gives complete insight on who, how, what and where of the medical business.

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  • Posted April 27, 2010

    A Wonderful Medical Billing Business Guide

    Medical billing is by far one of the most popular up and coming home businesses out there. As a stay-at-home mom, I find that with all of the "work from home and be financially independent" schemes, I would just as soon be my own boss and start a reputable business. Medical billing, with as in demand as it is, is a great fit for not only me, but thousands of people out there in the same boat.

    This book has proven not only immensely informative and useful, but also encouraging as well. Admittedly, I'd expected this book to read like a dry, jargon-filled tome, but that's not the case. I was pleased (and more than a little relieved) to find it incredibly easy to understand. Laura Gater takes the reader by the hand and guides them through the ins and outs of taking the first, terrifying steps into starting a home business in medical billing.

    She includes assistance for writing out your business plan, getting ready for tax season, and she shows you how to obtain tons of legal documents that you will find imperative. The cd-rom with many of these bonus features and documents was a life-saver, and I found it very convenient to be able to load files directly to my computer and print them out, rather than format my own or track them down online.

    I cannot recommend this book enough. Thank you so much!

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  • Posted April 19, 2010

    Complete medical billing reference

    As medical billing and coding continues as one of the fastest growing industries in the country, this comprehensive guide is a must read for anyone considering joining the field. Not only does Gater's book serve as a detailed resource on the ins and outs of medical billing and coding, but it also delves into the businesses side giving an aspiring entrepreneur with the basis on starting and running his or her service. This is a guide not only for people who want to join the field but those interested in making a healthy income from it.

    The industry can often be daunting for newcomers with its own language filled with insurance codes, medical jargon and legal guidelines. But the guide provides readers with an easy-to-understand breakdown of these terms and a detailed overview of the medical billing process. It then informs readers on how to obtain medical billing software and finding clients to get their billing practice off the ground.

    In the second half of the guide, Gater addresses administrative aspects of a medical billing service including writing a business plan, obtaining financing and preparing tax returns and other legal documents.

    Included with the guide is a CD-ROM containing electronic copies of medical billing forms as well as a pre-written business plan. This bonus helps make the guide a complete package not only focusing on starting a medical coding business but helping readers run a successful one.

    Was this review helpful? Yes  No   Report this review
  • Posted April 13, 2010

    Good Reference Book for Medical Billing Industry

    Starting your own business can be a daunting process. Where should I start? What is the process for getting a loan? Do the benefits outweigh the negatives? What are the specifics to running a business on my own? To answer these questions and any others that may come up in the process, a good reference book that is specific to the business you would like to open becomes imperative.
    How to Operate and Open a Financially Successful Medical Billing Service is an excellent starting point to learning the ins and outs of starting your own medical billing service. In her book, Ms. Gater does an first-rate job of explaining the details involved in the field of medical billing, the pluses and minuses of going into such a field and how to figure out if it is the right fit for you.
    An information-rich reference guide, this book offers field-specific vocabulary, detailed information on the medical community, best software choices and help in creating a business plan and getting financed. From soup to nuts, this book includes everything you need to know about the medical billing field, starting a business and operating a medical billing service. It also comes complete with a CD-ROM offering forms and a business plan template. A must-have.

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  • Posted April 6, 2010

    How-to for a home-based business

    The healthcare industry is one of the fastest growing segments of the economy, and will continue to grow as the "baby-boomers" age. Medical billing is an essential service to health providers.
    This book is a complete and clear overview of medical billing. It explains well what is involved, the qualities someone considering this business should have, the various health services, spectrum of insurance coverage, medical terminology, and where to get certification or diploma. There is a section that details the daily tasks of a medical biller, and suggestions for professional organizations you might wish to join for ongoing support, information, and credentialing.
    This book also takes a step-by-step approach to the mechanics of writing a business plan, getting financing, marketing, hiring, training and motivating employees and tax considerations for the small business owner.
    Also covered are the resources and equipment that will be needed for this business, the costs involved, and a complete overview and review of software requirements. If you are considering a small business that can be started from home, and have the commitment to make it work, this book will be a valuable tool for a complete road map.

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  • Posted April 6, 2010

    Review of How to Open & Operate a Financially Successful Medical Billing Service

    Being a Graduate with a Medical Office Administration degree I cannot say that I haven't thought about furthering my education and opening my own business in the future. Ignorant to all that comes with the medical billing business, I read this book, and got wonderful insight on what decision to make!
    The amount of everything needed to consider a medical billing business is enormous, it takes and incredible amount of time, attention to detail, incredible work ethic and much more. From needing to know what insurances companies policies consist of, how to find the best medical coder and why, being HIPPA certified, to the simplest of thoughts such as; what pens are you going to use, or what furniture, and even who to employ. Also offered in this book is an overview on how to finance you business, what bank to use, what loans to use, how to do your taxes when the business belongs to you, and so much more for your convenience.

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  • Anonymous

    Posted October 18, 2010

    No text was provided for this review.

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