Start Your Own Medical Claims Billing Service

Overview


Low startup requirements make this a great homebased business!

As insurance regulations and paperwork requirements get more complicated, doctors and other health care providers are turning to third-party billing services to take care of their billing needs. It’s a multi-billion dollar industry that’s growing like never before, creating a growing niche for entrepreneurs who are experts at tunneling their way through the paper avalanche.

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Start Your Own Medical Claims Billing Service

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Overview


Low startup requirements make this a great homebased business!

As insurance regulations and paperwork requirements get more complicated, doctors and other health care providers are turning to third-party billing services to take care of their billing needs. It’s a multi-billion dollar industry that’s growing like never before, creating a growing niche for entrepreneurs who are experts at tunneling their way through the paper avalanche.

With expert advice from medical claims billing professionals and the latest industry information you’ll learn everything you need to know to get into this perfect starter business including:

• Researching the market
• Calculating startup and operating costs
• Finding clients
• Getting referrals
• Demystifying medical jargon
• Dealing with insurance carriers
• Telecommuting options and online work
• Professional networking

Startup requirements and costs are minimal, opening the door for anyone to get started in this lucrative field.

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Product Details

  • ISBN-13: 9781599184449
  • Publisher: Entrepreneur Press
  • Publication date: 5/11/2012
  • Edition number: 3
  • Pages: 206
  • Sales rank: 644,285
  • Product dimensions: 6.90 (w) x 8.90 (h) x 0.50 (d)

Meet the Author

McGraw-Hill authors represent the leading experts in their fields and are dedicated to improving the lives, careers, and interests of readers worldwide

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Table of Contents

Preface xi

Chapter 1 Prescription for Success 1

The Doctor's Key 2

Not a Small World 2

Preventive Maintenance 4

The Problem 4

Electronic Filing Beats Paper 5

Software Magic 5

Skimming Along with Superbills 6

Counting Your Coconuts 7

Crank-Up Costs 10

The Rock of Gibraltar 10

The Right Stuff 11

Move Over, Miss Moneypenny 12

People Skills 12

The Great Debate 13

Starting Over 16

My Friends, the Doctors 17

Summing Up 18

The Prognosis 18

Chapter 2 Health Insurance 101 19

Who's Who in Insurance 20

Commercial Carriers 23

Those Dang Deductibles 23

The Big Three 25

The Blues 25

Alphabet Soup 26

Muddling through Medicare 28

Part B Particulars 30

Accepting Assignment 30

Oh, That Medigap! 32

Medicaid 32

TRICARE 33

Workers' Compensation 33

The End, Finito 35

Chapter 3 Day to Day Operations 37

Good Morning, Medical Biller! 38

Practice Particulars 39

The Nitty-Gritty 40

Secret Decoder Ring 41

Verify and Clarify 47

In the Groove 48

The Diagnosis Code Dirt 50

The Denied ICD-10 Code 51

Just the Fax, Ma'am 52

Organically Organized 54

The Instant "A" 55

The Old-Fashioned Way 57

Submission Time 57

Playing the Insurance Game 58

Winning the Game 60

Time Juggling 62

Chapter 4 Diagnosing Your Market 63

Tripping Doctors 64

Does Size Really Matter? 66

What's My Niche? 67

Starting from Retiring 68

Go the Extra Mile 69

Up Close and Personal 70

Ready, Willing, and Able 70

The Economic Pulse 71

Have Modem, Will Cybertravel 72

The Competition 73

Nosy-Not! 73

Shopping the Competition 75

Chapter 5 X-Ray of a Medical Billing Business 81

Name That Business 82

Buffalo Bill(ing) 84

The Fictitious Business Name 84

Your Skeletal Structure 85

Home Zoned Home 86

Strange Fees 87

Loose Lips Sink Ships 87

HTPAA, HIPAA… Oh No! 87

Your Business Gurus 89

Chapter 6 Pain Management: Figuring Your Finances 91

Startup Costs 92

Computing Computer Costs 92

Fax Facts 93

The Skinny on Software 93

Clearinghouse Costs 93

By Way of Reference 94

Phone Fun 94

Please Leave a Message 94

Office Supplies 95

Postage 95

Postage Meters and Internet Postage 96

Adding It All Up 96

Talking Money 97

Per-Claim Jumping 98

Counting the Hours 99

Operating Expenses 100

Cuckoo for Clearinghouses 101

Paying the Piper 103

Ole for Online Service 103

Putting It All Together 104

Help from Your Friends 104

Romancing the Bank 105

Chapter 7 Medical Center or House Calls: Locating Your Business 109

The Home Office 110

The Tax Man Speaketh 110

Growing Pains 111

Let's Make a Deal 111

Alternative Officing 111

The Medical Complex 112

Portrait of a Home Office 112

The Outside Office 115

Chapter 8 Employees, Insurance, and Other Facts of Life 117

Hired Hands 118

Slave Labor 119

The Temp 120

Insuring Your Gems 120

The Error of Omitting 121

Forward to the Basics 122

Chapter 9 Your Operating Theater: Equipping Your Business 123

Computer Glitterati 124

Monitoring the Monitor 125

Flashy Drives 125

Purring Printers 125

The Fax for You 126

Soft on Software 126

The Business Opportunity 128

Clearinghouse Check-Up 129

More Software 130

Hello, Central 132

Automated Answering Service 132

Vociferous Voice Mail 133

Rah-Rah Reference Manuals 133

Form-Fitting 134

Laugh at Lightning 134

Lightning Strikes Again 135

Cool and Calculating 135

Paper Cloning 135

Chapter 10 Blowing Your Own Horn 139

People Will Talk 140

The MTB Letter 141

At 'Em Advertising 142

(Cold) Calling All Clients 144

The Doctor's World 144

Handle with Care 146

Capture That Client 147

Percentage Pow! 148

The Per-Claim Pitch 148

You Must Remember This 149

People Who Need People 150

One Singular Sensation 151

Public Relations Patter 151

Are You Being Served? 157

Kill Them with Kindness 157

Chapter 11 More Pain Management: Controlling Your Finances 159

Making a Statement 160

Dud Doctors 161

The Tax Man Cometh 162

Chapter 12 Operating Successfully or Pulling the Plug 167

Ground Zero 168

The Quality of Life 168

Appendix A Medical Claims Billing Resources 171

Appendix B Medical Claims Forms 177

Glossary 197

Index 205

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