Medical Coding and Billing
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Tips For Medical Billing Business from Home

The gateway to your own homebased business is to start off small as a freelancer. Of course, there may be rules to consider, such as if you are still employed you may have a so-called noncompete clause in your contract. So, be aware and be informed. Furthermore, working on your own requires a job suited for working from home, a home suited for working in and self discipline to tackle any and all work the job demands.

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Starting Your Own Medical Billing Business - Part 1

« by Steve Verno, Certified Biller on: November 17, 2008, 05:01:52 AM »
 Starting Your Own Medical Billing Business  (Reprinted with permission) 

Steve is a Certified Master Medical Coder and Certified Master Medical Biller and Medical Coding/Billing Instructor. He also is the co-owner of Lucrum Consulting, LLC, which provides training in medical coding and billing issues, and helps physician's practices in areas such as A/R recovery, appeals, and staff training. Here is how Steve started his own medical billing and consulting services from home:

A Strong Foundation = Key To Success

"I've been working from home as a medical biller and independent consultant for six years. It started by working for the provider in his office, gaining his trust. It was his idea to let me work from home. I had to go through some of this due to Florida's requirements, but it helped me to get prepared mentally and financially - it was a way to do my homework beforehand."

Important steps to get started:

I went to my attorney and had my home and property zoned as home and business. I don't live in an HOA (Registration for Homeowners Associations (HOA). The Department of Planning and Zoning provides a registration service to Homeowners Associations). I pay my taxes as required. I do have a CPA to help me with my taxes. We bartered: he handles my finances and I resolve his medical bills and claims appeals for his child and family.

1) Check with your State Division of Corporations to see what is required and the costs involved. You may need to file State required filings such as a Fictitious Name Filing along with your paperwork to register your company with the State. The State may demand a bond be posted (again, this may differ per state). You may just have to register your business.

2) If you are going to be working out of your home, you need to see if you can do this. Where you live may not be zoned for a commercial business. Here in Florida, some home businesses are being shut down by the State because the location of the home business is zoned for residence only.

3) You need to contact the IRS for a Business Federal Tax ID number. Yes, you have to file and pay Federal and/or State taxes along with Medicare and Social Security Taxes.

4) You may be required by the city or county to have the location of your business inspected by the local firemarshall and/or someone from the City to see if your home is up to code before you might be issued a Certificate of Occupancy. You may need to do some repairs to your home such as adding fire sprinklers, creating emergency fire exits, or making your home accessible to the handicapped. Again, this would be a local requirement.

5) You may need a State, City, or County Occupational license before being allowed to do business in your home.

6) If you live in a homeowners association zone (HOA), you might want to check to see if a home business is allowed under the HOA articles, otherwise you could face fines, have your business closed down, or your home taken away from you by the HOA. Here in Florida, an HOA could foreclose on your home and sell it if you violate the HOA rules.

7) Check with your local Medicare or Medicaid carrier to find out their requirements. In Florida, a Medical Biller must enroll and obtain a Billing Agent Number. Medicaid requires a background check to be paid for out of your pocket. Next comes enrollment through their electronic claims submission department, which entails filling out their forms, sending a copy of your contract with the provider to see if it meet their approval, for example, no percentage billing with Medicaid and no checks to the billing company with Medicare.

Lets ask about you:

  • Where did you receive your billing training?
  • What were your scores in your classes?
  • Did you miss any training?
  • What were your strong and weak areas in class?
  • Are you certified with any organization?
  • If you have no experience, what can you do to overcome this?
  • Tell me what you know about my specialty?
  • What do you know about our State insurance laws?
  • Do you have the time to take a preemployment test.
Can you pass a background check?

You may never be asked any of these questions, but be prepared because doctors are getting smarter with who they want to work for them. Many places will give a preemployment test to see if you can do what you say you can do. I took five of them before being approved to work for my last provider. I also had to undergo two background checks. One by the service that hired me and the second through the provider themselves.

Check Your Finances

Make sure you are financially able to start your own business and to go a few months without any income as you do get started. In addition to what the State requires for filing and licensing, you will need to have some money for the following:

  • annual business filing with your State
  • marketing materials
  • office supplies/staples
  • computer and Printer/scanner/fax
  • extra phone line for phone, fax and answering machine
  • office supplies
  • billing software
  • training and/or certification
  • coding manuals
  • postage
  • claim forms
  • storage
  • car/gas
  • errors and omissions (E&O) insurance
  • CEUs and workshop fees
  • organization membership dues

Check Your Resources

Ingredients for success:

  • a detailed plan
  • education
  • experience
  • credentials
  • efficiency
  • determination
  • advertising
  • networking
  • industry specific know-how
  • the right equipment and software programs
  • a consistent client base
  • a boss who trusts and supports you


As you can see, starting a home based business is not easy. What I listed may not be all and inclusive of what you need to do to get your medical billing business up and running smoothly. Again, this is not Tupperware party, this is a serious business! Even though it can be difficult getting started, don't give up! Things open and close quickly.

-- Steve Verno, Certified Biller

NOW, ON TO PART 2: Marketing Your New Business

 

  1. Medical Billing a Viable Home Business?
  2. Marketing Your New Medical Billing Business
  3. Determining Medical Billing Fees & Service Rates
  4. Medical Billing Business Investment