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,...
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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 knowledgably 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 Word™) 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.This manual delivers innovative ways to streamline your business. Learn new ways to make your operation run smoother and increase performance. Successful entrepreneurs will appreciate this valuable resource and reference it in their daily activities as a source of ready-to-use forms, Web sites, operating and cost cutting ideas, and mathematical formulas that can easily be applied to their operations. The companion CD-ROM contains all the forms in the book, as well as a sample business plan you can adapt for your own use.
Introduction 11What is Medical Billing? 11Chapter 1 Industry Basics and Insurance Industry Overview 17Working With Patient Information 17Caregories of Health Services 19Insurance Options 22Insurance Verification 27Medical Ethics and Laws 28Getting Started in the Medical Industry 28Chapter 2 Organizations, Codes, and the Daily Duties of an MIB 33Professional Organizations 33Training and Certification 35A Day in the Life of a Medical Insurance Biller 44Claim Cycle 47Avoiding Rejected Claims 48Other Service Options 49Chapter 3 Medical Billing Reference Materials/Specifics 53Reference Materials 53Medical Coding 54Clearinghouses 58Start-Up Forms Needed 61Chapter 4 Software Choices 65Medical Claims Billing Software 66Coding and Reference Software 75Labeling Software 77Accounting Software 79Clearinghouse Options 80Chapter 5 Starting Your Medical Billing Business 83Diving into the Medical Billing Biz 83Researching Your Business Options 85Starting Your New Business Venture 86Trademark Registration 90Selecting a Business Structure 91Making a Commitment 99Goal Setting 103Chapter 6 Establishing a Business Plan 107Drafting Your Business Plan 111Creating Your Business's Financial Plan 118Chapter 7 Financing Your New Business 123Personal Savings and Certificates of Deposit (CDs) 124Credit Cards 125Obtaining a Loan to Finance Your Business 126Equity Investments 135Home Equity Loan 136Chapter 8 New Business Basics 139Work from a Home Office 139Work from an Office Away from Home 142Utilities 145Business Expenses 145Staying Organized 155Legal Considerarions 157Licenses and Zoning Requiremenrs 161Chapter 9 Operations 163Hours of Operation 163Accounting and Bookkeeping 165Profit Planning 171Leading the Company 173Chapter 10 Advertising and Marketing 175Developing a Marketing Plan 175Your Business Logo 177Finding Clients 178Direct Mail Campaigns 180Business Cards 187Cold Visits 188Referrals 189Following Up 189Building a Web Site 192Chapter 11 Working with Clients 199Meeting Prospective Clients 199Charging Your Clients Their Claim Fee 202Assessing Clients' Needs 205Handling Complaints 208Chapter 12 Expanding Your Business and Hiring Staff 211Hiring Employees 212Training Your Employees to Serve Clients 219Insurance Options 222Employee Evaluations 223Firing Employees 225Payroll and Keeping Track of Hours 227Respecting Everyone at Work 229Meetings 229Motivating Workers 231Conclusion 235Appendix A Sample Business Plan 237Appendix B Abbreviations 249Appendix C Resource Directory 261Online Resources 261Book Resources 263Appendix D Insurance Directory (For Business Insurance) 265Glossary 267Bibliography 277Author Biography 281Index 283
