March 7, 2023

How to start a medical billing company

With a positive industry outlook, you can start and grow a medical billing company by following these simple steps.

Medical billing is a service in high demand, so setting up a new billing company is a smart business move. According to the U.S. Bureau of Labor Statistics, employment for medical records and health information technicians — under which medical billers are classified — is expected to grow 11% from 2018 to 2028. This rate is much faster than the national average for all occupations.

In a Tebra study, 96% of medical billing service companies expect their organization to grow over the next year or at least remain stable. Some forecast revenue increases of over 20%.

This projected outlook is partially explained by the healthcare billing system’s growing complexity. Of surveyed physicians, 54% report that time spent on administrative tasks related to generating bills and collecting payments is a major problem for them. As a result, the demand for outsourcing medical billing has steadily increased. 

For those looking to establish a medical billing business, the future is bright. If you get started with a firm foundation, you can position your billing company for growth.

“96% of medical billing service companies expect their organization to grow over the next year or at least remain stable. Some forecast revenue increases of over 20%.”

"The State of the U.S. Medical Billing Industry" Report


Starting a new billing company

Every new business venture has a few things in common, and a medical billing business is no exception. You’ll want the right tools, relevant services, and ways to stand out. 

Choose the right software

Medical billing software selection is one of the most important decisions you’ll make when starting your small business. 

Your software should be a central platform where virtually all your billing operations are executed and controlled. Choosing one with all the necessary capabilities (and more) will help you to satisfy your clients and avoid problems down the line. 

First, the software should provide end-to-end claims management and the entire patient collections process accurately, with minimal effort from you. It should also accept multiple payment types, especially secure digital payments, as these are increasingly popular with patients. 

Next, many practice owners expect billing companies to handle not just bare-bones medical billing, but also practice management services and processes like scheduling and insurance eligibility verification. The top add-on medical billing services today are:

  • Chart audits
  • Practice technology support
  • Credentialing
  • Payer contract negotiations
  • Compliance consulting
  • Practice marketing consulting 

The best medical billing software may support some or all of these add-on services. 

Finally, you won’t always have 1, 2, or 3 clients. The software you choose should help you scale up quickly as you grow. The last thing you want is for your tool to become slow, unusable, or restricted as you attract more clients. 

Get your business license

Regardless of how small you intend to start out, you need to obtain a business license to run a medical billing company. It’s also best to get this out of the way early on to avoid fines, fees, and regulatory challenges later. 

However, before you apply for a license, be sure to conduct thorough research on your state and city requirements. 

Select a pricing model

Deciding what to charge can feel overwhelming. However, the way you price your services will determine how much money you can reinvest in customer acquisition and grow your business.

That said, there are only 3 models: percentage pricing, claims-based pricing, and hourly pricing. The most popular model, by far, is percentage pricing, and of those who use it, 1 in 4 medical billers charge 6% to 7% of collected revenue per month.

Some additional questions to ask yourself are:

  • Should you charge a set-up fee for new customers?
  • Will you require a minimum monthly volume for customers?
  • What is the regular invoice or claim volume for your customers’ specialization?

Set up your back office

There are multiple back-end processes involved in running a billing company that don’t have anything to do with billing itself. You’ll need insurance policies and coverage, legal counsel to draft and review your contracts and policies, and accounting services, just to name a few. Furthermore, an accounting service can help you choose your business structure, manage your company’s books, and handle your taxes.

To accelerate startup time and streamline your operations, it’s often helpful to partner with trusted professionals or reputable companies that offer these services — preferably with experience in the medical billing industry.

It can also help to form relationships with reputable collections agencies to which can refer clients for collections that exceed 120 days.

Join industry associations

If you lack the right kind of support and access to information, it’s easy to make avoidable mistakes. Established associations and organizations can help by providing you with sound guidance and access to valuable resources. Some of the industry’s top associations include:

These associations also offer networking opportunities, and some host training sessions. They all have varying membership fees that are typically charged annually.

Market, market, market

Customer acquisition is crucial to the success of any new medical billing company. You may have locked down every other aspect of establishing your business, but you need at least one customer to get things off the ground. 

And the best way to start is through differentiation. There are really 2 methods to stand out as a new medical biller:

  1. Select a medical practice specialization.
  2. Offer relevant billing and practice management services that relate to that niche.

Next, aim to make medical practices aware of your company and its services. You will need to employ marketing strategies to achieve this, with the first being to build a professional website. Then, create social media pages on different platforms that you can leverage for engagement. In addition, seek out a reputation management system that asks your customers for reviews and displays them on your website.

You can also create print marketing collateral like brochures, leaflets, and flyers to distribute to physicians and practices. Make sure to engage with practices, rather than simply dropping off your materials. The website, social media pages, and marketing materials should all contain open, up-to-date contact information through which interested clients can reach your company.

Once you land your first client, others will likely follow.

Prepare your client onboarding process

Make sure your client onboarding process and tools are ready before you seek out any new clients. That way there’s no delay between when potential clients show committed interest in using your services, and when they sign on the dotted line. 

You should have contract templates that cover terms and conditions, party responsibilities, and termination provisions, among other things. You also need forms to collect requisite and essential practice information from new clients. 

Finally, consider drafting an onboarding document that covers expected client questions, such as what your background is, if you belong to any associations, all the services you offer, and what client-biller communication structures you have in place.

Grow your billing company

Once your billing company is operational, the next point of focus is growth and expansion.

Manage your online reputation

Your company’s online reputation significantly affects your client acquisition ability. Audit your reputation by looking for mentions and profiles of your company on the internet. Leverage positive reviews to get referrals and address negative reviews as quickly as possible. 

Increase your service offerings

Integrating services like practice management, marketing, and patient engagement into your core offerings allows you to present your company as a one-stop solution for practices. And the software you choose is integral to your ability to make these business-growing additions.

“The software you choose is integral to your ability to make these business-growing additions.”

“I think of Kareo as more of an ecosystem than a platform because it has made us more creative in what we can do for our clients and lets us customize their individual experiences with us,” says Bob Trotta, CEO of Medical Claims Billing, who was able to expand his company’s service offerings by switching to Kareo, a Tebra company.

But are there services that do better than others? Here are some of the most popular services among high-growth companies:

  • 91% include appeals services
  • 84% include patient support
  • 38% include practice technology consulting or support 
  • 31% include credentialing 
  • 31% include compliance consulting 
  • 22% include marketing consulting 

Stay in the loop

The best way to launch a successful business is to research current strategies and review what high-growth billers are up to. We did that research for you. 

Read all the opportunities and challenges billing companies are experiencing in Tebra’s 2023 “The State of the U.S. Medical Billing Industry” Report. 

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