Medical Billing Businesses

Have you thought about starting your own medical billing business?

There is a great demand for medical billing businesses due to the fact that the paperwork associated with filing insurance claims is putting undue burden on physicians’ ability to practice medicine in earnest.

Whether you are considering the medical billing business as a career option or have already determined that it will be your business, it is advisable to have a definite understanding of what the medical billing business is and how it operates.


In a nutshell, medical billing businesses help doctors get the money owed to them from the insurance companies that provide coverage to their patients, as well as from the patients themselves. As simple as this sounds, it is a tedious process that is labor intensive. Virtual mountains of paperwork can be generated for every single patient within a physicians’ practice or care.

If a doctor’s office has minimal staffing, a great deal of the time, that staff will be skilled in and devoted to assisting the doctor in treating the patient. However, the growing administrative demands of billing have forced many physicians to hire office managers or billing specialists simply to process the paperwork associated with bringing revenue into the practice. Many doctors either cannot afford this or prefer to use the services of a third-party entity to handle the claims/billing process. This is where your medical billing business could be of service.


Medical billing professionals provide these seven services at a minimum:

1. Prepare claims for submission to all insurance companies pertaining to the treatment of a patient. Claims can be filed on paper or electronically.
2. Enter patient data into medical billing software. Keep in mind that you will have to observe laws and guidelines governing patient privacy.
3. Provide collection services to the physicians’ practice. These services include following up on outstanding insurance claims as well as following up with patients who have balances due.
4. Post payments to the medical billing system as received.
5. Handle all patient billing questions and comments.
6. Keep patient billing records accurate and up-to-date.
7. Provide billing reports to the doctor on at pre-determined intervals and as requested.


Starting a medical billing (also known as claims processing) business is no different from starting any other. There are basic principles of business start-up that must be applied in order to set the business upon the proper operational foundation and to position it for success.

Early start-up assignments and considerations one should make include:

1. Write a business plan.
2. Determine tax entity.
3. Decide on home-based operation or work from location other than home.
4. Complete business licensing.
5. Secure education and training.
6. Engage in marketing and networking.


The successful operation of a medical billing business hinges on the use of sophisticated medical billing software, designed specifically to handle the processing and the contact management associated with the process.

At its minimum functionality medical business billing software must be able to accommodate each of the seven essential functions of a medical billing business described above. The software must also be scalable to accommodate for the future addition of patients and their related claims.


Those in the medical billing business have to establish and maintain relationships that is based on trust.

Doctors use a third-party billing service to alleviate administrative headaches, so they have to be able to trust their service to do this. The medical billing professional has to trust a physicians’ (the client) to provide timely and accurate information to facilitate the prompt and accurate filing of claims.

The medical billing business is predicated upon an exhaustive exchange of information that, ultimately, serves the good of both parties by helping each to do their jobs better. This reflects on the quality of care that a physician is able to give to each patient.