Is medical billing a viable business? YES, it most definitely is! Unfortunately, there are many companies who misrepresent our profession. Statistics show that more than 80% of consumers fall victim to a misleading classified ads or internet opportunity for medical claims processing. This not only hurts the consumer who is misled down a path they believe will be instantly profitable, but it discredits the industry and those who have established their companies and have labored their way to where they are today. You will not get rich overnight, if at all! What you lack in experience MUST be made up with knowledge. If you do not research and educate yourself, you will not succeed! How much money you make cannot be determined by ANY vendor! Only you can make it happen. If a vendor proceeds to give you earning claims, then you tell them to back it up. By law, they have to!
Before we get into what medical billing is really about, we should tell you that our priorities are not just focused on the medical biller or medical billing company, we also take great pride in our work in educating medical biller’s for the many health care providers out there. In fact we tell doctors What to look for in a medical biller as well as give them a detailed job description of a medical billing specialist. With this in mind, you cannot afford to go into this blindly!
Healthcare Providers are our business too, It’s THEIR MONEY!
PMRNC is dedicated to the FACTS behind medical billing. We won’t tell you this business is easy and we won’t be referring you to a company who tells you this is easy. Medical billing, more accurately stated, is practice management and is a career that provides a valuable service to healthcare professionals. It is not as simple as purchasing a medical billing software package, taking a course, sending out flyers, letters or a resume. Healthcare providers do not hand over their receivables and financials easily. The services you will provide to your client not only put money in your pocket, but your provider’s income depends on YOUR knowledge. Doctors need to be convinced you are up to the task!
A professional billing center/practice management company is responsible for obtaining reimbursement for health care providers. This is your prospective client’s bread and butter. This is what pays their mortgage and feeds their children, just as your business or career is intended to do.
What sets you apart from other companies offering this service? What makes you different? Knowledge! Staying on top of industry changes, understanding what it takes to create consistent and maximum revenue, as well as a strong commitment to ongoing education within an ever-changing insurance industry. You must be prepared to learn every day! You must be committed to ongoing changes, education and compliance!
Consider this: Perhaps you have already purchased your software and supplies. You sent out your marketing materials, sent resumes and completed job applications. After a reasonable amount of time and effort, you still get no response. You need to re-evaluate your marketing methods. Your marketing efforts, whether you are a business startup or just looking for a job, should reflect not only your professionalism, but your expertise. Would you hire someone to do your taxes who just ran out and bought a tax accounting software, but neglected to educate himself or stay up to date on current tax laws? Of course not! If you are going to offer a service to a professional, then you must be a professional! Purchasing a medical billing software does not make you a medical biller, just as purchasing a tax software does not make you an accountant.
We told you that we wouldn’t fluff up this business and we meant it!
Once you decide that you want to pursue a career in medical billing, let’s take a look at the first nine steps for building the foundation and paving the way to becoming a medical biller, practice management expert, medical billing company, or healthcare administrator!
Our resources are built upon years of experience in cooperation with other professional billing services and vendors. We took all the hard knocks when we first started, and we are here to help you avoid potentially devastating pitfalls. We stay on top of the industry and make it accessible to you in ONE place! Our Learning Center and Getting Started pages are just the beginning! Once you are established, you’ll still find yourself coming back for more! We offer discounts to subscribers on such things as practice management software, clearinghouse fees, professionally designed marketing material, web design, hosting, claim forms, envelopes and other supplies. Become part of an incredible network of people just like you and those who have been around awhile. Continue chatting with the many new friends you will make. Our site is not just a website, we are a community of professionals sharing our knowledge and guiding each other through the trials and tribulations this industry presents! We have made valuable contacts and networking buddies through the years and we feel that’s such an incredible source of support!
- Get on your local Medicare’s mailing list for seminars and newsletters. Go to all the seminars your carriers give in your area. Do the same for Medicaid and Blue Cross/Blue Shield.
- Research the zoning laws regarding starting a home-based business. You would be surprised to know that many municipalities do not allow home-based businesses to operate from a residentially zoned neighborhood.
- Research business names. Visit your local township or municipality to find out the process in researching trade names. Make sure you also check to see if your state requires registration of third party medical billing companies. NJ is one such state.
- When you look for educational resources and software/training, look for a company who has been in business longer than 10 years, check their BBB report, the FTC and yours and their State Attorney General’s office. Be prepared for start-up costs realistically being $3,000 to $5,000 total. Many people start out slowly and build their business one step at time, so that the costs are not all consuming. We know many billers who have signed on with Temp Agencies and some have taken part-time jobs at doctors office and insurance companies. Not only does this help you obtain the funds for start-up, it’s a great way to get hands-on experience and add to your resume!
- If you decide to go for a online medical billing courses, make sure you ask for several references. Ask about ongoing support for the program and ask when it was last updated. Does it contain general coding issues? Will it help you learn about the various types of managed care? Will it help you in setting up your home office? Will it teach you about HIPAA and touch on OIG compliance? There are some good home study programs and there are some bad ones as well. Make sure you research these just as thoroughly as you would your software and training. Ask the company to give you a list of references, network with other billers and speak with them about the courses they have taken.
- Get Certified! Certification tells your prospective employers or clients that you are not only capable of handling their practice management and medical billing needs, but that you are committed to continued education. Check out PMRNC’s certifications. We offer the C.H.R.S. (Certified Healthcare Reimbursement Specialist) exam which is completely open book and open resource. A very challenging certification which will set you apart in the industry. We also offer the C.H.I.S. (Certified HIPAA information Specialist) which is another challenging exam that is also open book and open resource and focused on the extreme importance of HIPAA and what a medical biller MUST know about HIPAA.
- NETWORK! We can honestly say that if it were not for the support we have received from various networking groups, we would not be where we are today. Networking is the key to building better business relationships, a way to share and gain valuable knowledge from others who have walked in the same shoes you are walking in. We have a complete list of many medical billing networking groups, associations and discussion forums located on our site. You can never have too many resources!
Is this all there is? No, it’s not! There is so much more to this business … which is why we created PMRNC and all of our resources!
You asked “How do I get started”? We gave you the first 9 steps! You asked “Is this business viable”? We answered yes and proceeded to explain some pros and cons. The next steps are yours to take. Our members only area has a very large “getting started” area with a lot more resources you can use to help get YOU started! Should you choose to become a PMRNC member, we will be there for you and we will grow with you and support you through your journey!