starting your own billing company...2 | starting your own billing company: the five keys to doing it...

21 | Starting Your Own Billing Company: The Five Keys to Doing It Right

Starting Your Own Billing CompanyThe 5 Keys to Doing It Right


Table of Contents

Introduction01

Choosing Your Software02

Using Professional Services05

Associations and Memberships07

Marketing and Sales08

Customer Setup09


Introduction

There has never been a better time to start a billing company. The trend toward

outsourcing continues to rise and more and more providers are looking for ways to

cut costs and streamline their office procedures. Outsourcing to a billing company

is one of the main ways they are achieving this.

According to Black Book, 91% of practice managers fear that their practice will go

out of business using their current model. They are looking for an integrated set

of solutions to meet their needs. This represents a huge opportunity for billing

companies who can offer comprehensive solutions.

Follow this guide to starting a billing company, and you will learn to meet and

exceed the needs of providers, set yourself apart from the competition, and grow a

successful business.

82% of practices aim to integrate practice management, EHR, and outsourced billing with a single vendor.

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Practice ManagementThe days of separate systems and no transparency when using a billing service are

over. Practices today look to their billing company to do more than just the billing.

They are looking for more features such as help with patient management. You

want to think of your company as an integrated extension of their practice rather

than a separate office.

Every feature that you can add to help offices with patient flow and collections

will add value to your services and provide additional incentives for practices to

outsource their billing to you.

Practice Management Features to Look For:

• Customizable schedule

• Appointment reminders

– Email

– Phone

– Text

• Quick patient entry

• Individual & batch eligibility

• Credit card processing

• Access to reports and metrics

Choosing Your Software

One of the most important aspects of starting a billing company is to choose the

correct software system the first time. Having the right solution from the beginning

will allow you to hit the ground running , avoid big problems and changes down

the road, and ensure that you’re giving the practices you serve the tools they need

and want to not just stay in business but be profitable.

4 Must-Have Features for Your Software System1. Complete Billing and Practice Management

2. Multiple Practice Management Capability

3. Scalable

4. Integrated EHR

✔

✔

✔






BillingThe most important part of starting a billing company is to choose a system that

is going to help you get the billing out accurately the first time. You want a system

that works for you, not one that makes you hunt for the information you need to

do your job. And, make sure that your clearinghouse is integrated in the system

you choose. It will save you both time and money.

Billing Features to Look For:

• End-to-end claims management:

– Scrubbing

– >95% clean claims submission

– No Response alerts

– Denial alerts

– ERAs

• Patient Collections

– Credit card processing/credit card on file

– Paper & electronic claims

– Electronic receipts

– Online bill pay

DENIED

DENIED

DENIED

Patient balances now make up 30% of a practice’s A/R. This means that educating your practices on how to collect from patients at the time of service is crucial.






Multiple Practice Management Capability & ScalabilityYou may be starting out now serving only one provider, but you need to plan for

the growth of your company. You need a system that is scalable and provides you

with the tools to manage multiple practices. Look for software that will work for

one provider today, ten practices next year, and one-hundred practices five years

from now.

Tip: Choose a single system that can manage multiple practices and provides a comprehensive dashboard, one-time log in, and is designed with billing services in mind.

Why Choose Integrated EHRs?• Integrated EHRs improve billing, which is good for you and your clients.

• Less work and more money for everyone!

– Improve coding and overall accuracy

– Eliminate duplicate data entry

– Increase revenue by as much as $30k per provider per year

– Bill faster with electronic superbills






What do you need?

• Business license

• Insurance

– Liability

– Business interruption

– Office contents

– Umbrella policy

– Workers Comp

– Health/Disability/Life

– Employee Fidelity Bond

Professional Services

The next key to successfully starting your own billing company is to choose the

right professional help. Attorneys, CPAs, and insurance brokers are all people that

you are going to need to provide services for your business just like you provide

services for the physicians in the medical practices you work with. The most

important thing to remember is to find professionals you trust and then listen

to them.

Insurance & LicensesMake sure to check the requirements for running a business in your city. Even in

your home you need a license to operate a business. The fees and fines for not

being licensed while running a business can be steep and you don’t want to put

yourself out of business before you even get started.






Collections AgencyYou are not going to want to handle collections that are over 120 days. This means

that you will need to be able to refer your providers to a collections agency to

handle the process for them. It is a good idea to find two or three agencies in each

area that you have a provider to have on hand for referrals. Set up a contract with

them that spells out the policies on how information will flow from your office to

the collections agency. Make sure to choose a business that is well-established

and easy to work with.

Legal SupportAttorneys are not an everyday part of running a billing company. However, when

you are getting started or making any big changes in your business, you will want

to find good legal help.

What will your attorney help with?

• Review of your policies/procedures

• Develop/review client contract

• Help with choice of business structure

• Review office lease (if applicable)

AccountingRunning a business requires a huge amount of paperwork, from payroll to self-

employment taxes, and K1’s to 1040’s. A good accountant will help you decide on

the right structure for your business and keep your company running smoothly.

What will your accountant help with?

• Help with choice of business structure

• Tax ID

• Process for quarterly and annual business and employment taxes

$

$

$ $

Check reviews before you refer! H H H H HBefore you give a client a referral for a collection agency, be sure to check

references, ratings, and reviews. Google and LinkedIn are great sources

to make sure you only referring to the best possible companies.





• Offers training and several

certification programs

• $125/year per person (discounts for

students or more than six employees)

American Medical Billing Association

(AMBA – www.ambanet.net)

The AMBA’s focus is to provide industry and

regulatory education, networking opportunities,

and to share information and ideas on the

market for all their members. The AMBA also offers

a certification program to become a certified

medical reimbursement specialist.

• Since 1998

• Membership includes in office billers and

billing services

• CMRS certification

• $99/year with business membership

for over 3 employees

Associations & Memberships

Another key part of growing a successful billing company is finding the right help

and guidance along the way. A good place to find this is from some of the industry’s

top associations.

Healthcare Billing & Management Association (HBMA – www.hbma.com)

HBMA has thousands of billing company owners as members. They host

conferences and trainings across the county to help with networking and

advocacy training.

• Founded in 1993

• About 4,000 members, representing about 50% of billing services in the US

• Tools, resources, & certification and education program

• Annual dues are based on company size and range from $500 - $1500/year

American Association of Professional Coders (AAPC – www.aapc.com)

The primary focus of the AAPC is to provide education and professional certification

to physician-based medical coders and to elevate the standards of medical coding.

The AAPC is a great resource because they have local chapters, allowing you to

network with other billers right in your area.

• Since 1988, now has over 140,000 members

• Provides education and resources to physician-based coders






http://www.ambanet.net

http://www.hbma.org

https://www.aapc.com


Marketing & Sales

Sales and marketing is one of the

biggest challenges in starting your

own billing company and an important

key to your success. You have to get

noticed by providers that need your

services. When you are just starting out, you need to flood the area with your

name, your number, and your marketing materials.

Your first step is to create a professional-looking website. Think of your website as

your online business card. You will also need a Facebook page dedicated to your

business and a LinkedIn page to increase engagement with potential clients. Make

sure that all of these give interested providers multiple ways to reach you via email,

phone, etc… You want to make it easy for them to choose you.

The next step is to create marketing materials, such as brochures, that you can

send to the providers you would like to have as clients. Once you get your first

client, the best advertising is to do an amazing job for that provider. The referrals

you receive from happy clients will be a large part of your success.

Medical Group Management Association (MGMA – www.mgma.com)

MGMA is mainly for medical practice executives and leaders. This means that many

of your office administrators and office managers are probably going to be a part

of the MGMA, making it a great source for networking. They also provide many

studies and surveys answering questions you may have about the market, salaries,

and reimbursements.

• Industry leading practice management group

• Publications, research, resources, education

• ACMPE certification

• Cost ranges from $35 - $380

Local Chamber & BBB

It is very important to get involved and be a part of your local community. The best

way to do that is to join your local Chamber of Commerce or Better Business Bureau.

Your local Chamber and BBB will not only help you with networking and community

projects, but will also provide a wealth of resources for you as a new business owner.

• Chamber of Commerce

– Great opportunities to network

– Helps build reputation/awareness

• Better Business Bureau

– Look into your local/regional BBB

– Can get accreditation

– Access small business resources

Tip: Having a business Facebook page separate

from your personal page is crucial to presenting

yourself in a professional manner.





http://www.mgma.com


Include information on how the provider will get their data from you if they choose

to move to another billing company. How are they required to end their contract with

you? Is there a 30-day written notice or a 90-day written notice? What are you going

to require of them? How long do they give you to collect on claims that have already

been sent out? You must consider all of these things when writing your contract.

It’s also important to put in writing what is NOT included in your billing service.

List any fees and services that you are willing to provide that are not part of the

standard billing contract.

Going into a new contract is like any relationship. In the beginning it’s wonderful,

but when one of the parties ends up not being happy, it can turn confrontational.

So, having a contract that spells out exactly how to separate will help keep your

business on track as the relationship is ending.

Standard contract covers:

• Terms and conditions

• When payment is due

• What happens if not paid

• How does either party end the contract

• Responsibilities of each party

• Fees

• Any additional services

Customer Setup

Now that you know how to get your billing company started, you will need to know

what to do once you get your first client. You must have contracts ready to go,

forms for clients to fill out, and be prepared to answer the most common questions

potential customers may have for you.

ContractsThe first and most important thing is your contract. It is an outline of how you are

going to proceed after the provider chooses you as their biller. Make sure that your

contract not only gets you into business with the provider but also accounts for

how you’re going to end the relationship in detail.






Customers will ask these questions. Be prepared to answer!

• What does the service cost?

• Can you provide references?

• Who owns the data?

• What is the background/training of billers?

• What are your professional affiliations?

• Do you have a compliance plan?

• Who is going to be working on the account?

• How often will you communicate with the practice, send reports, etc.?

• Are most or all services electronic?

• What service don’t you handle? (i.e., past A/R, collections, etc.)

FormsYou will need to have a standard practice set-up form prepared for your initial

meeting with the practice manager. This will allow you to gather all the information

you need for customer set-up at one time.

Practice Setup form covers

• All info needed to set up with clearinghouse/payers

– NPIs

– EIN

– Location, address, and hours

– Appointment types/times

– PTAN number

– Insurance ID numbers for each provider

– Fee Schedules (if they have them)

Customer ExpectationsBy the time they call you, most offices are 60-80% of the way through their

research on which billing company to choose. At this point, they have checked out

your website and looked at your Facebook page and LinkedIn profile. If you can

answer their questions during the phone interview right away and in a professional

manner, they will feel more comfortable with you and will be more likely to choose

you for their billing needs.

Tip: Use this list of customer questions and answer them on your website to give providers one more reason to choose you!






About Kareo

Kareo is the only cloud-based medical office software and services platform purpose-built for small practices. At Kareo, we believe that,

with the right tools and support, small practices can do big things. We offer an integrated solution of products and services designed to

help physicians get paid faster, find new patients, run their business smarter, and provide better care. Our practice management software,

medical billing solution, practice marketing tools and free, award-winning fully certified EHR help more than 30,000 medical providers more

efficiently manage the business and clinical sides of their practice. Kareo has received extensive industry recognition, including the Deloitte

Technology Fast 500, Inc. 500/5000, Red Herring Top 100 Company, and Black Book #1 Integrated EHR, Practice Management and Billing

Vendor. Headquartered in Irvine, California, the Kareo mission is to help providers spend their time focused on patients, not paperwork. For

more information, visit www.kareo.com.

Follow us:

twitter.com/GoKareo

facebook.com/GoKareo

linkedin.com/company/kareo

http://www.kareo.com/practice-management

http://www.kareo.com/medical-billing

http://www.kareo.com/doctorbase

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