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Do Your Homework
The following checklist contains some of the more important factors you should consider when making decision to start a medical billing business: Do you have related or similar job experience?
Have you ever had or ran your own business before?
Do you have an interest in running your own business?
Are you a quick learner? Do you have good common sense?
Are you self-motivated, organized and willing to work hard?
Are you a self-confident person?
Do you feel you can you work with Doctors, and other healthcare professionals?
Do you have a business partner or will your spouse be a partner?
If your spouse is going to be your partner, will that present any problems?
Do you have any experience related to this business? ex: insurance, nursing? Have you figured out how much money you will need to start and run your business?
How much money do you expect to earn from this business?
How much time are you willing to devote to this business?
Do you have any knowledge in any related fields like accounting, or collections?
Are you willing to learn more either through additional training, reading or taking classes or free seminars?
Do you have any computer knowledge? If not, are you willing to learn?
Are you good at talking with people? Are you a good negotiator?
Are you intimidated easily? Do you fear rejection?
Can you accept advice and criticism from others?
Do you have related or similar job experience?
Only you can answer these questions. If you feel you have what it takes to be your own boss, and you have definitely made the decision to go into business for yourself, there are a few more considerations:
Have you gotten a report from the Better Business Bureau?
Did you check any references provided by the company?
Are getting the most products and services you can for your money?
Do you feel the company is on the level with you?
Are you comfortable in making a "yes" decision?
If you are not comfortable in making a "yes" decision, do some more research! Below are some additional tips for making an informed business decision.
Don't neglect to contact the Better Business Bureau (BBB) to obtain a report on a company. If the report indicates there have been some complaints, check to see if the company was responsive, whether or not the complaint(s) were resolved and how quickly.
Additionally, check to see if the BBB felt the complaint had significant merit. If you get a recorded message, ask for a return call or try to speak with a real person who may be able to be of even more help.
Not only should you check with the BBB in the nearest large city of your state, but also with the BBB in the nearest large city from the state in which the opportunity is being offered. If you live in Dallas, Texas, and the company offering the medical claims opportunity is located in Los Angeles, California, call the BBB in both cities.
In order to check on a company, you will need the area code and direct dial phone number of that company. Most times, an 800# will work but you may need a direct call number.
Evaluating A Better Business Bureau Report
If a company has no complaints against them with either BBB office, that would definitely be a bonus. When a company has less than 2 or 3 resolved complaints total, you should be somewhat concerned. Ask the company what the nature of the complaints were, and how they resolved them. Use caution, though. The answers you get may or may not indicate a possible problem area.
Good common sense will help you sort through your responses. Finally, bear in mind that not all salespeople of a company with complaints will honestly answer your questions when confronted with a "poor report." Often times, they will tell you minor details or conflicting facts that sound plausible, but may be far from the truth.
If the company has several unresolved complaints, clearly, you should deduct some credibility from them. Depending upon the results you obtain, you may, at this point want to cross that company off your list of possible choices, however, if the company has a favorable rating from the BBB, move on to the next step.
Clearinghouses are a major part of a billing service's ability to conduct business. Your professionalism and reputation depend on aligning yourself with a reputable clearinghouse.
What exactly does a clearinghouse do? Well, for one thing, they check claims for accuracy. But, the biggest thing they do is re-format the data you send to them to a format that a given carrier can read.
Clearinghouses charge fees in many ways. Some charge an initial start up fee to the billing service ranging from $125 to $300. Others are free to sign-up with initially. Some charge a provider enrollment fee for every healthcare provider you enroll, while others don't. Most of them charge a per claim fee of some sort, depending upon the carrier.
In the last couple of years, clearinghouses have adjusted their fees to the advantage of billing services. Many only charge for Medicare, Medicaid and Blue Cross/Blue Shield claims, while major commercial carrier claims are free in some cases.
If a company tells you they are their own clearinghouse, BEWARE!!! That means you are tied into them, and can't use any other clearinghouse. What happens to you if they go out of business? You'll have to buy new software so you can make your own connection with a different clearinghouse.
These days, you can find a company that offers you many choices in clearinghouses. You may need two or more for medical claims and another for dental claims. The point is, be sure your options are many, not few.
What kind of training does a company offer? Is it live, or is it on video. If it's video, make sure it's not just software training. Many companies will try to slide that one by you. Some companies concentrate their training on Marketing &Prospecting, while others teach mostly software. A combination of both would be ideal.
Many companies now offer online training. This is a great alternative to travel
and lodging expenses and may be something you want to consider.
Networking with others and the interaction will stimulate your motivation. You will start your company off at a distinct disadvantage if you do not obtain training since there is a LOT to learn about medical billing. We can't stress training enough!
Consider getting certified in medical billing or coding.
Beware of courses or companies that tell you certification is worthless.
Certification is optional and is not required by any state or Federal
Government. However, healthcare providers often view certification as a positive
and credible assurance of skills and professionalism.
The larger vendors sell a license to use their software and products. You won't actually own the program if you purchase under a licensing agreement. Smaller vendors actually sell you the software without licensing you (my preference).
While it is against FTC regulations to limit you to a particular territory or even tell you there are a limited number of licenses available in your area, some do. Most of them have marketed heavily in targeted areas via newspaper ads. Knowing how many licensees (or consumers) a vendor has sold to in your area would be worth knowing.
Ask the company these questions:
How many licensees does the company have as a total?
How many active licensees do they have in your area?
How many in your state?
How do they determine how many licensees they put in a particular area?
Consider how long the company has been in business and compare that to the number of licensees they claim to have sold to. Some of the large vendors have been claiming they have 2,000 for the last several years. They wouldn't want you to know they have a lot more than that.
If you are told by a vendor that you have to go through their approvals committee before you can become a licensee, don't believe it. Some companies tell you that, but they accept every person who wants to buy.
Web Based or Internet Based Software
Some companies provide web based
or online billing software products. You will have to consider the cost to use
this type of service vs. buying a software product that you own and have control
over. With these types of companies, you will not have control over your data
backups, and some do not allow the biller to have access to their own data if
they part ways. Again, this will be a matter of what is going to work best for
you for the cost.
Your new business will require that you have some sort of technical support for marketing and software use. Does the company you are considering offer support? Can you renew that support after it runs out? Will you call on an 800 line, or will support be provided by email? These are just some of the questions you should be concerned about.
GET A DEMO! See for yourself what the capabilities of the software are.
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