Starting A
Medical Billing Business

Starting a medical billing business can be an interesting business opportunity.  

While this appears (on the surface) to be a very technical business that might require a great deal of education and discourage you from considering this business idea, this is not necessarily a fact! 

This can indeed be a business which can be an awesome idea for the small entrepreneur wanting to start a business from home and yet may have little or no experience in the medical industry. 

While there are training/skills required to be successful (as with most businesses!),  it actually is less technical than you might initially think? 

How's that . . . ???

Medical billing often gets confused with medical coding or medical transcription. These are different fields and the knowledge required in these two areas is NOT required to start a medical billing business.

As the medical industry continues to grow and change, it is becoming more common place to outsource this responsibility to another small businesses (such as yours!). 

Starting a medical billing business allows you to offer your services to other small clinics and doctor's offices who are also small businesses and don't have the time to manage the process of the billing side of their business. You can step in and provide your doctor clients a degree of confidence knowing this important task is being handled professionally and timely.   

And since you do not have to spend a lot of time learning medical terminology or complicated coding charts, you can focus on learning the important skills of industry -- billing standards, the Health Insurance Portability Accountability Act (HIPAA), learning the industry billing forms/systems, different types of health insurance, etc.  

If you already have training in medical billing, (from working in a doctor’s office or clinic), you may be ready to start your business now.  

If you’re interested in learning the medical billing profession from instructors who are actually practicing n the industry, I would recommend checking out who provides extensive training in medical billing using educators who are medical billing business owners and specialists (not just someone who read the book and is now teaching a class even though they haven't even operated a medical billing business!). 

The instructors are knowledgeable and they provide terrific student resources including a group forum where you can ask specific questions and get valuable answers as you learn. 

You may already be aware the medical coding field is in the middle of some radical new changes being mandated by the U.S. Department of Health and Human Services (HHS) which must be implemented by October, 2014. 

Don't let these changes scare you away from taking a serious look at this business idea. That's because the medical coding is always done in the medical office by the doctors or coding specialists – this is not what you'll need to know as you're starting a medical billing business. 

Take a look at this interesting Medical Billing Infograph for a good idea of the work flow and processes required to be successful as a medical biller.

And you also don't need to be intimidated if you don't have an in=depth knowledge of medical terminology (something which I personally would find overwhelming to learn). So you ask, what will I be doing when starting a medical billing business? 

Good question . . . .

When starting a medical billing business, you’ll actually be entering patient information and billing codes (received from your doctor clients) into a billing system. This information is then submitted by you to insurance companies and/or clients for payment. Once payments are made, you post the payments in the system, and finally run management reports for your clients.  These are the routine tasks of a medical billing expert. 

N2 - Niche Notes

Niche Notes!!

You can target a variety of different medical professions of specialize in a certain area of medicine such as: 

1) General Practice

2) Dentistry

3) Pediatrics

3) Pathology

4) Physical Therapy

5) Cardiology

6) Psychiatrist

7) Cardiovascular

8) Neurology

9) Orthopedics

10) Occupational Health   

Starting a Medical Billing Business - What's It Take?


  • Medical billing training (don’t get confused with terminology and coding information!)
  • Computer and Practice Management Software skills
  • General accounting knowledge
  • Organization skills
  • Communication skills  


You’ll want to identify a work/office space where you can work comfortably.  You'll also need a good quality computer, phone, fax, and industry practice management software.  If your records are stored in hard copy, you’ll also need to have file storage which meets HIPAA requirements.

Make sure to compare training companies to make sure you’re getting the best training for your business. The different schools I've found range from several hundred dollars to tens of thousand of dollars.  

When you're starting a medical billing business, I recommend you look for a software package that will grow with your business, possibly once that will charge based on the size of your business vs. a flat rate to keep your overhead costs lower when your getting started. 

Make sure to factor in all training costs (if applicable) associated with learning the software in your initial cost estimates.  And make sure you'll have terrific customer service, training, and technical support to keep your business on track and minimize technical difficulties.  I also find the use of multiple monitors to be extremely important and increases my productivity by 200% (or more) when doing computer work.  

Time Required:    Part Time 15-20 hrs/wk; Full-time 30-40+ hrs/week


There are a variety of training options depending upon your goals.   I would recommend any training you consider, provide you with the Certified Medical Billing Professional (CMBP) Designation.   This will give your clients a great deal of confidence that you have the training and skills to handle their billing.  

This is a side of the medical profession that many doctors despise!  You can present yourself as a professional to doctors, nurses, and other clinicians – and this is a field with lots of educational degrees so it will help with credibility and possibly give you a competitive edge     

Market:                Private Practice Doctors, Health Clinics

Home Based:       Yes

Internet:              Yes

Location:              Local, Regional

Start-Up Costs:    $1,000 - $5,000

Minimizing Start-Up Costs:   As you are starting a medical billing business, your major expenses will be your medical billing training and software (including software training, if applicable). Researching the different options available could save you a great deal of money, time, and frustration. And you’ll want to make certain the software option you choose is already (or will be) ICD10 compliant for the upcoming 2014 changes.

If you already have a computer, printer, and fax machine; you may be able to use them in your start-up to minimize your initial expenses.  Or you may want to invest in newer technology if your equipment is older.  You may determine some of the efficiencies built-in to the new technologies may make it worth the overall investment of new hardware.   

I also recommend using networking groups and attending medical conferences to market your business.  Doctors’ are always in need of good quality medical billing and this is a position that can be a "revolving door" in theirs business.  You can solve this need with your business and services.  

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