# Can a CPC open a billing company?



## nelsong5 (Sep 27, 2008)

My main goal after i pass the CPC examination is to open a Billing Company, me and my partners already have many clinics who wish for us to bill their services.

What are the requirements to open a billing company?

Good things

nelsong5


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## ambergary (Oct 2, 2008)

the first step is to find a good medical billing software that will accomodate you!! one also that will help with insurance contracts if you're not familiar with how to do that. as with any business you will have to get a business license and so forth....i googled medical billing practice startup when i got started and came up with lots of good info....there is also a book at barnes and noble thats fairly cheap that tells you step by step how to get started....if you don't have funds you'll have to come up with a good business plan in order to get a small business loan...you will also need to know ins laws for correct filing and all that jazz...


hope this helps!


amber


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## nelsong5 (Oct 2, 2008)

Any reply helps, thank you so much.

Yes, we do have already a software to bill, Medisoft (which i would recommend for any new billing company, VERY user friendly), which i feel more than comfortable with. My 2 partners both own a medical clinic and a diagnostic center, so i do hope both know exactly what is needed, but i still have my doubts that all i need is the CPC licence. I already have an office setup with a network in different computers that will give access to the people i plan on employing to bill, as i mentioned i have have roughly 6 doctors that are waiting on me to bill their services. Me and my partners are very optimistic we will start off very smoothly and with good income, i have the billing experience and they have the financial/business making experience which i think is a perfect match. 

Any further comments are welcomed, me, im sure im not the only one who plans on doing the same, and tips from the most experienced CPCs in these forums are more than helpful

Thank you

Good things

nelsong5


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## ncgirl (Oct 3, 2008)

Could you please let me know the price of this Medisoft software ? Is it okay to ask this question ? I was looking on the net. It shows around $ 1000. I was just wondering how much should I spend for the set up for a single user with all the required information ? 

Thanks for your help.


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## ambergary (Oct 3, 2008)

nelsong5, you don't have to have anything other than a business license.....i would double check your state requirements which would be at the same place you obtain the business license.....as far as degrees and stuff you don't even need a cpc to own a billing service but if you do it does help with the clientele.

i've never used medisoft i do know of a very user friendly medical billing software that i use is 350 a month for one user you don't have to purchase the licensing unless you want the actual software on your computer....if you do everything through the net its roughly 350 a month...its called healthpac its based out of savannah georgia. check it out...


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## ARCPC9491 (Oct 3, 2008)

I have 2 friends that own billing companies - neither one of them have a degree or any certifications - they are EXTREMELY successful. you don't have to have any special type of certification such as CPC. it's good to have IF you don't have the clientele so you can prove that you have the skills/knowledge to perform your service. however, sounds like you already have 6... and that's a great start. those 6 will talk, and that's how you get your business rolling.


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## nelsong5 (Oct 4, 2008)

Thanks again for the replies, extremedly helpful and ill be sure to speak with my partners this monday about the situation.

NCgirl -The medisoft we have costs about $3000, yes it lets you intall that medisoft in various computers, lets you bill in all computers, you can enter patient info in all computers but the domain PC is the only one admitted to transmit to Medicare, unless they have upgraded because we purchased it in 2005. I do believe that the single user medisoft is $1000 dollars, i have not seen anyone else sell it at a cheaper price so id call their customer service if you want more info, hope this helps.

Questions for ARCPC9491:

Do they charge their sevices by a % that is billed? or is it a fixed income that they receive from the people they bill for?

Good things and thank you for the replies, hope this helps not only myself but also the billing community.

Thank you


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## punkyboo (Oct 4, 2008)

Hi there Nelsong,
I'm not the person you initially posed this qestion to, but I worked for a billing company up until the end of July, and they charged the clients a percentage based on the payments brought in monthly by the billing company.
Hope that helps. If you want to know anything else, PM me.

~Kat, CPC


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## smeeks31 (Oct 5, 2008)

*My question is.......*

Okay thank god someone has asked this question again. Okay so what I gather you need: a computer, software, business license, and your clients.  okay roughly 5,000 to start or 3,500 if you have the other necessaties.  

Okay how should I target my clients (brochures, letters, calling)?

How am I calculating payment?  Should I say this in my approach of catching my clients.  

What was the name of the book that you purchased from barnes and noble and what website

Where do I look to know and understand the laws of billing in my state of Nebraska?

I really would appreciate any feedback.  This has helped on my ideals of my small billing company.


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## ncgirl (Oct 6, 2008)

Thanks so much for answering my question. It helps.


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## ARCPC9491 (Oct 6, 2008)

nelsong5 said:


> Thanks again for the replies, extremedly helpful and ill be sure to speak with my partners this monday about the situation.
> 
> NCgirl -The medisoft we have costs about $3000, yes it lets you intall that medisoft in various computers, lets you bill in all computers, you can enter patient info in all computers but the domain PC is the only one admitted to transmit to Medicare, unless they have upgraded because we purchased it in 2005. I do believe that the single user medisoft is $1000 dollars, i have not seen anyone else sell it at a cheaper price so id call their customer service if you want more info, hope this helps.
> 
> ...



nelsong5,
Sorry, I didn't check this post for a few days. To answer your question, the billing service will get a commission from the collections received from what you billed. (i.e. you wouldn't collect a % from incentive payments that insurances give, because they do not relate to a patient charge) For self pays, normally the client has the option to allow you to bill and take a % of the payment or this is non-commissionable and the client handles self pays on their own. The % that is _billed _is not a factor. Basically, you do not get paid, unless your clients get paid. This is an industry standard. 

I would never go with a "fixed income" - what happens if the practice expands and the charges and payments increase dramatically? you'll be locked in to your contract and you'll be getting underpaid for the services you are providing! You always want to set a % of collections as YOUR income.

Also - about your software, Medisoft. Be aware that this software (atleast the version I have seen) limits reporting ability. Your clients will not only want standard reporting - but they will call you for off the wall things that most software doesn't have the ability to create. Reporting can be a burden on a billing company - so just make sure it can do LOTS of reporting i.e. by practice, by provider, by facility, by cpt, by charge, by referring md, make sure it can sort by day, month, year, just to name a few.


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## Icode4U (Oct 7, 2008)

*think about this*

If I were to hire you to code and bill my services, I would ask you......Do you send claims electronically?   What clearinghouse are you using for Federal, State and commercial payers?  Are you going to be using direct deposit and electronic payment posting?  What is you number of days for payment?  What is your denial rate?  Are you willing to come to my office to copy records if I don't have EMR?  If you are charging me by the chart, does this mean one charge for the chart from time of coding to time of payment.  Will you also be taking care of my creditentialing needs?  NPI's?  Denials? Appeals? Hearing level appeals?  Collections? Mailing statements?  Skip tracing?


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## ARCPC9491 (Oct 7, 2008)

Icode4U said:


> If I were to hire you to code and bill my services, I would ask you......Do you send claims electronically?   What clearinghouse are you using for Federal, State and commercial payers?  Are you going to be using direct deposit and electronic payment posting?  What is you number of days for payment?  What is your denial rate?  Are you willing to come to my office to copy records if I don't have EMR?  If you are charging me by the chart, does this mean one charge for the chart from time of coding to time of payment.  Will you also be taking care of my creditentialing needs?  NPI's?  Denials? Appeals? Hearing level appeals?  Collections? Mailing statements?  Skip tracing?




Oh the joys of Medical Billing ......... Let me add to that list 

If I was a client... I'd ask....

How will I pay you? Do you directly bill me or will you take your commission out? (Normally commission is paid on a WEEKLY basis)

How will I get my charges to you? Electronically or on paper? 

Will you create my super bill or charge slip? 

Do you have a courier that will come and gather my charges each day or do I mail them, or do I scan them?

Will you create my fee schedule? Will you update it? 

If you're doing my credentialing, who should I participate and why?

Will I have access to your software? 

Will I be able to check patient balances?

Are you going to code for me? or will I have to? 
(My advice - always make the coding the responsibility of the provider/practice - to protect yourself - this needs to be in the service agreement. You may have certified coders on staff, but the responsibility is still of that of the provider/practice.)

When will you report to me? Weekly, biweekly, monthly? 
(My advice - report WEEKLY - medical billing changes DAILY, actually by the minute!!!, if there is a problem, you don't want to wait a month to find out!! and they always call when they get the reports - so weekly is best!)

Do you track RVU's? 

Will you audit my charges?

Will you "train" me or "teach me" (or my staff) on E/M coding?

Just in my experience.... don't get involved in "collections" send them to a 3rd party collection agency - write off the bad debt off the A/R and be done with it - it's a hassle thats why collections/attorneys need to get involved further. However, you should be able to "identify" what patients are ready to go to collections - standard I believe is 3 patient statements, attempt to make phone calls, send one demand letter, and if no response, they are identified for "bad debt" and ready to go to collections with the approval of the provider/practice.


As I think of more questions, I'll add them


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