Contract Terminology

Contract Terminology

Contract Terminology

Posted on: January 31, 2012 - 12:24 pm
by Admin

Medical billing is quite popular on the Internet. Promises of making easy money, setting your own hours, appealing to moms hoping to find work-from-home opportunities, and having a low start-up cost all lead to a plethora of medical billing prospects. Don’t believe it, as any are scams. There are no easy business opportunities, and those that are legitimate may make it sound easier than it actually is. But, let’s say you have done your research, have relevant training or experience, have registered your business and are ready for set up. For practical purposes, create a checklist so you can track your progress as you refer to the steps below.

Steps in Setting up Your Medical Billing Business

  1. Create a business plan. A business plan is comprised of many elements. This may include review of the research you conducted, such as the SWOT analysis (strengths, weaknesses, opportunities and threats). It should include what services you plan to offer and how you may differentiate your business from the competition. It may also include a vision or mission statement, pricing and marketing strategies. In the simplest terms, this is the document outlining the plan for your business.
  2. Set up an office. You will need to set up an office to conduct your business, perhaps at a home office or in a leased space. This will include the basic necessities, such as a desk and chair, computer, printer and fax machine. All-in-one printers that include a fax and scanner are a good option for home offices. Since you will be handling sensitive patient information, you will also need to have a filing cabinet that can be secured, as well as safeguards to ensure IT security, such as firewalls, in place. In addition to the hardware needed, review your software needs. Medical billing software will be necessary, as well as accounting software to track your business income and expenses. Review and set up an account with a medical billing clearinghouse, which is the conduit that you will use to submit billing electronically.
  3. Gather office supplies and create letterhead. In addition to basic office supplies, part of setting up your business is to have a letterhead, envelopes, and business cards printed. Shop around for a local printer with good prices. Although not required, creating a logo to be placed on your letterhead and business materials is a good idea for branding purposes. You may want to consider a graphic designer to help you with creating a logo for your business.
  4. Compile reference materials. It is recommended to have several reference materials on hand. This may include an ICD 9 diagnosis book, a CPT (Current Procedure Terminology) book and an HCPCS (Healthcare Common Procedure Coding System) reference. Keeping a medical terminology guide on hand can also be useful.
  5. Create office documentation and forms. In setting up your business, you should begin with some basic policies and procedures on how you will conduct your business. Prior to setting up any providers, do your research on HIPAA, Office of Inspector General (OIG) and any compliance documentation that will need to be in place. For example, with HIPAA the necessary documentation may include a Business Associate Agreement (BAA). Have other various forms drafted and ready, such as new enrollment forms to capture provider details and a service agreement, or contract, for your services. It is a good idea to have a new client checklist that will include all necessary forms that can be sent to providers who are interested in signing up for your service. You want to create a professional image and make it easy for them, and you need to be the expert in this situation. Providers who will hire you will be looking for your expertise.

Medical billing is complex, and contrary to what may be on the Internet, there is a good deal of knowledge and background work necessary in order to start a business aside from just hanging out a shingle and getting medical billing software. These steps are meant to be a guide in pursuit of that venture, but take into consideration other preparedness that should be completed prior to these stages.