Q. How can I tell if my area is saturated with billers?
A. The easiest resource is the Yellow Pages in your local phone book. Look under "Billing" and "Insurance Claim Services." Divide the total number of companies listed by four to find the number of active services looking to increase their client base. 50% of the list will be out of business with their phones disconnected. 25% of the list will have all the clients they want and cannot handle any more doctors within the weekly work time limits that the owners have allotted themselves. The remaining 25% will be looking for one or two more clients, and when those are found, they will also stop looking.

Q. How much can I expect to make in this business?
A. If the average doctor generates 300 insurance and governmental claims per month each year, your billing (and rebilling) should earn you about $10,000 per doctor per year, gross.

Q. How much should I pay for software?
A. The cost of software ranges from $100 to $12,000. Software under $500 provides limited usage. Software over $2000 is typically considered a "business opportunity." These "opportunities" may include software, manuals, books, video tapes, training sessions at distant locations, transportation, lodging, meals, and other attractive incentives. In general, the software in most abundant use by active billers around the country has a retail price of between $500 and $1000. Beyond $1000, the next level of professional software (alone) will cost $25,000 or more.

Q. How much will it cost to start up this business?
A. You can expect to spend at least $3000 to start up this business. Software will cost $500 to $1000, marketing will cost $1000 over the first three months, and all other business necessities (books, manuals, forms, registration fees, association dues, stationery supplies, professional fees, etc.) will cost $1000.

Q. Do I need to take courses in coding and medical terminology?
A. Medical staff members who work onsite are usually expected to be multi-tasked. Office billers will also fill in as receptionists, medical assistants, and custodians. It is common for an office biller to perform coding tasks and to be fluent in medical terminology. It has become traditional for office staff to have acquired coding proficiency. However, the third-party biller was not on the scene when the diagnosis was determined and the procedure was performed, so all off-site billers must be told what was done, diagnostically and procedurally, at the office or in the hospital. They can be told narratively (in the language of medical terms) or they can be told what the code numbers are. It is always easier and more logical for the office staff to communicate the numbers to the offsite biller, rather than describing the event narratively and expecting the biller to convert the language to code numbers. Billing is an accounting task, not a medical task. If the biller already possesses coding skills or wants to acquire these skills, this provides an opportunity for additional income to the biller through training the office staff or revealing to the doctor income enhancement techniques of professional coding strategies. Coding skills are add-on benefits, not basic requirements of a biller.

Q. What is the background of the Electronic Medical Billing Network of America, Inc., and how did it come into existence?
A. The Network was started in 1995. The founder, Merlin Coslick, had operated a billing center since 1990 and had been teaching seminars in New Jersey about the medical billing business as a homebased opportunity. He wanted startup companies to be given an honest, objective view of all aspects of the business, not just a sales pitch. In response to the urging of students, he started a focus group about medical billing, which soon grew to be a regional organization. Following a very favorable writeup about Merlin and the Network by the national entrepreneurial magazine Business Startups, inquiries from around the country caused the association and its newsletter, The Electronic Biller, to gain nationwide attention and distribution. The Electronic Biller is now the flagship publication of the national association and has subscribers throughout this country and abroad. The Network is recognized by billers across the United States for its dominance in the field and is known for its objective view of all aspects of the billing business and its strict avoidance of commercial product promotion.

Q. What is the benefit of the designation Certified Electronic Medical Biller (CEMB)?
A. Every profession requires learning a body of information. The homebased course of study associated with the CEMB materials communicates the essentials of that information for the medical billing business to the student, including (1.) how to setup the business, both at home and with the related industry partners, (2.) how the claims are entered and transmitted electronically and by paper, and (3.) how to grow the established business. Comprehensive homework assignments reinforce this learning, which is evaluated through a final examination. The graduate is certified by the Network, and will experience the sense of accomplishment and security of knowledge that accompanies this significant achievement. The CEMB credential signifies to prospective clients that the biller has been awarded this designation in return for the diligent and successful application of time and skills. Appropriate rewards follow these achievements.

Q. How long does it take to complete the CEMB course?
A. Since this is a homestudy program, each student will move at his or her own pace. There are rigorous homework requirements for each unit. Typically, it takes two to three months to complete all three units. The work must be completed in six months or the application will expire.

Q. How do I get started in this business?
A. The worst place to start is by talking to someone who would like to sell you software. Software is a business tool that is needed eventually. A software demo, training class or instructional videotape will provide all necessary information about structure and application of a reliable software program. Software is not returnable and should only be purchased when marketing has produced a viable client for your billing service. The most practical start is achieved through research and information gathering. Books are the most reliable source. The authors of these books should be experienced independent entrepreneurs, not healthcare staff members. The best-selling book for this purpose is "Setting Up Your Medical Billing Business" by Merlin Coslick. Training courses offered by individuals at schools and colleges who have only medical facility backgrounds are rarely useful to prospective homebased billers. Medical facilities require office multi-tasking skills (phone answering, appointment setting, medical terminology familiarity, patient care, coding decisions, etc.) that have no application for the independent biller. The free booklet "Medical Billing as a Homebased Business, an Overview" is available on request from the Electronic Medical Billing Network of America, Inc. The booklet describes all necessary preparation and startup requirements for the independent biller.

Q. Newspaper classified ads may suggest that a company has a list of doctors who need someone to process their claims. The company claims to be a clearinghouse. They will make money by submitting the claims to the insurance carriers. Their software must be purchased to process these claims. Is this a quick way to get started?
A. This is a fraudulent claim. Public complaints against these companies may be observed at www.pub1.ezboard.com/bmedical billingscamwatch.

Q. Magazine ads describe companies offering a "business opportunity" program in medical billing. The programs are quite expensive, $5,000-12,000, but they seem to offer everything you need to set up this business. Why are they so expensive? Is the information available another way?
A. Business opportunity programs have 3 components; a software program, instructional materials, and hands-on training for 2-3 days at the company's home office location. The software program has a value of $500-1000 and the instructional materials (books, videotapes, marketing samples, flip charts, etc.) have a value of $500. All other costs ($4,000-10,000) apply to the in-person training. Similar or better quality software can be purchased directly from a local distributor for a nationally recognized medical software company for $600-1000. The books can be purchased from Amazon.com, the videotapes from the software company. The software instruction can be received via software company videotape (approximately $400), demo (free or less than $10), or through a software company seminar (approximately $250 for 2 days). The step-by-step process is fully described in our book "Setting Up Your Medical Billing Business." The convenience of the business opportunity package comes at a prohibitive expense. An intelligent entrepreneur should be able to tie all the pieces together at far less cost, with help from the member support desk at the Electronic Medical Billing Network of America, Inc.

Q. Some companies offer a list of healthcare providers who do not presently submit claims electronically. It would seem that these are prominent prospects for conversion to electronic billing, once they learn of the tremendous advantages of this process. Are these lists available anywhere else?
A. Call 1-800-MEDICARE for a free list. Unfortunately, these providers are the ones least likely to change over to electronic billing. Electronic processing has been available for over a dozen years. All providers are aware that it is faster, cheaper, more efficient, more reliable, and a far better method of claims processing than using paper claims. All providers know this and have heard every argument and persuasive appeal that should logically cause them to change over. Yet half of them still mail in their paper claims. Why? Why not? Their paper system is working and producing enough income for the provider to pay all professional and personal bills and maintain a comfortable lifestyle. Why change? It's not broken, why fix it? What if the replacement is worse than the old paper method? No, thanks. The only true prospect for conversion to electronic outsourcing is the provider whose current system is so inefficient, unreliable and broken that he will try anything to start up an adequate cashflow again. Even if it means outsourcing the billing and losing a multi-taskable office worker in the process. New dollar production must be more critical than the many-handed efficiency of the in-house biller/receptionist/medical aide. So let's give this electronic billing thing a try. It can't be any worse than the crippled system he has.

Q. What are my local laws concerning a homebased medical billing business?
A. There is no federal certification requirement for this business. Certain states require licensing of independent contractors. Many municipalities require registration of homebased businesses. Ask your municipal and county clerk's offices about these requirements. You do not need a tax identification number since you will not be a submitter of tax receipts. Corporations must have a tax identification number (EIN). You do not need to incorporate to start this business; you will be a sole proprietor on day one. The protection of a corporate shell will be important once you obtain a client and the accompanying risk. Your money is better spent for marketing than for incorporation expenses.

Q. I'm not very good at marketing. How do I find a company that will get clients for me?
A. There are a few companies around the country that advertise their skills at finding clients for medical billing companies. There is no proof that these companies perform according to their claims. An independent medical biller is an entrepreneur and must obtain clients through his/her personal direct marketing efforts. There is no shortcut, there are no outside helpers. If the new biller is reluctant to market or makes half-hearted attempts, the business will fail. The marketing procedures for this business are simple, non-threatening, professional and absolutely essential to apply. If the owner refuses to accept this personal responsibility, the chance of success is zero. A complete discussion of this process is found in the book "Medical Billing Marketing Success; Finding Local Clients" available at this website.

Q. When should I join the Electronic Medical Billing Network of America, Inc.?
A. The purpose of the association is to provide information, education, and support to the home-based independent medical biller. All of these functions are critical at the beginning of this business. Publications and telephone support will take the new business owner through the confusing startup phase of the business and provide aid during the new marketing period. Once up and running, the monthly newsletter provides current information on industry developments and new benefits for the established biller.