FREQUENTLY ASKED QUESTIONS 
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How can I tell if there is a
market for this business where I live?
How can I tell if my area is saturated with billers?
How much can I expect to make in this business?
How much should I pay for software?
How much will it cost to start up this business?
Do I need to take courses in coding and medical terminology?
What is the background of the Electronic Medical Billing Network
of America, Inc., and how did it come into existence?
What is the benefit of the designation Certified Electronic
Medical Biller (CEMB)?
How long does it take to complete the EMBN certification course?
How do I get started in this business?
Newspaper classified ads may suggest that a company has a list of
doctors who need someone to process their claims. I only need to purchase their software
to process these claims. Is this a quick way to get started?
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?
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?
What are my local laws concerning a home-based medical billing
business?
I'm not very good at marketing. How do I find a company that will
get clients for me?
When should I join the Electronic Medical Billing Network of
America, Inc.?
Q. How can I tell if
there is a market for this business where I live?
A. A simple rule of thumb is this. If there is a
population of 1000 doctors within a 10 sq. mi. area near you, there should be 2-3
providers at any given time within that population who urgently need a reliable billing
service to restore their cash flow.
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.
If this page has not
answered all your immediate questions,
please feel free to us contact our
Executive Director, Mr. Merlin Coslick at:
Electronic Medical Billing Network of America, Inc.
51 Eton Court, Bedminster, New Jersey 07921
Phone 908-470-4100 FAX 908-470-4233
Email: merl@medicalbillingnetwork.com
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