Before I start my home-based business

by Samantha
(Grand Rapids, MI)

A friend and I are both currently studying for our medical billing certificates from an online school, and then we plan on sitting for the certification exam. However, we don’t plan on starting our business right away. In the mean time, because I don’t want to give up my full time job, how should I go about gaining some experience before we start our business?


If there’s anyone you know currently in billing or coding I would see if you could spend some time with them so they can show you what they do. Even a little time with an experienced biller or coder can go a long ways towards helping you understand the business. Some of the online training doesn’t always give you good idea of how to put things into practice.

For anyone wanting to start a business I would recommend getting some experience – maybe 6 months – before starting. I learned so much in a short time by working for a billing service that I never could have learned through training. It can also give you an idea of what specialties you would like to bill for.

Another idea would be to download a demo of one of the more popular practice management software programs, install it on your PC, and “play around with it.” Maybe even take any tutorials they have if available. That way you can say you have experience on that particular application. There’s also some good online medical claim software like Kareo that have great demos and tutorials. Also anything you can learn about electronic records software is beneficial.

I know some trying to get experience have offered to work for free just to learn about billing and coding. If you are working full time you obviously don’t have a lot of free time to do this. And many will be reluctant to do this because it takes so much of their time to explain to someone that’s not experienced what needs to be done. Then there’s the issue of getting access to the practice management software and learning how to use it. Some will be willing to hand off tasks like follow-up on unpaid claims that can be handed off easily.

I think a good way to get into the field as a business owner is to take advantage of some of the changes in the industry and become knowledgeable on them. Some examples would be compliance with HIPAA and OIG (Office of Inspector General) guidelines and ICD-10 changes. Medicare always seems to have some initiatives or changes. If you’re knowledgeable on the HIPAA Privacy Standard you could offer to perform audits of a practice to identify their deficiencies and recommend how to fix them.

This is a great way to establish yourself as an expert and get additional business as a biller. Or you may just want to concentrate on offering consulting – there’s a lot of providers and office managers who don’t have a clue about some of the new legislation and their vulnerabilities if they don’t comply. A good marketing tactic would be to send out flyer’s or letters talking about what the penalties are for violation of HIPAA – or other new rules or guidelines.

Credentialing is another great way to get started and gain experience. Many providers and their staff don’t have the time or expertise to go through the credentialing process – that’s the process of enrolling a provider with an insurance company. You can offer to do this as a service for a fixed price to get a foot in the door. I’ve seen CAQH credentialing offered for $150 to $200.

Alice and Michele of Solutions Medical Billing have written some great books sharing their experience on starting a medical billing business. There’s links to all their books on our Medical Billing Books page.

I apologize for rambling so much here but really to answer your question anything you can do to become an expert on a niche in the field – like CAQH credentialing or HIPAA privacy or Medicare billing can present some great opportunities. To be honest it’s really difficult to gain experience when you’re already working full time. I would spend my spare time networking with anyone else in the industry or business and learning about current issues and soaking up anything that interests you in the industry – especially technology subjects.

Hope this helps – Thanks!