How to start a Medical Billing Business?


How to start a medical billing business plan template

Are you interested in starting your own Medical Billing Business?

Starting your own medical billing business can be a great way to become your own boss and control your own destiny. But it's not a decision to be taken lightly. Before you take the plunge, there are a few things you need to know to give yourself the best chance for success. In this section, we'll cover the basics of what you need to do to get started with your own medical billing business. We'll talk about the important things to consider before starting, what you need to do to get set up, and how to market your new business. By the end of this section, you should have a good understanding of what it takes to start a medical billing business. So let's get started!
Business Plan
If you're considering starting a medical billing business, the first step is to put together a business plan. This will help you determine the feasibility of your business and set goals for growth. Here's a look at some key components of a successful medical billing business plan.
1. Executive summary: This is a brief overview of your business, including your goals and objectives.
2. Company description: Describe your company, including your history, business model, and any unique selling points.
3. Market analysis: Research the medical billing industry and identify your target market. Include information on your competitors and how you plan to differentiate your business.
4. Sales and marketing strategy: Outline your plans for marketing and selling your medical billing services.
5. Financial projections: Create realistic financial projections for your business, including start-up costs, operating expenses, and revenue projections.
6. Management team: Introduce the members of your management team and their experience in the medical billing industry.
7. Appendix: Include any additional supporting materials, such as market research data or sample contracts.
Target Market
The first step to starting a medical billing business is to identify your target market. Who will you be providing services to? Will you be working with individual medical practices, hospitals, or other types of healthcare facilities? Once you have a good understanding of your target market, you can begin to develop a plan for marketing your business to them. Some things to consider when identifying your target market include:
-What type of medical billing services do they need?
-How many staff members will they need to support?
-What is their budget for medical billing services?
-What is their geographic location?
-What is the size of their practice or facility?
Once you have a good understanding of your target market, you can begin to develop a plan for marketing your business to them.
Business Model
There are a few different ways to set up a medical billing business. The most common way is to start your own business from scratch, either as a solo operation or with a team of employees. You can also buy an existing medical billing business, or franchise a brand that already has a good reputation. The first step is to decide which model is right for you. If you have the entrepreneurial spirit and are willing to put in the hard work to build a business from the ground up, then starting your own medical billing business is the way to go. If you would prefer to have everything in place from the start, then buying an existing business or franchising might be a better fit. Once you’ve decided on your business model, the next step is to put together a business plan. This document will outline your goals, strategies, and how you plan on making your medical billing business a success. Next, you need to secure funding for your new venture. This can come from personal savings, loans from family and friends, or investment from venture capitalists. Once you have the financials in place, it’s time to start setting up your business. This includes finding office space, hiring.
Competitive Landscape
There are a number of ways to get into the medical billing business. You can start your own business, you can join an existing company, or you can work as an independent contractor. The competitive landscape for medical billing businesses is fairly fragmented. There are a number of small businesses and a few large companies that dominate the market. The largest companies in the medical billing space are McKesson and Navicure. If you are thinking about starting your own medical billing business, you will need to consider the competition. You will need to find a niche where you can compete effectively against the larger companies. You will also need to develop a good marketing plan to attract clients.
Costs & Pricing Strategy
There are a number of costs associated with starting a medical billing business. These include the cost of software, hardware, and training. The price of medical billing services can vary depending on the provider, but typically range from $500 to $5,000 per month. There are a number of pricing models for medical billing services. The most common is the fee-for-service model, where the provider charges a percentage of the total amount billed to the insurance company. Other pricing models include flat-fee and per-claim pricing. The best pricing strategy for your medical billing business will depend on a number of factors, including the size and complexity of your practice, the type of services you offer, and the competitive landscape in your area.
Forming a Legal Entity
If you want to start a Medical Billing business, you will need to form a legal entity. This will protect you from personal liability and help you raise money for your business. You can choose to form a sole proprietorship, partnership, limited liability company (LLC), or corporation. Each type of entity has its own pros and cons, so you will need to choose the one that is right for your business. If you are the only owner of your business, a sole proprietorship may be the best option. This type of business is easy to set up and you will not have to deal with much paperwork. However, sole proprietorships offer no personal liability protection, which means that you could be held responsible for debts incurred by your business. Partnerships are similar to sole proprietorships in that they are easy to set up and offer no personal liability protection. If you decide to form a partnership, you will need to choose a business partner who you can trust and who has complementary skills. It is important to have a written partnership agreement that outlines each partner's roles and responsibilities. A limited liability company (LLC) offers personal liability protection and is a good option for a small group of founders. 
Opening a Business Bank Account
When you’re ready to start your Medical Billing business, one of the first steps is to open a business bank account. This will help you keep your personal and business finances separate and will make it easier to track your expenses and income. To open a business bank account, you’ll need to have the following information and documents:
-Your business name and address
-Your Social Security number or Employer Identification Number (EIN)
-A list of the owners, officers, and directors of the company
-Articles of incorporation or a business license
-A voided check or deposit slip from the account you’ll be using for your business
Once you have all of the required information and documents, you can visit your local bank or credit union to open a business checking account.
Setting up Business Accounting
If you're starting a Medical Billing business, one of the first things you need to do is set up your business accounting. This will ensure that you're keeping track of your finances and that you're complying with any financial regulations that apply to your business. Here's a quick guide to setting up your business accounting:
1. Choose an accounting software. There are many different accounting software packages available, so do some research to find one that will suit your needs.
2. Set up your chart of accounts. This is a list of all the categories of income and expenditure that you will track in your accounting system.
3. Set up your bank account. You will need a business bank account to manage your finances effectively.
4. Keep track of your income and expenditure. Make sure you keep accurate records of all money coming in and going out of your business.
5. Prepare and file your tax return. Once a year, you will need to file a tax return for your business. Make sure you keep on top of this so that you don't miss the deadline
Setting up Business Insurance
As a business owner, it is important to protect your company with the proper insurance. When setting up a Medical Billing business, you will need to consider the following types of insurance:
-Product liability insurance: This will protect you in the event that a product you designed and printed causes injury or damage.
-Professional liability insurance: This will protect you in the event that a client suffers damages as a result of your work.
-Business property insurance: This will protect your equipment and premises in the event of damage or theft.
-Business interruption insurance: This will protect you in the event that your business has to stop operations due to a covered event.
-Employee dishonesty insurance: This will protect you in the event that an employee steals from your business.
Speak with an insurance agent to determine which policies are right for your business
Setting up a Business Website
If you want to start a Medical Billing business, one of the first things you need to do is set up a website. This will be your online home base, where potential customers can learn more about your business and what you have to offer. There are a few key things you need to include on your website:
-An About page: This is where you can tell your story and give potential customers a sense of who you are and what you stand for.
-A portfolio: Showcase your best version on your website so that potential clients can see your work.
-A contact page: Make it easy for people to get in touch with you by including your email address and/or social media links.
-Pricing information: Let visitors know how much you charge for your services.
By having a well-designed website, you’ll be able to attract more customers and grow your Medical Billing business
Obtaining the Necessary Permits
In order to start a medical billing business, you will need to obtain the necessary permits. Depending on your location, this may require a business license, a resale permit, and/or a professional license. You will also need to make sure that your business is properly zoned for the type of business you will be conducting. To find out what permits you will need, you can contact your local chamber of commerce or business licensing office.
Setting up a Business Number or Appointment Setter
When you’re ready to start your Medical Billing business, one of the first things you need to do is set up a business phone number or an appointment setter. You can use a service like Google Voice to set up a business phone number for your Medical Billing business. Google Voice will give you a free business phone number that you can use to make and receive calls. Once you have a business phone number, you can start taking calls from potential customers. When you get a call, be sure to take down the customer’s name, contact information, and what they need. Once you have this information, you can give the customer a call back to discuss the project in more detail and give them a quote.

Training and Certification Requirements

Obtaining the necessary training and certification to start a medical billing business is essential. Medical billing certification programs are available online or in-person, and they will teach you the basics of medical coding, insurance billing processes, and other related topics. Once you’ve completed your coursework, it’s important to stay up to date on industry trends by regularly attending seminars or classes to keep your skills sharp.

Building a Client Base

One of the most important steps in starting a successful medical billing business is building a strong client base. To do so, you will need to reach out to potential customers and market your services effectively. This could include creating an online presence through a website or social media page, attending networking events, and reaching out to healthcare provider offices directly.

Invest in Technology

In order to run an efficient and profitable medical billing business, it’s important to invest in the right technology. This includes investing in electronic health records systems and medical coding software that will help streamline the billing process. Additionally, it’s important to stay up to date on the latest technology trends in order to remain competitive in the industry.

Developing Relationships with Insurance Companies

Establishing relationships with insurance companies is an important step when running a medical billing business. It’s important to ensure that you understand the specific requirements of each insurance provider when submitting claims and that you are familiar with their billing processes. Developing strong relationships with insurance companies can help you ensure that your claims are processed correctly and quickly.

Hiring and Managing Employees

If you plan on expanding your medical billing business, it will be necessary for you to hire staff members to assist with the additional workload. When recruiting employees for your business, it’s important to make sure they have experience working in the field of medical coding and that they are knowledgeable about insurance billing processes. Additionally, it’s important to create an environment that encourages employee growth so that your staff members feel valued and motivated.

Marketing Your Business

When starting a medical billing business, it is important to market yourself effectively in order to attract customers. This could include creating an online presence through a website or social media page, attending networking events, and reaching out to healthcare provider offices directly. Additionally, it’s important to create content such as blog posts or informational videos that potential customers can find when searching for medical billing services online.

Staying Up To Date with Industry Trends

In order for your medical billing business to remain competitive in the industry, it’s important stay up-to-date on current industry trends. This could include attending conferences or seminars related to the healthcare industry or subscribing to industry publications so that you can stay informed of any changes or updates that may affect your business operations. Additionally, it’s beneficial for you and your staff members to stay up-to-date on any changes made by insurance providers as these changes could affect how claims are processed and billed.
If you're thinking about starting a medical billing business, there are a few things you need to know. First, you'll need to become familiar with the medical billing process and the software that's used to bill insurance companies. Next, you'll need to find clients who are willing to pay for your services. And finally, you'll need to stay up-to-date on the ever-changing world of medical billing. Starting a medical billing business can be a rewarding way to make a living. With the right knowledge and a little hard work, you can be successful in this field.

Why write a business plan?

A business plan is a critical tool for businesses and startups for a number of reasons:
  • Business Plans can help to articulate and flesh out the business’s goals and objectives. This can be beneficial not only for the business owner, but also for potential investors or partners
  • Business Plans can serve as a roadmap for the business, helping to keep it on track and on target. This is especially important for businesses that are growing and evolving, as it can be easy to get sidetracked without a clear plan in place.
  • Business plans can be a valuable tool for communicating the business’s vision to employees, customers, and other key stakeholders.
  • Business plans are one of the most affordable and straightforward ways of ensuring your business is successful.
  • Business plans allow you to understand your competition better to critically analyze your unique business proposition and differentiate yourself from the market.
  • Business Plans allow you to better understand your customer. Conducting a customer analysis is essential to create better products and services and market more effectively.
  • Business Plans allow you to determine the financial needs of the business leading to a better understanding of how much capital is needed to start the business and how much fundraising is needed.
  • Business Plans allow you to put your business model in words and analyze it further to improve revenues or fill the holes in your strategy.
  • Business plans allow you to attract investors and partners into the business as they can read an explanation about the business.
  • Business plans allow you to position your brand by understanding your company’s role in the marketplace.
  • Business Plans allow you to uncover new opportunities by undergoing the process of brainstorming while drafting your business plan which allows you to see your business in a new light. This allows you to come up with new ideas for products/services, business and marketing strategies.
  • Business Plans allow you to access the growth and success of your business by comparing actual operational results versus the forecasts and assumptions in your business plan. This allows you to update your business plan to a business growth plan and ensure the long-term success and survival of your business.

Business Plan Content


Many people struggle with drafting a business plan and it is necessary to ensure all important sections are present in a business plan:
  1. Executive Summary
  2. Company Overview
  3. Industry Analysis
  4. Consumer Analysis
  5. Competitor Analysis & Advantages
  6. Marketing Strategies & Plan
  7. Plan of Action
  8. Management Team

The financial forecast template is an extensive Microsoft Excel sheet with Sheets on Required Start-up Capital, Salary & Wage Plans, 5-year Income Statement, 5-year Cash-Flow Statement, 5-Year Balance Sheet, 5-Year Financial Highlights and other accounting statements that would cost in excess of £1000 if obtained by an accountant.

The financial forecast has been excluded from the business plan template. If you’d like to receive the financial forecast template for your start-up, please contact us at . Our consultants will be happy to discuss your business plan and provide you with the financial forecast template to accompany your business plan.

Instructions for the Business Plan Template

To complete your perfect Medical Billing business plan, fill out the form below and download our Medical Billing business plan template. The template is a word document that can be edited to include information about your Medical Billing business. The document contains instructions to complete the business plan and will go over all sections of the plan. Instructions are given in the document in red font and some tips are also included in blue font. The free template includes all sections excluding the financial forecast. If you need any additional help with drafting your business plan from our business plan template, please set up a complimentary 30-minute consultation with one of our consultants.

Ongoing Business Planning


With the growth of your business, your initial goals and plan is bound to change. To ensure the continued growth and success of your business, it is necessary to periodically update your business plan. Your business plan will convert to a business growth plan with versions that are updated every quarter/year. Avvale Consulting recommends that you update your business plan every few months and practice this as a process. Your business is also more likely to grow if you access your performance regularly against your business plans and reassess targets for business growth plans.


Want a Bespoke Business Plan for your Medical Billing Business?

Our Expertise


Avvale Consulting has extensive experience working with companies in many sectors including the Medical Billing industry. You can avail a free 30-minute business consultation to ask any questions you have about starting your Medical Billing business. We would also be happy to create a bespoke Medical Billing business plan for your Medical Billing business including a 5-year financial forecast to ensure the success of your Medical Billing business and raise capital from investors to start your Medical Billing business. This will include high-value consulting hours with our consultants and multiple value-added products such as investor lists and Angel Investor introductions.


About Us


Avvale Consulting is a leading startup business consulting firm based in London, United Kingdom. Our consultants have years of experience working with startups and have worked with over 300 startups from all around the world. Our team has thousands of business plans, pitch decks and other investment documents for startups leading to over $100 Million raised from various sources. Our business plan templates are the combination of years of startup fundraising and operational experience and can be easily completed by a business owner regardless of their business stage or expertise. So, whether you are a budding entrepreneur or a veteran businessman, download our business plan template and get started on your business growth journey today.