The billing business for medical services

There is a large number of hospitals, ambulatory service centers, specialized clinics and laboratories with modern technology. The number of doctors who practice their profession on the Island is significant. Patients have private, governmental and federal health insurance. There are laws that promote good service and protect the rights of the people who receive or request them. All these elements represent an attraction for some companies that sell equipment, medicines, various products and electronic systems to facilitate the administration of the office or billing.

It also represents an attraction for those who study or train as health service bureaus. More than 60% of the people who take training in the Association of Medical Billers have the interest to establish a business or develop a career as an independent invoice.

What should be considered before starting a business related to this profession?

The field of claims for health services is broad. The professional component is possibly the most extensive. It is called “professional component” to any type of service offered by a doctor or a specialist authorized by health insurance. These services are offered at the patient’s home, in the office or at the hospital. The “institutional component” is the service a patient receives in a hospital or any other facility classified as such by insurance. The patient’s room, medications, the nursing service and some specialized rooms are examples of institutional services.

There are other components that the biller should consider before planning and establishing his business. For example, there are stores that sell durable medical equipment, ground ambulance services, clinical, radiological and nuclear laboratories. Pharmacies and opticians are also storing that request billing services. These establishments can be a substantial economic alternative for those whose goal is to become entrepreneurs.

What is the best alternative for the future entrepreneur?

Although the professional component is the widest, most of the candidates specialize in this type of service, converting the component into a highly competitive one. This situation diminishes the possibilities of employment and clients. Within the component is the medical office. It is advisable to consider other service areas. Some of them have great possibilities for growth, such as centers for healing ulcers and wounds with hyperbaric oxygenation. Other services that are increasing are hospices, physical therapy and rehabilitation centers, emergency rooms and dialysis centers.

What are these details?

The certifications that are required, the specialized training, the system that will be used for the electronic collections, the investment costs and the type of business that will be established are the fundamental elements that must be considered in the decision-making process.

There are a variety of alternatives to meet the needs of the provider. Companies that sell electronic tools or security devices for compliance with the HIPAA Act and for the administration of the medical office are known as “vendors”. In the United States and Puerto Rico, it is a requirement that these systems be certified by the Federal Government. But, despite the existence of devices and high technology, being in the age of the electronic medical record and about to implement a new coding system (ICD-10), the health services biller continues to be a fundamental part of the process. the industry.

The business of billing health services can be an excellent goal if the future entrepreneur takes into consideration the points discussed above, the current laws and establishes a strategic and effective business plan.

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