Medical Claims Billing

Episode #58

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A small medical clinic is busy every day, but the owner still feels broke. Then they open their aging report and realize they have tens of thousands sitting in “denied” and “unpaid” claims.

✅ You’re selling recovered cashflow, not medical billing.

Most small clinics do the work, submit the claim, and assume money will arrive. When a claim gets denied or stuck, it quietly becomes “someone will handle it later.” Later turns into never, and never turns into a pile of unpaid revenue.

The twist that makes this profitable is specialization. Don’t sell “billing.” Sell “denial recovery for one niche,” like chiropractic, PT, or mental health. You become the person who knows the top denial reasons cold and fixes them fast. Your time per recovered dollar drops.

The underrated advantage: this is one of the few “learnable admin skills” where you can get competent without a degree. You’re not learning medicine — you’re learning the rules of getting paid. A focused path is: insurance basics → CPT/ICD basics → common denial codes → appeal packages → payer follow-up systems. (Cert paths like AAPC’s CPB training + AHIMA reimbursement courses exist if you want structure.)

PROOF IT’S REAL

The medical billing world is full of quiet leaks, and Tebra’s “True Cost of Medical Billing” report reads like a checklist of where the money disappears. It breaks down how claim denials, write-offs, and slow follow-up create real cashflow hits for clinics that are doing the care but not getting paid fast enough.

From the vendor side, billing platforms make it clear that denial follow-up is an ongoing operational workload, not a one-time clean-up. It is the type of repetitive admin that practices hate doing but can’t ignore because every unworked denial is money left on the table. That’s why a tight operator who can run the appeals queue, track outcomes, and document fixes becomes valuable fast.

And yes — solopreneurs are already selling this as a service.

You can see denial-recovery work getting hired in the wild as freelance gigs and solo contractors:

THE ECONOMICS

Billing services often charge a percentage of collections or a retainer. A working range to validate in your specialty is 4%–10% of collected revenue (see examples from DrChrono billing services pricing and Kareo’s overview of billing service costs).

Simple math: if a clinic collects $80,000/month and you charge 5%, that’s $4,000/month. Two clinics gets you to $8,000. Three clinics puts you above $10k/month.

Your costs are mostly time, plus any software access. You’re trading structured follow-up for money already earned.

Reality check on solo pricing: denial roles often land in the ~$20–$30/hr range, which gives you a “floor” if you start hourly before moving to performance pricing.

THE PLAYBOOK (Step-by-step plan)

FIRST CUSTOMER SCRIPT (copy/paste)

“Hey [Name] — quick question. Do you know how much A/R you have sitting over 60 days right now? I help small clinics recover denied claims and get paid on recovered cash. Want me to audit your top denial reasons and show what you could collect this month?”

Garage door repair is one of the purest “I need this now” searches, but most companies still market like it’s a slow purchase. That is the broken market. ServiceTitan’s garage door marketing guide even spells out the intent: homeowners search “garage door repair near me” and pick fast. Housecall Pro makes the same point from an SEO angle, using “garage door won’t open” as an example of high-intent problem searches.

Here’s the opening: sell certainty. Most sites hide the basics. No price range. No arrival window. No proof. No “what happens next.” In a panic search, that feels risky.

A small operator can win by being the most specific company on the page. Put the common problems at the top. “Door won’t open.” “Broken spring.” “Off track.” For each, show a 20-second video, a price range, and the soonest available appointment. This is not fancy marketing. It is lowering fear.

The opening: Build a “door won’t open” landing page with 3 problem buttons and instant booking for the next available slot.