The business in one offer
Who it serves
Solo licensed therapists, counselors or physical therapists who see insurance clients and spend their evenings resubmitting denied claims. They usually have an EHR already but no staff, and they pay because unpaid claims directly affect their income.
What to sell first
Monthly claims management for one clinician: weekly claim submission from the practice's EHR, payment posting, denial follow-up and a short monthly report of outstanding claims. Excluded: credentialing with payers, coding decisions beyond correcting obvious data errors, patient collections calls, and any work outside the practice's existing software.
Working inside the client's own EHR avoids buying billing software, and a solo practice has a manageable claim count. A flat fee makes the monthly bill predictable for the therapist and keeps you from arguing about what counts as collected.
What could it cost to start?
This is an original example budget for the limited pilot described above. It is not a researched market average or a complete quote for every location.
| Item to price | Example allowance |
|---|---|
| Medical billing and coding course | $800.00 |
| HIPAA training and policy templates | $200.00 |
| Cyber and professional liability insurance allowance | $900.00 |
| Encrypted laptop setup and password manager | $250.00 |
| Simple website and secure contact form | $150.00 |
| Example total | $2,300.00 |
What this assumes—and excludes
Assumes you already have a computer that can be encrypted and a private work area. Excludes billing software licenses, office rent, owner pay and local business licenses. Requirements for privacy and security vary by client, so get legal, insurance and software quotes before you begin.
Collect actual supplier, insurance and local-authority information. Add a reserve for delays and unexpected costs; the example total is not a funding recommendation.
How the unit economics work
At an assumed $600.00 per monthly practice and $30.00 in direct costs, contribution is $570.00 before monthly fixed costs, owner pay and taxes. With 10 all-in working hours per unit, that is $57.00 per delivery hour before those deductions. These inputs illustrate the arithmetic; they do not establish a market price or expected earnings.
The example also allows $200.00 in monthly fixed costs. Include unpaid acquisition and administrative time when deciding whether the offer is worthwhile.
Try your own numbers
These are editable planning assumptions, not prices we have verified. Calculations stay in your browser.
Operating result = (price − direct cost) × units − monthly fixed costs. Before owner pay, taxes, financing and startup recovery. At these inputs, delivery requires 100 hours per month, plus any work not included in your per-unit estimate. Sales volume is a scenario, not a forecast.
How to find the first customers
Test a small offer before scaling traffic. Record the source of each enquiry, whether it fits the offer, and whether the buyer pays.
- Ask therapists in a local professional association or peer consultation group how they handle billing today. Offer a free 30-minute review of their aging report, under a signed agreement.
- Contact two EHR consultants or practice coaches who help solo clinicians set up their offices, and ask whether they refer billing work. Disclose any referral fees to clients.
- Write a plain explainer on common claim denial reasons for outpatient therapy and share it in professional forums where self-promotion is allowed. Track which posts lead to calls.
- Offer your first client a reduced first month in exchange for honest feedback on your reports. Do not ask for public reviews tied to the discount.
What to validate before spending more
- Have a health law attorney review your business associate agreement template and your intake process before you access any client data.
- Shadow or test inside a sandbox EHR account to learn the claim workflow. Time how long ten practice claims take from entry to submission.
- Ask two practices how many claims they submit monthly, then calculate your hours at that volume and confirm the flat fee still covers your time.
- Check whether your state regulates billing services or collection activity, and confirm your insurance covers errors in claim submission.
The operational catch
Timely filing limits are the silent danger. Each payer sets a window to submit or appeal, and claims that sit past it may never be paid. When onboarding a new practice, pull every unpaid claim and sort by date of service first, then work the oldest ones before you touch new submissions.
A practical way to fund the first step
Start with one or two practices whose existing software you can learn without purchases. Bill monthly in advance so you never carry a month of work unpaid, and use the first fees to cover insurance before adding clients.
Separate cash already available from money still to earn. Count only proceeds after direct expenses, and do not spend customer funds needed to fulfill their existing orders.
Questions before you start
Is a percentage of collections better than a flat fee?
A percentage ties your income to collections but makes your revenue unpredictable and can create tension over which payments count. A flat fee suits a solo practice with steady volume; review it every six months as claim counts change.
Do I need a coding certification?
It helps credibility, but therapy practices use a small set of codes chosen by the clinician. Your job is to make sure claims are complete and match the documentation, not to choose codes on the clinician's behalf.
Can I work from home?
Yes, if you protect client data. Use an encrypted device, a private workspace and your own login for each client system. Never share passwords or store patient information on personal devices.
Source-backed checks
These references support the specific checks below. They do not endorse this business idea or substantiate the example prices, costs or demand.
CISA offers cyber guidance designed to help small businesses reduce their exposure to cyber threats. CISA: Cyber Guidance for Small Businesses.
SBA explains common types of business insurance and recommends consulting a licensed agent. U.S. Small Business Administration: Get business insurance.
The IRS advises keeping records that support the income and expenses shown on a tax return. Internal Revenue Service: Recordkeeping.
- Cyber Guidance for Small BusinessesCISA · Reference checked September 8, 2026
- Get business insuranceU.S. Small Business Administration · Reference checked September 8, 2026
- RecordkeepingInternal Revenue Service · Reference checked September 8, 2026
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