New practices must register with payers, choose software or a billing service, understand CPT/ICD codes, and set up secure workflows. HIPAA compliance and eligibility tools are key priorities from day one.
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Answer reviewed by Ken Ahbar, Certified Medical Billing Expert – updated July 2025
Starting medical billing as a new practice in 2025 requires careful setup. First, enroll with Medicare, Medicaid, and commercial payers. Then, choose between hiring in-house billers or outsourcing to a billing service. Next, select an EHR/billing platform that meets your specialty’s needs and offers strong payer integration. Learning the basics of CPT/ICD-10 coding, denial management, and prior authorization processes is also important, even if someone else handles the work. Make sure your systems are HIPAA-compliant and include audit logs. Tools for eligibility verification and claims scrubbing can prevent costly delays. It's also wise to set up processes for patient collections early—more patients now have high deductibles. Billing can make or break your cash flow, so getting it right from day one helps your new practice scale faster and stay financially healthy.
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Answer reviewed by Ken Ahbar, Certified Medical Billing Expert – updated July 2025