Validate a Medical Billing Advocacy Business for US Patients

This step draws the legal boundary of what you may sell, before you spend a cent. The service is patient-side help with denied claims, billing errors and overcharges. Three fences define it: you work for the patient, never the provider; you charge a flat fee or an hourly rate — contingency fees are restricted in most states and are only ever legal for ERISA appeals where your state permits them; and you never promise savings or a specific outcome.

Run these checks and record the date of each:

1. Find your state's insurance department in the NAIC directory and look for rules on patient or billing advocates: registration, licensing, contingency fees, record retention.
2. Read the FTC's advertising and marketing guidance and note which claims would be deceptive for a service like yours.
3. Write the one-page scope statement: the service, the excluded work (provider-side billing, coding, legal representation), the fee structures your state allows, and the claims you will not make.
4. Date the page — the rules change, and the date is what makes the check real.