The $35K Business Opportunity Most Entrepreneurs Never Think About: Inside American Business Systems
How a Low-Cost Medical Billing Model Can Create Recurring Revenue, Flexibility, and Scalability
When most people think about business ownership, they tend to picture restaurants, retail stores, home services, fitness concepts, or perhaps a traditional franchise.
Medical billing probably does not make the list.
And that is exactly why our recent conversation with Adam Phillips, CEO of American Business Systems, and Jason Pettit, Chief Growth Officer, was so interesting.
On the latest episode of the Franchise Wizards Podcast, we explored a business model that sits behind an enormous part of the healthcare industry: helping medical practices get paid accurately and efficiently for the services they provide.
American Business Systems, or ABS, has been helping entrepreneurs build independent medical billing and revenue cycle management businesses since 1994. What surprised us was not only the demand for the service, but also the relatively low barrier to entry, recurring-revenue potential, flexibility, and scalability of the model.
The Problem: Doctors Are Providing Care — But Getting Paid Is Complicated
Medical billing sounds simple on the surface.
A physician sees a patient. The practice submits a claim. The insurance company pays.
In reality, it is much more complicated.
During our conversation, Adam and Jason explained that medical practices continue to struggle with rejected claims, coding issues, incomplete documentation, underpayments, eligibility problems, and the constant follow-up required to collect money that may legitimately be owed to the practice.
According to ABS leadership, claim rejection rates can reach 20% to 30% in some medical practices, depending on the circumstances. ABS says the systems used by its business owners operate at rejection rates below 2% nationwide, month after month.
The challenge can be especially significant for smaller private practices.
A large hospital system may have dedicated billing teams, coders, compliance staff and sophisticated internal systems. A smaller private practice may instead have an office manager or administrative employee juggling billing alongside scheduling patients, answering phones, managing paperwork and countless other responsibilities.
That creates an opportunity for specialized revenue cycle management companies.
The ABS Research Guide describes medical billing as only one piece of a broader Medical Revenue Management service that can also include denied-claim follow-up, patient statements, secondary insurance processing, reporting, practice analysis and other revenue-enhancement services.
So What Exactly Is American Business Systems?
One of the first distinctions we discussed in the podcast is that American Business Systems is not a franchise.
It is classified as a business opportunity.
That distinction matters.
An ABS business owner operates under their own business name, rather than under the American Business Systems brand. There are also no territorial restrictions, meaning owners can potentially serve physicians anywhere in the United States.
And unlike a traditional franchise structure, ABS does not charge ongoing franchise royalties.
Instead, ABS provides the infrastructure for someone to launch and grow their own independent medical billing and revenue cycle management business.
That includes training, technology, marketing systems, proposals, practice analysis tools, ongoing education, coaching and lifetime support.
According to the ABS Research Guide, the current one-time initial investment is approximately $35,000. That investment includes live training, lifetime support, access to systems and services, and initial marketing materials.
ABS also offers a 30-day money-back guarantee, allowing a new owner to complete the training program and determine whether the business is truly a good fit before fully committing.
The Economics Are What Really Get Your Attention
The numbers were one of the most interesting parts of our conversation.
According to Adam, an individual physician client can potentially generate approximately $30,000 to $50,000 in annual gross revenue for an ABS business owner, depending on factors such as specialty, patient volume and claims volume.
Owners typically charge medical practices a percentage of the money collected from insurance companies and patients.
That creates some unusual unit economics.
With an initial investment of approximately $35,000, a single solid physician client could potentially generate revenue approaching the initial investment over the course of a year.
And because each client can represent meaningful recurring revenue, an owner does not necessarily need dozens of customers to create a substantial business.
The ABS Research Guide also describes additional revenue streams beyond core medical billing, including electronic medical records support, chronic care management, patient payment systems, credentialing, medical coding, collections, HIPAA compliance and other ancillary services.
Of course, results vary substantially. Client size, medical specialty, pricing, operating expenses, owner effort, market conditions and execution all affect performance. But the underlying economics help explain why some entrepreneurs find this model so compelling.
But How Do You Actually Get Doctors as Clients?
This is the obvious question.
Having a good business model means very little if you cannot acquire customers.
ABS does not simply teach medical billing. A significant part of its training and ongoing support is focused on how to find and sign physician clients.
Adam explained that ABS teaches approximately a dozen different marketing approaches so owners can choose methods that fit their personality and experience.
These can include business networking, referrals, email outreach, social media, local business organizations and strategic relationships.
One particularly interesting strategy involves partnering with pharmaceutical sales representatives, medical device representatives and other professionals who already have established relationships with physicians.
Jason explained that ABS also teaches owners which medical specialties tend to be attractive targets. In the podcast, he highlighted cardiology, podiatry and pain management among the specialties that can be particularly strong prospects.
For someone who enters the business full-time and consistently follows the ABS marketing plan, Adam said the first client is often secured in approximately 30 to 90 days.
That is not a guarantee, and timing varies considerably. But it gives prospective owners a useful benchmark for understanding the ramp-up process.
Could You Start This While Keeping Your Corporate Job?
This may be one of the most attractive aspects of the model for corporate professionals.
Many people we speak with through Franchise Wizards are interested in entrepreneurship but are not prepared to simply resign from a well-paying job and hope a new business works.
They want to build a bridge.
ABS can potentially offer that bridge.
Adam explained that many owners begin while they still have another job. They may acquire one or two clients, learn the operational side of the business and gradually grow their recurring revenue before deciding whether to transition into entrepreneurship full-time.
For a typical smaller medical practice, Adam estimated that processing approximately 30 claims per day might represent roughly one hour of billing work.
As the business grows, owners also do not necessarily have to perform all of the billing themselves.
ABS has staffing resources available to help owners hire billing professionals. That means an entrepreneur can eventually move away from day-to-day claims processing and focus more heavily on client relationships, business development and growth.
This creates several possible ownership styles.
Someone may want a small, highly flexible business with just a few physician clients.
Another owner may want to build a larger organization with employees and dozens—or even hundreds—of providers.
Both approaches exist within the ABS system.
What About AI?
No conversation about technology today would be complete without talking about artificial intelligence.
Medical billing is no exception.
ABS says its technology partners are already integrating AI and automation into many of the systems used by its business owners. The Research Guide specifically notes that AI tools are being incorporated into billing and revenue cycle systems to improve efficiency and reduce errors.
But Adam made an important point during our discussion.
He does not believe AI eliminates the need for humans in medical revenue management.
Instead, he described the future as “human in the loop.”
AI may help identify codes, review documentation, streamline workflows and flag potential issues. But healthcare is complex, highly regulated and directly connected to patient care.
Human oversight remains critical.
Jason offered a great analogy: most people are comfortable knowing that an airplane spends much of its flight operating on autopilot. But they probably still want a trained pilot sitting in the cockpit.
That is how ABS currently views AI in medical billing.
From Lifestyle Business to Large Enterprise
One of the best parts of the podcast was hearing the different paths ABS owners have taken.
Some are intentionally small.
Adam shared the story of Jaye Beattie, a retired corporate professional who wanted to remain productive but had no interest in rebuilding another demanding career. He eventually worked with two podiatrists and structured the business around the lifestyle he wanted.
The ABS Research Guide describes Jaye as working approximately 20 hours per week with two clients and earning six figures while maintaining a flexible, part-time schedule.
At the other extreme, Jason shared examples of owners who built very large operations.
One pair of business partners eventually grew to more than 400 clients.
That is not presented as a typical outcome, and ABS is very clear that individual results vary. But it illustrates the scalability available to an owner who has the skill set, ambition and operational capability to build a larger organization.
Another case study in the ABS Research Guide follows Benny Biordi, who transitioned from Wall Street and eventually built a medical billing operation serving 30 physicians with a team of employees.
The lesson is not that everyone should build a huge company.
The more interesting point is that the model can be shaped around different entrepreneurial goals.
Who Might Find This Business Interesting?
This opportunity may be worth investigating for people in several different stages of life.
A corporate professional may want to build recurring income before leaving a job.
Someone already prepared for entrepreneurship may want to jump in full-time and focus aggressively on client acquisition.
A healthcare, pharmaceutical or medical sales professional may be able to leverage existing industry relationships.
And someone approaching retirement may want a business that provides income, intellectual engagement and purpose without recreating the intensity of a corporate career.
The ABS model is not right for everyone.
No business is.
But one of the reasons we created the Franchise Wizards Podcast is to expose aspiring entrepreneurs to business models they might never discover on their own.
American Business Systems is a great example.
Medical billing may not sound glamorous.
But when you examine the economics, recurring revenue structure, low overhead, flexibility and underlying need in the healthcare market, it becomes much more interesting.
And sometimes the best business opportunity is not the one you originally imagined yourself owning.
It is the one that best fits your skills, goals, financial position and desired lifestyle.
🎥 Watch the Full Podcast Episode
Hear our complete conversation with Adam Phillips, CEO of American Business Systems, and Jason Pettit, Chief Growth Officer, including the economics, client acquisition strategies, owner case studies, AI trends and what the day-to-day business actually looks like.
👉 WATCH THE FULL EPISODE: https://youtu.be/cPHfF8XgpxI?si=6NIm8OraggYPwRQm
📘 Want to Learn More About American Business Systems?
The ABS Medical Billing Research Guide includes industry information, business-owner case studies, details about the business package, revenue streams, operating costs, marketing resources and more.
👉 DOWNLOAD THE AMERICAN BUSINESS SYSTEMS RESEARCH GUIDE: https://franchisewizards.com/podcast/lp/abs
🔎 Not Sure ABS Is the Right Fit? Find Businesses Matched to You.
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