The following excerpt is from Start Your Own Medical Claims Billing Service. Buy it now from Amazon | Barnes & Noble | iTunes

While landing that first client can be the hardest part of the medical billing business, there are ways to nab that first doctor, and the one after that, and the one after that.

The absolute best way to attract clients is through word-of-mouth. Doctors have a set of jungle drums -- a grapevine. Doctors gossip. Like that shampoo commercial where the silken-tressed model tells two friends and “they tell two friends and they tell two friends,” doctors also pass the word on.

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“Yeah,” you might be muttering aloud, “but how do I get the first one?”

Relax. You have a lot of options.

People will talk

The first option is referrals, or networking, which is really a variation on word-of-mouth. The difference is that with word-of-mouth, you sit back and wait for others to talk about you and send business your way. With networking, you actively seek referrals.

Talk to everybody you know. Let them all in on the exciting news that you’re now running a medical billing service. You can start with your own doctor. Next time you see them on a professional basis, tell them about your service. But don’t ask directly for their business, as this might put a strain on your relationship.

Chances are, however, that they’ll have referrals and probably some tips on how to approach other doctors. Terrific! It’s always easier to call other doctors when you can say “Dr. Whatsit suggested I call,” or “Dr. Whatsit referred me.” People always pay more attention when someone they know has given you the green light.

After you talk to your doctor, call other providers you know directly or indirectly: your children’s pediatrician, your husband’s internist, your father’s cardiologist, your pharmacist and your dentist. Using the name of a recognized patient, or being one, can give you a foot in the door.

Once you’ve tapped out those resources, start approaching physicians who specialize in an area you’re interested in. For instance, if you have small children, you might start with pediatricians; if you’re into athletics, you could try sports medicine practitioners.

There also are lots of other people you already know who you can put on your networking list. Your attorney, accountant, insurance agent and real estate agent probably have their own little card files full of physicians and may be happy to make referrals.

Related: Startup Expenses for a Medical Claims Billing Service

When you’re finished with professional types, call your friends. Call your parents. Call your parents’ friends. Good referrals can come from unlikely sources. And everybody either knows somebody or knows somebody who knows somebody. This is what makes networking work.

The MIB letter

Many medical insurance billers (MIBs) have had great success with newsletters or other direct-mail pieces. Along with your newsletter, include an introductory letter and resume describing your services.

One MIB we know sends out a newsletter to existing clients about every two months, featuring small articles about coding changes -- and more. This helps to position you as an expert in the medical claims billing industry, which builds credibility. When you show doctors your expertise in various phases of medical billing or practice management, you give them the confidence to go with your company. You can also make their mouths water. Let them think “Wow, if I had this billing service, I’d have this sort of stuff available all the time.”

(Cold) Calling all clients

If you hated the “ask the fellow” part of Sadie Hawkins dances, or if you were at the bottom of the Cub Scout candy-sales pack because you didn’t like knocking on doors, then cold-calling (calling on a prospect unannounced) will leave you chilled to the bone.

Although general industry reviews are mixed, the MIBs we talked with who’ve tried this approach were pleased with the results. Curt J. says, “If you don’t have any clients yet and you don’t have any experience, the only thing you have to sell is yourself. So because I wasn’t afraid of face-to-face selling, I just made up my own brochures along with some other material, and I went door to door and gave them my materials. I followed up with another visit and then followed that up with a phone call.”

Calling on doctors is a unique experience. They usually have a chorus line of patients waiting in the wings, colleagues and pharmacists dialing up with questions, and assistants darting back and forth with questions from patients. There’s little time for dillydallying, shooting the breeze or kicking back for a cup of coffee and a chat. If you understand how a doctor’s office works, you’ll have a better chance of seamlessly insinuating yourself into it.

As with most businesses, the typical health-care office is made up of various personalities, job descriptions and educational backgrounds. The staff usually includes a receptionist, various office assistants, an office manager and clinical staff help such as nurses, therapists or hygienists. To land work, you’ll want to talk to either the office assistants or, more likely, the office manager. Large medical and dental practices employ office assistants to help the receptionist with clerical and administrative tasks such as maintaining patient accounts and general bookkeeping. They may or may not have a say in administra­tive decisions, but it’s a smart idea to deal with them as if they do.

Related: How to Determine the Best Markets to Target for Your Medical Claims Billing Service

If the physician’s practice is large enough to have an office manager, this person is usually responsible for managing the office staff, maintaining patient relations, monitoring accounts and collections, gathering financial information for the doctor and accountant and overseeing office operations. The doctor usually grants the office manager a great deal of decision-making power. They might have been trained at a trade school and might have several years’ experience in health-care administration. Winning over this key staffer can be every bit as important as winning over the doctor. If you succeed in gaining their interest, they should have enough leverage to set up the big meeting between you and her boss and the doc­tor will take their suggestions seriously. In some cases, the office manager has the authority to decide on their own whether to use your service.