This document outlines the basic steps an independent RNFA needs to take to begin medical billing. The steps include: 1) applying for facility privileges, 2) obtaining a National Provider Identifier number, 3) deciding how to structure billing under an SSN, LLC, or corporation, 4) finding a surgeon to work with who will provide billing codes, 5) choosing a specialty with high reimbursement, 6) determining the surgeon's Medicare caseload, 7) checking states that allow RNFA reimbursement, 8) reviewing useful resources, and 9) optionally hiring NIFA for medical billing assistance.