In-House or Outsourced Medical Billing: Which to Choose?

Have you been unable to decide if you should outsource medical billing or manage the process in-house? Read on to find out more.

The right answer to this dilemma will vary from practice to practice and will be based on a range of factors, such as, the state of your practice’s finances, the age of your business and the size of your local labor market amongst others. You will also need to evaluate your practice’s volume metrics, staffing and cost to find out what is best for you.

In-House Medical Billing

The Pros

  • Retain and exercise hands-on control over your financial operation through in-house billing
  • Better return on investment, if you have already invested on trained medical billers and medical billing technology
  • Closer proximity and more accessibility to your in-house billing department, where problems can be quickly addressed

The Cons

  • The cost of billers’ salaries, providing employee benefits and buying technology systems can be more expensive than outsourcing medical billing to a third-party
  • If your managers do not keep a stringent eye on your medical billing operations, you will have to deal with discarded superbills, ignored encounter forms or unappealed claim denials
  • If your medical billing department has only two to five medical billers, your cash flow and operations can get stalled even if a single employee quits, takes a vacation or takes a leave of absence.

Outsourced Medical Billing

The Pros

  • If you are starting a new practice or facing a transition phase, because of an employee’s resignation, outsourcing medical billing will make the most financial sense.
  • A professional medical billing company will supply you with detailed performance reports either automatically or upon your request.  These reports will give you visibility and transparency on your medical billing operation, without you having to manage or oversee any problems.
  • Experience enhanced consistency, as your service provider will be obliged to perform services, like appealing denials. You will also never have to worry about staffing, as your service provider will support your needs all through the year.

The Cons

  • It may be tough for your hands-on managers to relinquish control of your medical billing process to a third-party service provider.
  • Most medical billing service providers will charge you a percentage of collection, so the more you bring in, the more you will be paying for. This will make it hard to budget your expected billing expenses, as the cost will keep differing between busy and slow months.
  • Outsourcing contracts can contain hidden fees for startup charges, printing statements or sending reports. At times, you may also incur a fee, if you cancel your membership.

Now that you know the pros and cons of in-house billing and outsourcing medical billing, which would you choose for your practice and why? Let us know by leaving a comment in the box below. We, at Outsource2india love to hear from you!

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