Deciding between In-house and Outsourced Medical Billing

The way medical practices manage their operations is rapidly changing due to the evolution of modern technologies, regulations by the government, financial boundaries and patient empowerment. This has led practitioners to decide from the various methods they can garner revenues and cut costs without compromising on the quality of their services, including medical billing.
Professional medical coding practices should be the main priority for practitioners, regardless of whether the medical billing is in-house or outsourced. Coding practices should not be taken lightly and are the fundamentals to healthy billing operations.
In spite of everything mentioned above, a medical practitioner like you will have to decide between in-house and outsourced billing. So which of the two is best for you? Let’s take a look!
In-house Medical Billing
On average, an in-house billing department usually consists of around two expert trained billers who cater to around three providers each. The costs for an in-house billing department, apart from salaries include the cost of hardware, software, clearinghouse registration, storage and material such as courses, books etc.
The advantages reaped from having an in-house billing department far outweighs the overheads associated with it. In-house billing departments have the advantage of having things done in real time, which means that as a practitioner, you will have oversight on the processes taking place right then. You can hence take more control over the account receivables and have changes implemented when you want.
There are many examples of companies which failed to pursue account receivables due to budget constraints required to process those collectibles. A company with a large number of patients with account receivables having minimal dollars is something that amounts to a lot of money. This issue can actually avoid by having an in-house billing staff.
Outsourced Billing
Outsourced Billing is an ideal solution for medical practitioners who do not want to engross themselves in the process of hiring and training a separate billing department altogether. What they can do with utmost ease is to outsource their billing functions to a billing company who will then handle all the aspects themselves. A team of well-trained staff is generally hired by medical billing companies who are completely well-equipped to handle the ins and outs of medical billing.
It is ideal for small-sized practices to outsource their billing to billing companies since it saves them a lot of cost which is usually attributed with setting up of their own, dedicated billing departments. They will not need to spend thousands of dollars on setup costs, administrative costs and overheads. Instead, they can pay a certain percentage of their monthly or annual collections to the billing companies who will solve all their hassles.
The only problem that can arise out of such a scenario is that since the claims processing and records are no longer present in the practice itself, sometimes, the claims which are submitted by billing companies can be erroneous and might cause you some problems. It is imperative to hire a billing company which excels in billing rather than just falling for someone inexperienced in the industry.
Around 5 to 10 % is what top end medical billing companies charge from your practice’s collections. This might look a lot at first to many concerns, but you must remember that over a long period, it will save you from additional costs associated with in-house billing.
It is advisable for medical practices, especially small ones, to do a careful cost analysis of in-house billing versus outsourced billing. In case you are going for the second option, it is always important to negotiate with the billing company for as low as possible. These days, billing companies will also provide you with free EMR/EHR and Practice Management solutions if you outsource your billing to them. You can also include the cost of availing this great facility when doing the cost analysis of both options available to you.
Ultimately, the most feasible option for your practice depends upon your management style. If you are a complete control freak, and don’t really care about extra delays related to your accounts receivable, then you might want to tilt towards in-house billing. However if securing your Receivables at the earliest is your first and foremost concern then it would be a wiser option to opt for outsourced billing.