Outsourced vs. In-House Medical Billing

Fotolia_32362887_XSMany medical practices are faced with an important question and that is whether to opt for outsourced medical billing or keep it in-house. The right answer to this question actually varies from practice to practice. Where one practice may benefit more from outsourced medical billing, another may just need a little guidance to effectively manage their in-house billing. Revenue management services that assist in such matters can help practices realize what they need and guide them toward the next step.

Here are some of the factors that need to be looked at when considering type of medical billing that needs to be used:

•    The age of the practice
•    The state of the practice’s finances
•    The size of the local labor market
•    The difficulty in finding qualified medical billing professionals
•    Billing needs of the business
•    The state of the current billing system

The number of errors that show up are also a factor that needs to be evaluated because practices cannot afford errors since they cost money. If there are frequent billing disputes or any audits that are performed reveal errors, then it may help to hire a medical billing agency to help. This is because revenue cycle management and billing are two very important aspects of the practice in addition to the clinical services provided to patients. This is why how you handle your services should not be taken lightly. You can do thorough assessments of the cost of the practice, volume metrics, and staffing to determine which is the right route to take.

In the preliminary stages of your evaluation and the decision-making process, you should take a generalized look at what most administrators and doctors consider to be the advantages and disadvantages of both in-house billing and outsourced medical billing.

Revenue Management Services: Outsourced Medical Billing

Here are some things to consider about outsourced medical billing:

  •  It is less expensive, especially if the practice is a new one or there is a transition within the practice, such as the resignation of an employee. Outsourcing can make a lot of financial sense.
  • Consistency is enhanced and this is something that is important. The Medical billing agency taking care of billing is contractually obligated to perform specific services, such as appealing claim denials. This gives the practice a certain degree of success. Plus, you don’t have to worry about hiring another employee since it is the agency’s job to support your needs throughout the year.
  • Transparency in the way of receiving performance reports when you request them. This is a tool that shows you the job is being done right, and that you do not have to micromanage or spend a lot of time overseeing the operations or any of the staffers performing the work.

These are all elements of outsourced medical billing to consider, which will help you make an informed decision about what you want to do with your billing.

Revenue Management Services: In-House Medical Billing

Here are the aspects that you can consider about in-house medical billing when deciding whether or not you should go that route or just outsource the task:

  • The costs are generally higher because of salaries that need to be paid, employee benefits, and purchasing the technology systems that are needed to complete billing tasks. Third-party billing solutions already have the staff and equipment in place and they pay benefits to their own employees out of their pockets.
  • Medical billing departments have been known to be hotbeds for embezzlement. Employee neglect is also an issue. Forms of neglect include discarding superbills, ignoring encounter forms, and not appealing claim denials. If managers don’t keep a close eye on their billing operations, then these forms of neglect can go unnoticed.
  • There may be support issues if only a few people work in the billing department and one of them gets sick or goes on vacation. Sometimes they simply quit and that causes productivity issues that cannot be afforded.

Which you do is entirely up to you, but opting for a medical billing agency to handle your billing can be an affordable and convenient service. Because you already have enough to worry about in your practice, this eliminates one of them so that more focus can be placed on what is important.

If you know that there are issues within your medical billing department or you are a new practice evaluating your medical billing options, MD Pro Solutions can help you. Call us at 508-946-1665 or fill out our contact form to request more information.