In House Vs. Outsourced Medical Billing Pros And Cons

Medical billing often sidetracks medical providers from their primary objective, taking care of patients. The reason behind this is that medical billing usually consumes a lot of time and is tedious. The problem is that medical billing is as crucial as the clinical services that medical providers provide. The cash flow and the stability of the practice highly depend on the medical billing and revenue cycle. In order to give equal importance to both clinical services and medical billing, most medical practices have transitioned from in-house medical billing to outsourced medical billing. 

In House Vs. Outsourced Medical Billing.

In-house and outsourced, both the methods have their medical billing pros and cons. There are no concrete factors as to which way is better for medical billing operations. The choice depends on the needs of every medical practice. To choose between in-house vs. Outsourced medical billing, one should analyze the following factors:

  • The age of your business
  • The size of your practice
  • The financial state of the practice

To help you make a decision, we will now discuss the medical billing pros and cons of both in-house and outsourced. 

In-house Medical Billing

In order to set an in-house medical billing system, a medical practice requires at least two adequately trained medical billers and coders – per insurance provider. In addition, the medical practice should ensure that they can afford start-up expenses like:

  • Payroll
  • Purchasing the correct computer system
  • Purchasing the correct software
  • Registration with a financial institution
  • Storage equipment for record-keeping
  • Billing/coding manuals

It should be noted that the practice is entrusting the whole revenue cycle to these employees. Therefore, it is crucial to invest money into the hiring process to ensure it goes smoothly.

In-House Medical Billing Pros and cons 

Pros

Flexibility 

When your medical billing is handled in-house, you are the one who makes the rules. Whereas when you work with a third party, you are locked in by the rules mentioned in the contract. If you want to make changes to your billing system down the road, it’ll be much more complicated.

Full control over the billing process

In-house medical billing provides direct control and oversight over financial processes. If you have any queries, you can just walk down the hall and ask your staff and have them answered. You can also implement any billing changes instantaneously. Additionally, there is more accountability and transparency when all the finances are monitored by yourself. 

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Use your resources

To start your own medical practice is not so easy, peasy! If you already have everything to handle medical billing in-house, you can use your hard-earned resources. For instance, if you’ve bought good medical billing software and trained your staff, then it won’t be worth making the switch.

Cons

Liability 

There are many security and insurance protocols that medical billers have to handle. It is vital to ensure that your in-house staff has competency in HIPAA privacy and PHI security. It is essential to understand them because they can be huge liabilities to you. In-house medical billing requires you to keep a close watch to ensure that they aren’t:

  • Ignoring encounter forms 
  • Discarding superbills
  • Failing to appeal claim denials 

Cost 

In-house medical billing is often more costly than outsourcing. This is on the grounds that you have to pay your staff’s salary, benefits, software, and training. Therefore, it is important to consider the two possibilities while mapping out. In order to make the right decision, always consider the size of your business, as it is usually the most significant factor.

Support Issues

In-house billing may cause some support issues. Hiring a lot of billers in your administrative team will require you to invest a lot. Whereas hiring just 1-2 medical billers will be challenging. One of your billers might get sick, take leave, go on vacation, or quit; your cash flow and medical billing operations will be stalled.

Outsourced Medical Billing

The opposite of in-house medical billing is outsourcing medical billing from approved medical billing companies. Outsourcing has recently become an increasingly popular choice. The industry of medical billing is booming every day. Every year, many expert medical billers and coders enter the workforce. Partnering with medical billing companies ensures that the revenue is being left to the experts. Additionally, outsourcing medical billing services can help you to:

  • Avoid costly start-up expenses.
  • Receive extremely prompt submissions of claims
  • Avoid worrying about staffing
  • Remove stress from management across the board.

Outsourced Medical Billing pros and cons

Pros

Productivity

Outsourcing medical billing helps medical practices to increase productivity. With outsourcing, practice doesn’t have to hire, train, and manage an administrative staff. The medical practice can simply take care of their patients and handle other operational tasks. This is essential as most patients expect the undivided attention of their doctors.

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Increase Revenue

Another benefit of outsourcing medical billing is that it can save medical practices money. You can save money on in-house start-up costs, administrative salaries and benefits, software, supplies, and equipment. In addition, medical billing companies work to maximize your revenue. They ensure that you get the correct amount for your services by bidding with insurance companies. 

Accuracy & Compliance 

The Medical billing companies have all the expert billers and coders, whereas when a practice hires an independent medical biller to work in-house, they risk low claim success rates. This is a serious threat to your revenue. By outsourcing from a good medical billing company, you can avoid these risks and ensure that your finances will be handled professionally. Additionally, outsourced medical billing companies focus on quickly mending rejected claims, so you get your money. 

Cons

Less control

By outsourcing medical billing services, you’ll have less control over the management and less knowledge of the way insurance claims are being handled. You will have to schedule a phone call in case of any queries instead of getting answers down the hall. 

Variable Cost

Medical billing companies usually get paid a small percentage of your practice’s total revenue. This may cause some difficulties in budgeting your monthly expenses. You will pay less to the medical biller during slow months, but you will pay more in busy months.

Communication to Patients

When a third party handles your billing, you will not have immediate access to the patient billing records. You may not be able to answer your patients’ queries related to insurance or billing. In order to cover this, you can set a communication protocol with your service provider.

Wrap Up!

After knowing about the pros and cons of in-house and outsourced medical billing, If you are considering outsourcing your medical billing, UControl Billing can help. They offer many medical billing services and affordable prices. If you want a smooth billing process, then set up a time to chat with one of their billing specialists and see how your practice can get help from them.

 

 

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