In House vs Outsourced Medical Billing: Pros and Cons

A lot of medical practices these days have opted to outsource their medical billing to external agencies due to the ease and convenience that it offers. However, there are still a number of medical practitioners out there who think that their in-house medical billing is any day better.

If truth be told, the decision mainly depends on a number of factors like how old the practice is, how sorted out the finances and claims are, how large the clientele is etc. It is important to remember that apart from the services that you offer, you revenue and billing are the other crucial aspects of your practice. These really can’t be taken very lightly. You need to assess the various expenses that you incur and how these affect your overall revenues.

However, if you are in the initial stages of decision making, weighing the few pros and cons can be helpful. Take a look at what these are:

In-House Medical Billing: Pros

  • Control over the Process: When it comes to in-house medical billing, it is easier for the doctors to have a controlover the whole process. Also, they can easily discuss any concern or confusion that may have, with their staff.
  • Better Return on Investments: A number of medical practitioners may have already got their staff trained in the medical billing process and may have also invested in medical billing software. In such a scenario, outsourcing the whole system may seem like a waste of time and resources that was put into it in the first place. Refining the process may seem a much more feasible decision at such instances.

In-House Medical Billing – Cons

  • Higher Operational Costs: Doctors who have a fully fledged staff to handle their medical billing may sometimes end up paying more for the salaries than the amount generated as monthly revenue. Also investing in the training of the staff and the latest technology would mean shelling out more money.
  • Unplanned Stalling of Work: If the in-house medical billing department of a service comprises of just a few employees, even the absence of one of these can cause the stalling of the whole claim submission and reimbursement process.
  • Higher Chances of Liabilities: With an in-house medical billing system, chances are rife that the employees may not be too committed to the whole billing process owing to the fact that their salaries are nevertheless paid. Thus, they could ignore important things like appealing the denied claims, discarded super bills etc.

Outsourced Medical Billing: Pros

  • Lower Expenses: Outsourcing the medical billing system is any day less expensive than maintaining a whole staff. The medical billing services are paid a percentage of your collections. Thus, their payment is directly proportional to your earnings, which means if your revenues are low the expenses would also be low. Also, you do not have to worry about all the expenditure that you have to incur when you have a staff.
  • Better Transparency: A medical billing service agency is quite transparent about your collection reports and claims. This may not be the case with the office staff, which may hide things from you to keep their errors under cover.
  • Improved Consistency: Since your collection determines the payment of the medical billing service, they make sure to pursue the health insurance provider to check on the denied claims and extracting the maximum reimbursement amount. Thus, you can be sure of a consistent rise in your revenues.

Outsourced Medical Billing: Cons

  • Zero Control: Outsourcing the medical billing would seem to be a relief to practices that do not mind a third party taking over the hassles of preparing the documents. However, people who wish to keep things under their control may not be really very happy with the arrangement.
  • Variable Revenue: Though the fact that the medical billing service charges a percentage of the collection may seem like a blessing, it has its downside too. This would mean that it would not be easy for you to have a clear estimate of your revenues as these would differ from one month to the next.

Hiring a medical billing service has its share of pros and cons. Thus, it is totally up to the medical practitioner to take a call based on his requirements and his comfort zone. To know more about Primed Billing Contact us .

To know more about our medical billing services, click here