Should Private Practices Outsource Medical Billing?

There are some advantages and disadvantages to both in-house and outsourced medical billing.  The right answer is going to vary for each practice, based on a multitude of factors (like size of practice, personnel training, number of employees, etc).  If, for instance, you have employees that have coding and billing experience already, it may not make sense to outsource - especially if those employees will likely stick with your company for the long-term.  On the other hand, if you have a smaller private practice and that employee goes on vacation, falls ill, or quits, the financial position of your practice will be impacted. So what to do?

3 signs you should outsource medical billing & coding

Your employees are wearing too many hats already.
It’s not uncommon in smaller practices for people to fill more than one role to make the business happen. Granted, medical billing requires a certain level of expertise so your billers might not be accomplishing other tasks, but having overworked employees is a recipe for disaster. When the same person is worrying about revenue cycle management, employee issues, and patient happiness, it’s easy for mistakes to happen.

Medical billing mistakes are costing too much. When those mistakes happen on the medical billing side of a practice, it can end up costing a significant amount of revenue over the course of time. Think about it: it’s not in the best interests of insurance carriers to pay out every claim right away; better to take advantage of the time value of money. What this means for practices, though, is to hedge the bets in your favor. A higher pass-through rate for claims will directly impact funds coming in. 

The ICD-10 transition is wrecking your world. Has your practice gotten fully on board with all the changes? As we’ve discussed in previous blogs, the potential exists for the ICD-10 transition to impact incoming revenue, most likely because mistakes in diagnostic and procedural coding will delay payment. Here are some tips your practice can implement quickly, but outsourcing to a reliable medical biller is a great option to ease the transition.

 

Pros

  • If you outsource medical billing, you will not have to pay for additional training when processes and regulations change - which happens often.

  • Outsourced medical billing is typically cheaper than paying a full-time employee (especially when benefits, office space, overhead, etc are factored in).

  • Third party medical billing companies are experts in their fields, leaving you and your staff to focus on providing excellent care, rather than becoming jacks of all trades.

CONS

  • Keeping all departments under the same roof may enhance communication and streamline troubleshooting.

  • It is easier to ensure that billing personnel are representing your practice in the same manner that you would treat patients.

  • The costs associated with in-house billing are generally fixed, whereas most medical billing companies work on a percentage basis.