In doubt, whether you want to outsource a medical billing company or want to keep the process of billing and coding in-house totally depends on doctors and practice managers. The solution to this query depends on several factors that include, size of the business, age of business, state of practice finances,and several others.

Aside from the clinical services you provide, proper revenue cycle management is also crucial. Your cash flow, finance depends on the staff that handles billing. So, it is important whom you choose to handle these services. You have to keep several things in mind like cost, the volume of claims, and so on. 

A medical billing service provider is mainly a team that handles claims professionally. With the help of certified coders, they handle claims, provide denial management service, and so on. Most of them are experienced in every field of medicine. They provide a lot of services which include physician medical billing, laboratory billing services, and so on. 

In this article, you will learn about the pros and cons of both in-house medical billing and outsider billing company and then you can choose the right thing for you that matches your needs and preferences. 

In-House Medical Billing

In-house medical billing means whether you hire some certified coders and billers or assign this task to some of the staff members. If you make someone from your staff to be responsible for billing and coding that may not help much because they may not find time to deal with claims effectively. Let’s have a look into the pros and cons of in-house medical billing. 

Pros

Retaining Control:

When you hire some long-term, trusted employees, you have full control over them. You can keep a check on the financial activities, and have more information about everything with an in-house billing staff. 

Return on Investment:

If you have trained some medical billers and bought technology that helps in billing, choosing a medical billing isn’t the right choice then. When you have a valid infrastructure in place then you should just focus and refine the existing processes to produce the best ROI. 

Close Proximity:

When having an in-house medical billing staff, the accessibility level is high and it allows you to counter any issue that comes up during billing and coding. You can observe, amend, and do other things in the process of billing. 

Cons

Higher Costs: 

It is a commonly known fact that, as compared to third party medical billing, the expense of paying in-house medical billing staff is higher because a person not only needs to pay to cover employee benefits but have to purchase technology that is needed. 

Support Issues:

If you have a department of billing that has two or three members then the activities and cash flow can be heavily influenced when an employee gets sick or take leave or be absent for any reason possible. 

Outsourced Medical Billing

Pros

Less Expensive:

As mentioned above an in-house medical billing is expensive as compared to medical billing service providers. The cost is greatly reduced because you don’t need to pay salaries, the maintenance cost of technology installed, you don’t have to pay extra bills for electricity and other related things. Outsourcing a third-party medical billing company makes sense when you want to cut your expenses.

Transparency:

Most of the known medical billing companies provide a full detailed report of the operations to their clients. Some send these reports automatically and some send these reports when requested. This is one great feature that allows you to be more financially secure and you don’t have to micromanage or oversee any of your staff. 

Enhanced Consistency:

When outsourcing, the provider will be obliged to provide you certain services like appealing denials with a certain success rate. Also, you don’t have to worry about staffing as it is their job to help you with everything that you need regarding medical billing and coding. 

Cons

Hands-Off:

Some people consider this as an advantage to physicians that outsourcing means that billing becomes someone else’s problem. However, it is tough to hand over your finance and give relinquish control of the process to an outsider. 

Variable Cost: 

Many of the billing companies charge their clients according to the collection. They charge a percentage of collection and this means the more claims you bring the more you have to pay. This makes it hard to budget your practice’s expenses as the cost varies a lot between slow and busy months. 

Hidden Fees: 

Before you choose a company to be responsible for medical billing and coding, you should read the contract carefully. You have to look for things like, are there any startup charges? Fee for sending reports? Is there any penalty if you cancel your membership? Make sure you have seen every condition carefully so that you know every hidden fee. This way you can make sure that you are not running in loss.