In-house or Outsource Medical Billing: Which One Would You Prefer?

Health care service providers get reimbursement From the insurance companies for the services rendered to the patient. The medical billing system has gone through many steps and any error can lead to claim denial.

Some health service providers prefer to operate their billing activity through an in-house medical billing team while some outsource their billing management.

In this article, we will determine the difference between in-house medical billing and outsourced medical billing and which one is better for your practice.

What is Medical Billing?

The medical billing process has several steps from Patient registration to follow-ups. Here is an outline of the steps involved in medical billing.

• Patient registration process.

• Insurance verification and coverage

• Claim generation through coding

• Claim submission

• Patient statement preparation

• Follow up.

In-house Medical Billing

In the In-house medical Billing process, your medical practice has direct control over your billing activity. In-house billing has its own pros and cons.

Pros:Complete control

In the in-house medical billing system, the service provider has complete control over the financial management of the practice.

With complete control, you can implement any changes instantaneously and maintain transparency and accountability in your financial statements.

Effective Resource Management

With in-house medical billing, you can effectively manage your resources.

While you have spent a lot of your money in the training of your staff and utilizing the best software solution, in-house management gives you some control to handle your expenses if you have a good financial team in your setup.

Greater flexibility

When you are managing your finances on your own. You can control and manage it without being attached to any contract so you can make abrupt changes and change the system at any time while outsourcing has no such flexibility.

Cons:Higher Cost:

The cost is much higher if you are managing your billing activity on your own. Like you have to hire more staff, especially those who are experts in coding and administration.

You also need customized EHR/EMR software to manage the whole activity, which eventually can cost you a lot.

Inexperienced Staff:

The majority of the time the in-house billing activity is managed by their medical staff, this is the reason that many of the practice lack resources and fund to hire an experienced and skillful expert in their in-house team so lack of experience cost them a lot which ultimately raises the chances of error in the coding and other statements which is one of the top reasons behind higher denial rates.

Interruptions in the operations:

Many in-house billing teams have only a few staff members to perform the operations. It is a serious issue especially when any staff member is out of the office like going on vacation or sick then it can interrupt your whole financial system.

On the other hand, it will also impact the productivity of your other staff members as their workload increases.

Outsource Medical Billing

Outsourcing is the activity of handing over your financial and billing management to an outside company that has experts to handle the financial system. Here are the pros and cons of Outsourcing.

Cons:

Lack of Control:

The lack of control over the billing activities is one of the major disadvantages of outsourcing your billing. Many health practices show this concern that they have less control over their financial management.

Variability in cost:

For outsourcing, you have to make sure about the hidden fees. Some of the billing companies charge extra fees like chargers for printing and mailing bills and charge a cancellation fee if you choose to terminate your account. The best you can do is to read the contract carefully before signing it.

Pros:Maximize Productivity:

The medical billing system is not easy to manage. Many health service providers found it difficult to hire professionals and train them to manage the whole administrative and financial work which requires a lot of resources and time.

While doing all this activity the patient care system can be compromised because the health professionals are busy managing the financial system so they get less time to properly check their patients so outsourcing can help them out in this scenario.

Through outsourcing, they can get rid of the billing process and only focus to give their patients proper treatment.

Increasing Revenues:

With outsourcing, you can increase the revenues of your services. While on one side you are maximizing your productivity on the other side the medical billing companies assure you to get all the remaining payments for the services you rendered to the patient.

Because they have experts to handle the coding activity, follow-ups, and generating claims to maximize the chances of reimbursement.

Low chances of errors:

The chances of errors are very low while you outsource your billing. Most of the medical billing service providers have highly skilled staff to manage the coding, follow-ups, and claim denials.

With highly skilled staff the chances of error are also reduced so you can get maximum reimbursement without facing any higher denied rates.

Higher Transparency:

The transparency rate is higher as you can get a comprehensive performance report from your medical billing company at any time.

This report allows you to make a fair assessment of your billing operations and you can forecast better results and demand more from your provider.

Safety and security measures :

A good medical billing company is aware of the latest trends and regulations in the market so they are bound to follow the regulations by HIPPA.

So the chances of any rules and regulations violations are low and this will ensure more transparency and safety in the whole financial management.

Final Verdict:

Throughout the article, we have seen some of the pros and cons of in-house and outsourced medical billing operations. While the in-house billing operations give you greater control, effective resource management, and flexibility in your system.

On the other hand, outsourcing gives you more productivity, increases revenues, lower chances of error, higher transparency, and good security measures. Clearly, you can increase your revenue through outsourcing.

If you want to outsource your billing activity call now at (888) 598-9181

Med-Miles have a team of experts that can fulfill all your requirements and give you a better solution so you can get maximum reimbursement with lower denial rates.

Cathryn Baum is a Content writer who offers ghostwriting, copywriting and blogging services. She works closely with B2C and B2B businesses providing Healthcare and digital marketing content that increases their search engine visibility.