Inhouse vs Outsourced Medical Billing

Medical billing is one of the most complicated aspects of running a medical practice. With thousands of possible codes for diagnoses and procedures and multiple payers, the ability to have efficient billing is a real challenge. Unfortunately, there isn’t a one-size-fits-all solution for medical billing. Still, the two main options are in-house billing through a practice management system (PMS), with or without an electronic medical record (EMR), or outsourcing to a medical billing company.

To determine whether to keep billing services in-house or to outsource them, you should conduct a cost-benefit analysis to weigh the costs of billing to your agency for personnel, training, technology, and other resources versus the cost of contracting with an outside organization.

At the outset, it’s more convenient and much quicker to work with outsourced RCM. A look at the numbers helps illustrate how a smaller practice can improve revenue through outsourcing – 60% of claims would be collected onsite compared to 70% with a third party, clearly indicating that you get astonishing results if you outsource. Of course, you may prefer reading an X-ray scan to a spreadsheet as a physician. But it’s helpful to have an overview of the potential savings you can achieve by outsourcing billing to a third party in the future.

Aside from clinical services, billing and revenue cycle management are the most critical processes of your practice. Your cash flow depends on them, so the decision of how to handle these services shouldn’t be taken lightly. It would help if you thoroughly assess your practice’s cost, staffing, and volume metrics to determine what’s right for you.

Pros and cons of in-house billing vs. outsourced medical billing

In the preliminary stages of the decision-making process, however, you’ll need to take a generalized look at what most doctors and administrators consider the significant advantages and disadvantages that the in-house and outsourcing options each present.

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