In house v/s Outsourced Medical Billing Services – Benefits & Challenges

As per Medliminal Healthcare Solutions (MHS), at least four in five medical bills have mistakes, which costs US$68 billion annually in unnecessary healthcare expenditure by doctors and patients alike. A lot of medical practitioners are thus choosing to outsource their billing needs to a medical billing company rather than going for an in-house team. However, both in-house and outsourcing have their benefits and complications.

Medical Billing
Medical Billing

There are a few challenges involved in outsourcing billing services rather than keeping it in-house. One of the major concerns is patient’s data security. There have been cases of data breach where personal medical data has been made public. However, a good medical billing company understands its significance and invests a considerable amount in maintaining strict data security. Another common problem with outsourcing is the lack of accessibility as compared to getting billing errors rectified with an in-house team. Third most common challenge medical practitioners face is of hidden costs. Medical billing agencies often charge extra fees for some additional services. However, in dealing with a reputed billing service provider, there is no need to worry about hidden charges because everythingis mentioned beforehand in the contract.

Why should practices choose to outsource?

  • Outsourcing is lighter on your pocket. Maintaining an in-house medical billing department will cost you around 10-12% of your annual income. Whereas, medical billing service providers charge you around 4-8%. It saves you from additional expenditure involved in the set up of in-house department, and hiring and training of staff.
  • Coding errors are one of the common causes of claim denials. Codes increased from 13000 in ICD-9 to almost 68000 in ICD-10. This significantly increased the chances of error, especially with newly trained staff. Outsourcing gives you access to professional coders who are constantly updated with coding changes and requirements.
  • In-house billing requires regular monitoring. You will have to dedicate considerable amount of time for its proper functioning. This robs you of valuable time that can be invested in patient care, and other vital administrative tasks. Outsourcing lets you focus on your core responsibilities, which in turn improves engagement with patients, and increases their satisfaction level.
  • Working with a reputed medical billing firm can boost your cash flow. With their latest technology, and automated claim submission software, claims are reimbursed faster. Quick and error-free claims submission means quick payments.

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