MANAGEMENT CONSULTANTS FOR PROFESSIONALS, INC. 

In House Billing

Outsourced Billing


PROS:

  • Retaining Control: Especially when trusted, long-term employees are executing medical coding and RCM duties, doctors and administrators appreciate having hands-on control of financial operations through in-house billing.

  • Return on Investment: Once a practice has invested in training medical billers and purchasing billing technology, moving to an outsourced solution means losing lots of time and money spent. When there’s a valid infrastructure in place, it’s worthwhile to just refine existing processes to generate the best ROI.

  • Close Proximity: Should issues arise, the accessibility of your in-house billing department is a major advantage, since all it takes to observe the billing process and address any problems is a walk across the office floor.

CONS:

  • Higher Costs: It’s generally accepted that the expenses of paying billers’ salaries, covering employee benefits, and purchasing technology systems add up to more than is commonly paid out to a third-party billing solution.

  • Liabilities: Medical billing departments can be hotbeds for embezzlement, and general employee neglect (think ignored encounter forms, discarded superbills, and unappealed claim denials) can go largely unnoticed if managers don’t keep a stringent eye on billing operations.

  • Support Issues: If your billing department consists of only two or three staffers, your operations – and cash flow – can be majorly stalled when even just one employee gets sick, goes on vacation, takes a leave of absence or quits altogether.

PROS:

  • Less Expensive: Especially if you’re starting up a new business or transitioning because of an employee’s resignation, outsourcing makes the most financial sense. Check out this hypothetical cost analysis on the topic from Physicians News Digest.

  • Transparency: A medical billing company should be able to supply you with comprehensive performance reports automatically or upon request. This capability grants you unparalleled visibility into your billing operations without requiring you to micromanage – or even oversee – any staffers.

  • Enhanced Consistency: Your outsourcer will be contractually obliged to perform certain services, such as appealing denials, for you with a certain level of success. Plus, you never have to worry about staffing, since it’s their job to support your needs year-round.

CONS:

  • Hands-Off: While many consider it an advantage that outsourcing makes the management of billing someone else’s problem, it’s tough for more hands-on managers to relinquish control of the process to another entity.  We allow our provider to have as much hand-on information that they want or need.

  • Variable Cost: Most medical billing companies charge a percentage of collections, so the more you bring in, the more you’ll pay out. This can make it hard to budget your practice’s expected billing expenses, since costs differ widely between slow and busy months.  Our cost is not variable.  We charge a percentage on the amount collected by your practice.