Which Is Better Outsourcing Or In-House Medical Billing?

Medical billing plays a critical role in the success of any medical practice. Medical coding errors, problems with data collection, discrepancies, inefficient analytics, and inconsistent audits in the medical billing process can have significant repercussions in the revenue stream. Claim denials, claim rejections, and delays can also cause an inconsistent revenue stream, which can hamper the growth of your practice.

Many solo practitioners and small practices choose to either hire an in-house administrative staff or outsource their medical billing to a third-party vendor like Operant Billing Solutions. If this sounds like you, then you might be wondering which is better handing medical billing in-house or outsourcing medical billing?

To understand which is right for you, it helps to take a closer look at the strengths and potential drawbacks of outsourcing your medical billing needs.

What Is Outsourced Medical Billing?

When you outsource your medical billing needs you are reducing or perhaps eliminating the need for in-house administrative staff. You pay a third party vendor like Operant Billing Solutions, to handle your medical billing process for you. This includes handling things like:

• Accurate coding
• Claim creation
• Streamlining the revenue cycle
• Developing a more consistent revenue stream
• Easy to interpret reports
• More efficient audits
• Analytics that are easier to implement
• Fewer claim denials
• Fewer rejected claims
• A more consistent revenue stream
• Faster payment from payers and patients with an outstanding balance
• Lower overhead costs

More Patient Treatment Time

For small practices and solo practitioners outsourcing the medical billing process immediately frees up your time to focus on the important needs of your patients. Not only does this ensure that your patients receive your undivided attention, but it also means you will have more time available to treat additional patients.

Over time, many small medical practices that outsource their medical billing to a third party find that they also have more time available to expand the scope of their clinical services.

Greater Accuracy From Medical Billing Specialists
Most small practices and solo practitioners recognize that their time is better spent focusing on patient treatment outcomes. Many practitioners in this scenario will choose to hire one or two people to serve as their administrative staff.

These individuals are usually tasked with a wide range of duties including:

• Scheduling
• Fielding phone calls
• Physical filing
• Coordinating with insurance providers
• Ordering materials
• Maintaining the clinical office space
• And more

Adding medical billing to your administrative staff’s already full plate can be daunting. Not to mention the likelihood of other important administrative duties distracting them. This increases the chances of coding errors and missed data entry fields that can later translate into delays in payment, denied claims, or rejected claims.

It also means that you or your administrative staff will be able to stay focused on other critical tasks, without having to spend exorbitant hours on medical billing coding and claim creation.

More Effective Record Keeping

When medical billing documents are correctly coded and processed correctly using industry best practices, the net result is more organized records. This leads to faster analytics, easier to interpret data, and the ability to quickly recognize patterns that can hurt your revenue cycle.

More Organized Audits

When medical billing services are professionally outsourced to highly trained and experienced individuals like the professionals at Operant Billing Solutions, the data collected is accurate and very easy to interpret. This makes it easier for you to apply analytics and other interpretive audits to ensure a clear understanding of your revenue cycle. It also means you have more reliable access to patient information.

Reduced Office Management Costs

There is more than hours worked that go into the cost of administrative staff handling your medical billing process. Basic overhead from maintaining office space, materials, software, tech management, and payroll data all get wrapped into the overall cost of having one or more administrative staff handling the medical billing process. Ultimately, by outsourcing these services, you are saving time and money, while allowing yourself to stay focused on patient treatment outcomes.

Are There Drawbacks To Outsourcing Your Medical Billing Process?

Ultimately, medical billing outsourcing isn’t for everyone. If you have an existing administrative staff that has been handling all your medical billing practices efficiently, then you already have a significant investment in their training, software, and other associated overhead. Sometimes referred to as a “Sunk” cost, taking medical billing out of their hands might ultimately translate into a loss of investment.

If this individual was to retire, change jobs, need retraining, or change positions in the future, the cost of training them and supporting their medical billing practices might again make outsourcing your medical billing practices more cost-efficient.

Less Oversight Of Your Day-To-Day Operations

Of course, when you outsource your medical billing process to a third party vendor, you don’t have quite as much day to day oversight of the process. For some people, this is hard to deal with at first. Especially if you are a solo practitioner and you’ve been handling your medical billing on your own for a long time.

Though many solo practitioners find that outsourcing their medical billing tends to help reduce stress. Especially once the first round of payments gets deposited, the reports arrive and they notice their revenue stream getting stronger and more consistent.

HIPAA Compliance

In some scenarios, HIPPA regulations may make it difficult to outsource your medical billing. Though this is usually a small number of specialist practices and is usually related to confidentiality of information being transmitted during claims creation or in correcting a past claim denial. This is a question that needs to be answered on a practice-by-practice basis. If your claim creations frequently require you to disclose confidential information to the payer, institution, or insurance provider, you might want to keep your medical billing in-house.

Conclusion

There are a lot of strong reasons for solo practitioners and small practices to consider outsourcing their medical billing needs. This starts with freeing up your valuable time to focus on patient treatment goals and outcomes as well as managing the hands-on details of your practice. It can also be a great way to give your administrative task the time they need to stay focused on other critical tasks.

In the long run, most small practices find that outsourcing their medical billing needs helps maximize their revenue stream with greater consistency. Over time this also translates into better analytics and the potential to grow their client base.