Many small medical practices still do their billing in-house. The success or failure of your billing team can make or break your practice as a business. However, it can be one of the most difficult functions your staff performs. You might have a crack team of billing analysts who are also great at collections. Chances are, though, that you will get better results with a company that specializes in billing and collecting millions of dollars a month for various clients.

In this article, we talk about the difference between in-house and outsourced billing, discuss the pros and cons of each and give you a look at the cost and savings associated with an outsourced solution. If you aren’t ready to hand over 100% of your billing operations, you can start with a hybrid approach, such as seeking assistance with collections and simplifying your billing system.

Whatever you decide, OmniMD has solutions that can help your front desk and back-office crew minimize mistakes, improve efficiency and increase patient satisfaction.

In-House Vs Outsourced Billing Comparison

In-house medical billing typically consists of billing clerks entering medical codes into billing software that interfaces with insurance companies and other payers. It also involves handling various aspects, such as reporting, required to close the revenue cycle.

When you outsource your medical billing, you or your business manager engages with a third-party company that specializes in billing, collections and other aspects of the revenue cycle. Ideally, this gives physicians and staff members more time to focus on patients and day-to-day operations.

Let’s take a deeper dive into the pros and cons of both options to give you a clearer picture of which one would work for you.

In-House Medical Billing

Many physicians or other practitioners decide to keep their billing in the hands of their staff. You may feel more comfortable having oversight over revenue and collections, and that’s understandable.

You may not want to trust a third party with your patient information or the part of your business responsible for bringing in the money. However, there are pros and cons of using EHR billing software versus customized billing solutions from a third party. You might be surprised what you would find if you crunched the numbers, taking into account the total cost and savings of each option. Additionally, you should consider factors such as accurate billing and timely entry of payment requests.

You may feel you have effective billers who enter data and collect payments efficiently. Therefore, switching to an outsourced solution may seem counterintuitive. With in-house personnel, you can walk down the hallway to check on a billing issue. When you outsource this function, you have to contact the billing company,

However, there’s a price for this convenience. When you pay billing analysts and billing clerks directly, you also have numerous administrative costs that are lower or nonexistent when you go with an outsourced billing provider.

Many practices are still feeling the crunch of government regulations that resulted in lower reimbursements. If you want to save money, you can’t just cut salaries or hire less qualified people. However, if you transition to an outsourced billing company, you may realize significant cost savings.

In-house billers often lack the necessary support to perform at their highest level on every task. Additionally, small offices may only have one or two people doing the billing. If someone quits or gets sick, you’re going to see a major reduction in revenue until you are once again fully staffed.

Pros and Cons of In-house Billing

Pros

Maintain control
Proximity
No need to invest in a new system

Cons

Administrative burden
Higher staffing and support costs
Subject to turnover and other employee challenges

Outsourced Medical Billing

By outsourcing your medical billing, you access the bench strength of a large billing department. So, if you are a small practice, you don’t have to worry about decreased revenue due to an employee falling ill, going on vacation or seeking other employment. Instead, there’s always someone to fill in the gap to keep your revenue stream steady.

When you hand your billing over to a third party, you pay a small percentage of your collections. Therefore, the company only gets paid if they bring in revenue. This motivates outsourced billing providers to work with maximum efficiency. An outsourced billing team, such as that available at OmniMD, is also going to work harder to recover aged collections.

Many physicians spend as much as an entire day on paperwork. That’s a lose-lose situation. Every minute a health care provider isn’t with a patient costs your practice money. Additionally, most doctors aren’t trained in billing and administrative tasks nor do they find the work satisfying. This may put your office at further risk of missing payments or letting a superbill fall through the cracks.

On the downside, patients and staff members may find using a third-party billing company inconvenient. Since outsourced billing takes place off premises, it requires extra effort to monitor and provide the necessary information needed to establish effective billing practices. Therefore, it’s important to choose a vendor with great collaboration and communication skills.

Choose a company with proactive business practices and automated reporting and other functions. Choosing a company such as OmniMD gives you virtually endless opportunities to customize your billing software and enjoy a transparent relationship that improves your revenue collections, billing efficiency and staff and patient satisfaction.

When considering both options, outsource billing appears to have fewer shortcomings than hiring billing clerks and analysts on premises. Plus, having less oversight can be both a pro and a con for physicians who want to concentrate on the practice, not paperwork.

Outsourcing Pros and Con

Pros

Reduces billing errors and denied claims
Improves cash flow
Ensures billing compliance
Maximizes use of office space for medical business
Puts physician focus back on patient care
Reduces employee count and administrative responsibilities
Improves revenue cycle management
No-cost regulatory-compliance
Update your billing technology and simplify data entry

Cons

Give up some control
Not located on premises

Cost Savings Example With Outsourced Billing

Billing specialists can make six-figure salaries, while it costs around $4,000 or less for billing services. There are many other costs that you can reduce or eliminate by outsourcing the billing for your practice, including the following:

Billing Staff Salaries
Billing Software Cost
Hardware costs
Continued Education Training Cost (will be less when you outsource)
Ancillary Costs
(Office Space/Office Supplies, Patient Statements, Others)

Carrying collections in the form of bad debt is a reality for many practices. When you outsource your billing, you gain access to persistent collections specialists. While in-house collection efforts typically yield a 60% collection rate, that figure jumps to 68% when you partner with an effective medical billing provider.

Let’s say you have $2.5 million in uncollected debt. Your in-house collections team may recover $1.5 million, or 60% of the debt. Meanwhile, focused specialists at a third-party provider might collect $1.7 million, or 68% of bad debt that otherwise becomes a write-off.
Taking a Hybrid Approach

There may be sensitive accounts or services that you want to bill for directly. It’s perfectly acceptable and you can achieve the same boost in collections and savings while keeping a portion of the billing in-house. Find a company that will work with you to meet the needs of your practice.

Are You Shopping for Billing Solutions for a Billing Company?</h3/>

OmniMD also provides billing solutions for billing companies. If you want to implement intuitive, consistent forms for all of your medical billing clients, partner with our team for end-to-end medical billing services that allow your staff to manage all your customers with a single sign-on. OmniMD has your solution. We will integrate data from all of your legacy systems, including EHR, Practice Management, and Patient Portals.

Want to know why more physicians and practices choose OmniMD? Request a demo today!