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As a medical practice owner, perhaps the only thing more complicated than understanding medical billing is making the decision to keep billing in-house or to outsource it. I wish I could say there was a right decision. The right answer, however, varies by the uniqueness of each medical practice. There are, however, some consideration points for you to ponder as you decide the best option for your business.

 

Ponder Point #1: Customer Service

Customer service is the most important thing you provide at your medical practice, and no matter where your billing is done, this mantra must remain true. Patients should be able to talk to a live person about bills or claims. This is typically easier to do if billing is done in-house because you have total control over who answers the phone and how they are trained to treat customers. If you outsource your billing, make sure the company you hire is known for providing quality customer service. Ask for references from other companies who use their services. Also, realize when you outsource your billing you are adding a third party into the problem-solution mix. When one of your employees receives a question, they will either have to give the customer a phone number to the billing company, or they will have to contact the billing company directly and then report back to the customer.

 

Ponder Point #2: Staffing

Depending on the size of your medical practice, it may be difficult for you to hire all of the people needed to run your billing department smoothly in-house. One of the biggest pluses to outsourcing your billing is it allows you access to a staff with specialized training in all aspects of the billing cycle and with training on how different payors handle the claims process. On the other hand, if you have the funding available to hire your own billing staff, you can have that knowledge available in-house. If you are a small clinic, seeing around 20-50 patients a day, hiring one person with knowledge in all aspects of medical practice billing is sufficient staffing. As you continue to grow, however, you will need to add additional staff.

 

Ponder Point #3: Experienced Coders

Coding is the heartbeat of your billing process, and it often requires a good deal of communication between the coder and the medical providers. Having your coder in-house can often make communication between providers smoother, as they can have face-to-face meetings with the providers to fix errors. If you opt to outsource your billing, make sure the company has training programs for providers and a communication system in place to help make sure all provider errors are fixed in a timely manner and not repeated. Whether you outsource your coding or you keep your coding in house, you must make sure your coders receive continuing education to stay up-to-date with changes. Your coders should also be experienced in medical practice coding.

 

Ponder Point #4: Collections

Even if you opt to keep your billing in-house, you may opt to outsource your collections through a collection agency. This agency will make calls or collection efforts on your behalf for a fee. If you outsource both your billing and collections, understand that often times there is a second fee for collections in addition to what you are already paying the billing company. One plus to handling collections and denials in-house is you can ensure your team of collectors understands the accounts they are collecting on. Before sending anything to a collection agency, you want to make sure all efforts to collect the money on your behalf have been exhausted. A customer who gets a call from a collection agency who has never heard from your company before could very easily become a lost customer for life.

 

Ponder Point #5: Operations Control

The final thing you should consider when pondering how to do your billing is control. Many business owners do not want to give up control over their accounts receivable. If you want to have complete control over this process, you should probably keep your billing in-house. If you can set-up a good working relationship with the billing company you utilize, however, outsourcing your billing can be beneficial. First, it takes away a lot of the administrative obligations associated with billing. Second, it frees you up to spend more time focusing on patient care. Healthcare billing is a very complex and complicated process. Your medical practice’s financial stability depends on accurately executing this process. You may decide hiring a billing company for their expertise and time is the best solution for your company’s success. Or, you may prefer to bring your billing in-house and hire the best experts in the field to work directly for you.  

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Testimonials

“I learned many things I want to take back to our clinics. My problem is just choosing which ones to do first.”

Evelyn Young
M.D.

“The content and the speakers are awesome! Kudos to everyone involved in MPS. Great job!”

Michelle Mojares
PA

“<p>It&#39;s amazing how much the proper coding makes a difference in your claims and collections. Thank you Kelli and Team for showing us&nbsp;what we&#39;ve been missing.</p> ”

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“I learned many things I want to take back to our clinics. My problem is just choosing which ones to do first.”

Evelyn Young
M.D.

“The content and the speakers are awesome! Kudos to everyone involved in MPS. Great job!”

Michelle Mojares
PA

“<p>It&#39;s amazing how much the proper coding makes a difference in your claims and collections. Thank you Kelli and Team for showing us&nbsp;what we&#39;ve been missing.</p> ”

Signed
Happy Client

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Top Financial Mistakes That Will Crash Your Business. We know running a medical practice can be difficult. Most medical practice owners are physicians who graduated from medical school, not business school. Often, their teams are friends and family members with a medical background. Our goal is to educate medical practice owners, and their teams, to develop their business management and leadership skills.