Medical Billing Service VS In-House Billing

What I want to do with this post, is mention in detail some of the major differences of using medical billing services and keeping the billing process within your practice. I know in other posts I have talked about general subject matters (such as insurance, basics on medical billing) but in this post, I want to make sure this message is reaching all medical professionals. Hopefully by the end of this article, you can have a few more resources that will help you select a billing model that fits your practice.

As a medical practice, the minute you accept insurance, you need to make sure you are sending out claims to the insures appropriately. Therefore, you will need to have someone working on this process – the medical billing process. medical-billing

Benefits of using a medical billing service include:

  1. Saving time
  2. Saving resources
  3. Professional medical billing conducted
  4. Added security
  5. Better quality practice

Let me analyze each a little bit here.

Saving time: By hiring a professional team, you will get knowledgeable people working on your medical billing – people who have studied coding, sending correct and valid claims, and actually collecting revenue. You will have people that do nothing else, than medical billing. That has to be important and extremely beneficial for you and your practice.

Saving resources: I will quote a phrase said by someone very wise: “If you think hiring a professional is expensive, try hiring an amateur.” In other words, you will better off if you get the job done the first time, than go back and try to re do it. By hiring a medical billing professional, you make sure that the job is done well and you won’t have to worry about it. And if they aren’t performing the way you like, you can always replace them. But speaking of resources (in which money I think is considered a resource), if you send out a claim and there are mistakes on it (like a wrong digit on the social security number of the patient or whatever), then the insurance company is not going to accept the claim and will send it back. In a worst case scenario, you may not get paid for that claim. So it’s smart to want to earn your entitled money, so that your practice is actually creating more revenue.

Professional medical billing conducted: This was basically included in the above paragraphs: When you get people who know what they are doing, you save both time and money. Get it right the first time, ’cause if you don’t, it gets very complicated and you have a bunch of loopholes to jump through.

Added security: When we talk about security, we aren’t just talking about making sure everything abides to the laws and regulations. We are talking about securing your practice’s future: If you can’t secure a claim, you are going to go belly up. A practice needs to be focusing on getting more patients and treating more people – not dealing with bureaucratic billing loopholes.

Better quality practice: Having achieved all the above, rest assured your practice is going to improve in quality. Your medical professionals won’t be distracted from their jobs and the whole driving force of your medical practice can focus on its main goal: treating patients. Overall, you will be more successful as a group of professionals and even the communication with your patients will be of better quality. That is because you will know, that you will get reimbursed for everyone you treat.

Negatives of using In-House Billing include:

  1. Additional office expenses (billing software, mailing materials)
  2. Training of employees
  3. On site collections

I know this isn’t a very fair game for “in-house billing” as it’s being considered a bad decision. You are obviously free to do whatever you think works best. Having worked though in this area for a very long time, I can tell you that not many medical practices who do their own billing, have been successful with it (especially the smaller ones.)

Additional office expenses: You need to restructure the way your practice operates. You are obviously familiar with the computer software you have paid for, to run an organized practice. Imagine having to buy additional software (and learn how to use it) just for billing purposes. It can turn out to be a hassle. Quite frankly, the time and money you would spend on doing that, just hire a professional and be over with it.

Training employees: The people working on this (either front desk employees or back office ones) will need to learn to do this some way. They won’t magically walk in, knowing everything about it. So what this means is, that you either need to know yourself how the system works to train them, or you need to  hire a trainer to teach them. So again my question would be: Why not hire someone in the first place and be over with it?

On site collections: Usually the way the in-house billing works is, your front desk makes the claims and does the basic parts of medical billing, and then you have a coder in the background making sure everything runs smoothly, and he conducts all the “dirty work.” If mistakes happen (and they will happen), the last thing you want to do is create frustration among your employees. You want people who work well together. If your medical biller is always frustrated by the front desk performance and vice versa, this will “kill” your teamwork. 

I don’t want you to believe this is a bias post, that only supports medical billing experts. Nor would I like you to think, that I’m doing this to beef up my own business. As I have mentioned before, I don’t plan on promoting any of my ventures via this site. Having said this, I do want to point out something in regards to billing services: If you hire the wrong people, rest assured your are going to spend countless amounts of dollars on candy. In that case, you would probably do a better job within your practice. Hiring a professional team, only works if they are actually professional and know what they do. Make sure to request a detailed portfolio and work history. And if along the way you see they are not performing well, you can cut them loose anytime. That alone, should be very motivational for them to want to work hard.

See you in upcoming posts.

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