Outsource Medical Billing Work and Increase Your Cash Flow (Outsourcing Vs In-House) The matter of whether to outsource medical billing operations or keep the procedure in-house is one that ponders vigorously on many medical specialists and practitioners. The correct answer differs from practice to practice that directly relates to many factors such as age of the business, present state of practice finances, and some other important considerations. Beside clinical procedures, medical billing and RCM are very important processes of your practice. Your monthly cash flow highly connected to the model you have adopted. So you must be decisive because taking it on a light view would hurt your practice overall performance. You ought to do exhaustive evaluations of your practice’s cost, staffing, and volume measurements to figure out what’s appropriate for you. In the preparatory phases of the decision making process, you will have to investigate what most specialists and physicians consider to be the real favorable circumstances and weaknesses that the in-house and outsourcing alternatives each present.
In-house Medical Billing
- An in-house medical biller costs a clinic $ 14 to $ 15 an hour in the United States
- Billing operations can easily stall – whether an in-house billing staff is made up of one person or three, if someone is out of the office, the billing department can see a sharp decline in productivity. This may have a negative impact for a few reasons. First, those left behind at work will have more work to do. Second, the biller will have a lot of work to catch up on when they return to the office. Third, cash flow into the office could significantly decrease because of this stall in billing operations.
- Higher costs – While it may not be easy to budget for outsourcing, it may still be cheaper than hiring an in-house billing staff. Why? When a doctor has an in-house staff, they have more overhead. They have to pay an hourly wage, benefits such as medical insurance, sick time and paid vacation time. In addition, there is the cost of setting up a billing system. Other costs include the software and tech support needed to process and send claims and to create billing statements.
- More opportunity for liability –In-house billing can result in some liabilities for the company. If a doctor hires a biller who doesn’t perform accurately, they can end up with miss-billings or incorrect billings. This can result in patients receiving inaccurate estimates or being billed for more than they actually owe.
Outsourced Medical Billing
- A medical billing company pays less than $ 2 an hour to a medical biller. Especially if a clinic is starting up, outsourcing is less expensive.
- In terms of follow-up of medical claim with insurance companies, negotiation skills of medical billing companies are more effective, than in-house medical billers.
- The medical billing companies are able to provide 24 x 7 billing service, mainly because the support staffs of medical billers are flexible and willing to work in any 8 hour shift allocated to them. The advantage that this offers is that the billing and documenting process is continuous, and there are very few backlogs
- State of the art billing software.
- Access to individuals with expertise in medical coding and billing.
- Access to staff who are up -to-date with regulations and recent changes to regulations.
- Consistency in billing – Not only will a medical billing company regularly send claims to insurance companies, they are contractually obligated to follow up on all unpaid and denied claims. Often, claims will be denied because of a lack of information or inaccurate documentation. Once the issue has been fixed, the claim can be resubmitted.
- Regularity of billing – A doctor doesn’t have to worry about bills not being sent out in a timely manner because of staff illness or heavy workload. A medical billing company is hired to focus on one thing: medical billing. Therefore, bills and claims should be sent regularly and on time through a company.
- The doctor has a better idea of billing operations –If requested, medical billing companies are required to give a provider performance reports. Based on these reports, the provider is not only able to see how well the practice is doing financially; it will be able to evaluate the performance of the billing company.