Is Outsourcing Medical Billing Services More Viable than In-house Practices?


“Although, in-house medical billing, owing to its proximity to the physician’s supervision, can work relate itself better than the outsourced solutions, yet, it is beset with inherent adequacies”

Although physicians practices have equally been divided between in-house medical billing and outsourced solutions, there has been a considerable migration to the latter in the last 5 years or so. The pattern, amidst an interesting debate over which is better – in-house or outsourced – assumes greater significance. Whereas the trend may enable us in concluding outsourced medical billing being financially more viable, yet coming to a hasty conclusion without making a relative study of the two might prove to be premature. Therefore, amidst the prevailing scenario, there should be an impartial comparison of relative merits and demerits of the two available recourses.

Although, in-house medical billing, owing to its proximity to the physicians’ practices, can work relate itself better than the outsourced solutions, yet it is beset with inherent adequacies, such as:

  • Inability of the internal staff to adequately devote to the requisite medical demand: Torn between medical and administrative functions, your medical staff might not be able to show the degree of flexibility required to efficiently carry out medical billing, coding, submitting, and realization of medical claims. Consequently, there can be frequent incidence of denials or delays in claim realization.
  • Limited adaptability: Given the rate at which the medical billing and coding norms are undergoing transition, your staff, already grappling with inadequate time, might not be able to match up to the demands of radical billing and coding transitions. As a result, it is going to show up in medical claim retrieval rates.
  • Employee-turnover factor: As in the case of any industry, medical industry too is prone to a high degree of employee attrition. Practices that operate in such attrition-prone environment, might find it impossible to run their medical billing solutions effectively and seamlessly.
  • Frequent capital outlay on technology make-over: Prompted by the frequent transitions in medical and coding norms, physicians’ practices are called upon to undergo capital-intensive technology make-over for accommodating electronic recording, billing, coding, and processing medical claims. Given the prevailing competition in the medical industry, physicians might find it impossible to operate even at sustainable margins.

Quite evidently, barring a better-oriented functioning, in-house medical billing is beset with major concerns for physicians.

Contrarily, outsourced billing solutions, being focused on medical billing alone, can not only negate the in-house medical deficiencies, but also offer affordable and revenue-maximizing solutions. Given the scope of their operations in an ever-growing healthcare industry, physicians’ practice can look to avail services that are comparatively far economical yet superior.

    • Superior expertise and resources:
      Outsourced medical billing services come with a tag of superior expertise and resources. With the single most objective of improving clients’ reimbursement rates, medical billing companies are usually self-sufficient in specialized medical billing tools, techniques, technologies, and knowledge
    • Greater control over operating costs:
      Operating in a voluminous market, medical billing companies – along with achieving operational efficiencies – can easily pass on the economies of operation to their clients or physician fraternity.
    • Seamless claim realization:
      As a result of superior competency, and operational efficiency, medical billing companies are known for ensuring seamless claim realization for medical services rendered by their clients.
    • Directing internal staff to core-activities:
      With a dedicated outsourced medical billing practice in operation, physicians’ internal staff can be diverted to core medical services, thus elevating the quality of medical care.

Risk aversion

  • Amidst the highly demanding government regulations (HIPAA), competition, financial conditions, and technology demands, physicians’ can easily avert the risk by outsourcing their medical billing needs from competent sources
  • Improve core business focus
    Consequently, because of being free from the shackles of medical billing, physicians are able to devote time and resources to their core concern of keeping the practice-benchmark in congruence with the prevailing best practices.

Amidst all this propensity for migrating to outsourced medical billing practices, – known for perceived level of control over promoting business-critical knowledge, data security, accuracy in claims processing, and billing transparency – should be a preferential choice for cost-optimizing and revenue-maximizing medical billing services.

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