Orthopedic Billing: In-House Vs. Outsourcing

Unlike any other practice, billing is a very crucial factor, even to orthopedic practices that are looking out for steady cash flow and decent revenues. It is a major decision that medical practices need to make whether to handle the billing in-house itself or to outsource it to a  professional orthopedic billing company?  You will need to make the decision based on several factors depending on your specific practice, the resources at your disposal, and your style of operation. You need to consider every single option carefully before coming to a decision.

In-House Orthopedic Billing

As the term itself implies, in-house billing signifies a situation where the practice employs staff on the payroll to handle all the orthopedic billing requirements. Of course, when you have a person working directly under your supervision, you can have full control over the entire billing process, provided you have the time to spare, and can surmount the inherent difficulties like:

Cost factor:

When you choose to do the billing in-house, it means that you need to hire a full-time employee who will be dedicated to taking care of billing. In addition to paying an annual salary (quite high for qualified and experienced hands), you need to take care of other benefits like health care and insurance. Your time also needs to spend and money on a training run. In the long, you will notice that these costs far outweigh the cost of simply outsourcing your orthopedic billing to a professional billing company.

Problems with personnel:

When you employ a person on a full-time basis, you need to think of associated issues like the person taking days off reporting sick, or going away on vacation. Moreover, you will not be able to question inefficiency and poor performance apart from poor productivity levels.

Added responsibilities:

While hiring employees on a full-time basis, it is the practice’s responsibility to monitor the performance and look out for mistakes and errors that can happen easily. Even if errors manage to creep in, it is the responsibility of the management and not on a particular employee, though he or she can be pulled up for it.

Outsourced Orthopedic Billing

While you outsource your orthopedic billing to a professional billing and coding company, you need to pay a percentage of the total revenues that they bill on your behalf. This way, you ensure that you are paying only for the work executed, though the percentage of the commission has to be agreed upon mutually. You will be handing over all controls to the company you are outsourcing to, though there are several benefits you enjoy while doing so like:

Expertise and Experience:

Once you outsource your orthopedic billing to a professional company, you are ensured that their expertise and experience in the field will be a major advantage. For instance, converting from ICD-9  to ICD-10 is a tedious process that you may not have been able to handle by yourself. Once you outsource billing, you do not have to worry about updates and training your staff on the latest rules, which takes away a lot of unnecessary stress.

Less responsibility:

While outsourcing billing to a professional orthopedic billing company, your responsibility ceases as it is shifted onto the company. You are paying the company to take care of your billing needs and it is up to them to handle it responsibly, saving you a lot of precious time that you can spend on your core competencies.

Better Patient Care:

With more time at your disposal, you can focus on providing better care for your patients, which will translate to better patient retention and more referrals,  which will contribute to better revenue and profitability.


While in-house billing gives you more control over the process, the associated stress and responsibility are probably not worth the trouble. Outsourcing is the proven way to success in any practice, especially orthopedic billing, which calls for use of proper codes and detailed billing, lest the reimbursement is delayed or denied.

Medical Billers and Coders (MBC) is a leading outsourcing medical billing company providing complete revenue cycle solutions. Our medical billing services will help to receive accurate insurance reimbursements for private and government payers. To know more about our orthopedic billing and coding services, contact us at info@medicalbillersandcoders.com/888-357-3226.