Outsourced Insurance Billing vs In-House Insurance Billing

Infographic on outsourced vs In-house billing
As a healthcare practitioner, there are several functions your office must complete in order to not only survive but thrive. Arguably, medical billing is one of the most important because if the money owed to you doesn’t come in regularly and in a timely manner, you’re not going to be able to stay open for long.
Additionally, one study conducted by InstaMed found that two out of three patients (65 percent) are willing to find a new healthcare provider if their current one doesn’t provide a satisfying payment experience. So, not only can inefficient medical billing processes hurt your practice from a financial standpoint, but it can also cause you to lose patients.
Yet, the question that many health practitioners have with regard to billing is whether they should outsource this important task or perform it in house. Determining the answer lies in considering these eight factors.

1. Costs

How much money are you willing to spend to obtain reimbursement from insurance providers and payments from patients? If your answer is none, then in-house billing is for you as PriceItHere.com, a buyer’s guide for businesses, reports that outsourcing fees can be as much as eight percent of total collections. That amount can really add up over time, especially when you’re capable of doing this task yourself.

2. Convenience

Another factor to consider is convenience, and this is one where outsourcing generally wins because you don’t have to post payments, track billing statuses, or even send the initial bill. Instead, the person or company you contract with to provide this service is responsible for these types of duties, making the collections process much easier on you and your staff.

3. Accuracy

It doesn’t matter how good a medical billing service is, no one will ever pay as close attention to ensuring that you get the money owed to you as you will. So, where an outsourced medical biller may miss seeking payments for certain billable services, copays, and deductibles, you’re less likely to do so because the accuracy of the amount due is more important to you, the one who actually provided the service.

4. Responsiveness

When considering whether to outsource your medical billing or do it in-house, it’s also important to think about how long you can wait for incoming payments to hit your bank account. When you’re responsible for your own billing, there is no wait time for deposits as you can put the money in the bank the day it is received. This is much different than when you outsource as these deposits are typically delayed, especially if your billing provider has a large number of clients and, as a result, only makes deposits on certain days of the week.

5. Adaptability

Medical reimbursement rates change all of the time. For instance, on April 15, 2019, Medi-Cal insurance—which is a low-cost health coverage plan for Californians with limited incomes—adjusted its payment amounts for providers who serviced patients on or after March 1, 2009. If you regularly interact with this insurance company, you likely know about these changes whereas your outsourced medical biller may not, causing them to charge an incorrect amount and slow the reimbursement process.

6. Understandable

After interviewing 355 patients online, Mad*Pow found that many had at least some level of confusion about their medical bills. Some of this confusion was caused by the way the bill listed financial details, making it extremely difficult to understand. This can be avoided by developing your own easy-to-understand bills, which also makes it easier to answer patient questions when they arise.

7. Management

Medical billing requires a certain level of patient account management. Therefore, when you perform this task in-house, you can expect to be more involved in the account management process than if you outsource. This can take additional time and resources, so it is a factor to consider if you’re limited in either or both.

8. Return on Investment (ROI)

One of the main reasons a healthcare practitioner may decide to keep billing in-house is because there is a higher return on investment (ROI) in doing so. This is partially due to lower overhead costs, but it is also because of some of the other factors, such as increased accuracy and improved adaptability in the billing process.
Which Option Wins?
When you look at all of these factors, it is clear that in-house billing offers more advantages than outsourcing. This is because, when looking after your billings yourself, you have more control over what is paid, lower overhead, a better understanding of patient bills, better cash flow, and better ROI. Together, this helps you create a stronger practice. A practice that is capable of withstanding the test of time.