Should Your Practice Consider Outsourcing Medical Billing?

Amanda Weber
Nov 3, 2021
By Amanda Weber

A growing number of medical practices are opting to outsource their medical billing. Outsourcing means hiring a third-party company to code and bill patients' insurance claims. Other options include having the company pre-check coverage, follow up on submitted claims, and billing patients for the remaining balances.   

Many medical providers like having the option to choose from a variety of medical billing services. They can make the choice between which services stay in-house and those handled by the billing company.  

In this article, we’ll discuss what your practice should consider when deciding on outsourcing medical billing. Before making that choice for your practice, consider some of the pros and cons below. 

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Pros of Outsourcing Medical Billing 

Billing tends to be one of the tasks that take up the most time for a medical practice. Below are some of the pros to consider when determining if outsourcing is right for your practice. 

Reduce the Stress on Your Medical Staff 

Many medical practices are already understaffed and overwhelmed. The pandemic has led to staff shortages and, for some, an increase in patients. In-house medical billing puts an added burden on staff members. It also takes them away from the patients who rely on them for care. Outsourcing your medical billing lets them focus on your patient's full time. For many practices, this is one of the most important reasons to outsource medical billing to a third-party company. 

Check Ahead on Patient Eligibility 

Some medical billings outsource companies to check patient eligibility ahead of time. It lets the physician’s office know if the patient is partially or fully covered for a visit or procedure. A pre-check tells physicians if they are in or out of the patient’s network. It also flags the provider when the insurance company requires pre-authorization. 

With 19% of households facing problems with medical bills or debt, learning about coverage prior to treatment gives patients and physicians better visibility of coverage. Both patient and medical provider can make informed decisions about which procedures are necessary. 

Reduce Coding and Billing Errors 

The coding system required for government insurance is complex and constantly evolving. A simple coding error can result in a partially unpaid or denied claim. 

Errors on personal information can also slow down the claims process. A misspelled name or address might result in a denial. Turning your medical billing over to the experts can reduce or eliminate these costly mistakes. 

Improves Patient Care 

Letting a third party take care of your medical billing frees up more time for you and your medical staff. Your team will have more time to focus on patient care. 

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Cons of Outsourcing Medical Billing 

While there are many pros to outsourcing medical billing, it’s important to know the cons that come with outsourcing as well.  

Less Control Over the Billing Accounts 

You no longer see the statements that go to your patients. You won’t know when there’s a problem or have the information needed to discuss them directly with your patients. It’s also difficult, if not impossible, to monitor the billing company. You can’t know for sure if they are processing and following up on patients’ claims. 

Outsourcing Medical Billing Overseas Doesn’t Work 

Some medical providers take outsourcing medical billing a step further by going with a company overseas. The reason is to save more money on their services. One reason this turns into a problem is that when billing issues arise, patients find it difficult to reach someone to discuss the problem.  

Some medical practices have pulled back from outsourcing overseas. They don’t get the quality service provided by companies situated in the United States. A company that offers medical billing outsourcing in the U.S. will help keep you compliant.  

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Is Outsourced Medical Billing Right for Your Practice? 

Making the choice to outsource your medical billing is a big one. You might wonder if this is the right time for such an important change. Ask yourself the questions below to help you make the best decision for your practice. 

Are You Having Problems With Cash Flow Into Your Practice? 

Payment delays and denied claims reduce the cash flow into your practice. A medical billing company can help you get more claims paid faster by reducing errors in the initial filing process. A more efficient process will result in your getting more claims paid faster. 

Do You Have the Additional Staff You Need To Provide Dependable In-house Medical Billing? 

The more patients you have, the more time your staff must devote to patient billing. If you don’t already have the resources you need, you could end up paying an increase in salaries for existing and/or new employees as well as training expenses. 

Are You Prepared To Cover the Expenses for Ongoing Technology and Training? 

Remember, all your billing practices must meet the standards for a medical practice. That means keeping your billing staff up to date on laws and technology. You might end up paying for new software, refresher training, and training for new employees repeatedly. These are some of the hidden expenses of in-house medical billing that medical practices don’t always consider until they’re already invested. 

Do You Have a Large Patient Turnover? 

Outsourcing medical billing can improve patient retention in two ways. First, it lets your team put all their focus on taking care of patients. Second, it gives patients clarity about billing. They don’t have to worry about surprises that they can’t afford to pay. 

What Are Your Future Goals for Your Practice? 

Patient retention is just half of achieving growth. The other half is adding new patients to your practice. A dependable billing system will give your existing patients confidence in your practice. That’s something they will share with their friends and families. 

Your choice to outsource medical billing impacts a variety of factors. It improves patient satisfaction, increases cash flow, and helps you provide better care to your patients. 

Final Thoughts 

If you’re wondering if this is the right time to look into outsourcing medical billing for your practice, consider the questions above. While there are pros and cons to each side of the decision, the right medical billing company will benefit your medical practice, your staff, and your patients. 

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