Outsourcing Medical Billing: Is It Right for Your Practice?

Running billing in-house means hiring, training and keeping billers and coders up to date with constant rule changes. Many practices find that a specialized billing partner collects more, faster – while their own staff focus on patients.

In-house vs. outsourced billing

• Cost: in-house billing includes salaries, benefits, software, training and turnover. Outsourced billing is usually a percentage of collections, so you pay when you get paid.
• Expertise: a billing company works with many specialties and payers every day and sees rule changes early.
• Coverage: no gaps when a biller is sick, on leave or quits.
• Control: you keep full visibility through regular reports and access to your own systems.

Signs it's time to outsource

• Days in A/R or denials are rising
• Old claims are not being followed up
• Staff spend more time on billing than on patients
• You are opening a new practice or adding providers and locations

What to look for in a billing partner

1. Certified coders and experience in your specialty
2. A signed Business Associate Agreement and strong HIPAA safeguards
3. Work in your existing EHR / practice-management system
4. Clear monthly reporting on collections, denials and A/R
5. A dedicated contact who knows your practice
6. Transparent pricing with no hidden fees