Is it more cost effective to have the billing and coding held in house?

In today’s Healthcare market the physician practice has had to morph into that "super practice". Unfortunately that also means that staff is also handling several positions at one time, juggling their responsibilities, trying to get everything done, and probably doing a mediocre job of it.

If your office staff is doing intake of patients, answering phones, making appointments, obtaining referrals and precertifications, confirming insurances, completing off–work/disability forms, handling medical records requests, coding and posting charges, and discharging patients, they are not going to do a great job getting money into the practice.

What are the fears in out sourcing the billing?

Control is the number 1 answer. The reality is that the Physician has better control when the service is outsourced because billing companies are paid on % of collections, not a salary. The physician is given monthly reports on his receivables in several formats and all monies are received directly from insurers and/or patients at the physician’s office. It is financially advantageous to our billing service to obtain the best reimbursement possible for the physician.

What are the benefits of a billing service over keeping staff in-house?

One of the biggest benefits is that the billing service has dedicated staff to the job. Most medical practices have patient care priorities and cannot focus on the billing. As a result, the physician’s office is more fragmented in their approach to collections. The billing service is a specialist in obtaining physician reimbursement from both insurers and patients. This is what we do all day every day, without interruption. By removing the billing and account follow-up from your office staff’s responsibilities they are free to focus on other responsibilities that can increase quality of service to your patients.

If you look at the cost of maintaining staff for billing you have their salary, or hourly wage, benefits, and then you also have the office manager portion of their salary and benefits because they are the ones who monitor what that person(s) is doing on a daily basis. Lets put it into dollars.

What happens when the office biller is sick and doesn’t’ come in, or is on vacation? Who does the job then? Do you wait until they come back, or does someone who is untrained take the job just trying to get the work done? Error rates will inevitably go up. With Medicare and most other insurers only reimbursing at approximately 33% of billed charges, your stream of cash has just hit the wall.

If the practice bills out:

$125K/month at 33% reimbursement = $41,250 and the billing service is charging you 6% your monthly fee would be $2475.00 and over a year $29,700.00.

That is a savings of $11,260.00.