In-House or Outsourced: Which Medical Billing to Choose?


Medical billing is a big process that involves many follow up on claims with the insurance provider to help the individual to get the payment from the health care provider on the services rendered by the provider. All these routine processes in the background are usually carried out by the Insurance Claim Processing units in the company.

All these processes can be either outsourced or done in-house depending on the various factors like your labor strength, your financial status, the size of the company etc. Estimating the cost of maintaining an in-house claim processing services or outsourcing them can be decided easily. To a few managing these tiring process under their observation is an obvious choice, but for some, it is quite impossible.

To make the choices simpler let’s put down a few points on the pros and cons of both:

In-house medical billing

One major advantage of upholding an in-house system is that one can retain and administer complete control over the financial operations. If you have trained billers in your company who can efficiently look into the system, then you might get better returns. As compared to outsourcing medical billing services, wherein a third party is involved, where the decisions are delayed as there is no direct involvement, the in-house decisions are quite speedy.

The major cons in maintaining an in-house system are the difficulty in handling the expenses regarding the payment of the billers, their bonuses, buying technologies to keep up with the market etc. Hiring experts will be quite expensive. If you do not have experts then, you have to deal with human errors which might cause you a huge loss at times.

Outsourced medical billing

The main advantage of taking the help of an outsourcing firm for medical billing is that you can work with an equally qualified professional at a reasonable pay at any time. Even if an employee quits or leaves, the process is never stopped because the third-party assures that whatever happens, the insurance claim service provider is never at stake. These service providers are up-to-date in the case of technology and experts. They manage to oversee the problems and help to maintain transparency. The reports are detailed and perfect even managed efficiently. Other major pros of hiring a service provider are that you can escape from the burden of maintaining these administrative paper works. They focus on minor errors and work together to maintain error-free documents which are indexed and stored for future reference.

Cost in an important factor that runs against outsourcing, even though the cost is comparatively lesser as compared to preserving an in-house one. The company is bound to pay a percentage of their profit to the outsourcing firm in order to maintain a friendly tie-up. Most of the company managers find it hard to exhibit control over the third-party employees as they do not exercise direct control over them.

Every process has pros and cons. Choosing them wisely will be the only way to accomplish your organizational tasks in the business world.

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