Home | In-House vs Outsourced Medical Billing
In-House vs Outsourced Medical Billing: Which Is Right for Your Practice?
An Honest Comparison of Cost, Control and Cash Flow
Every practice has to decide who handles its billing: staff on your own payroll, or a billing company. Both can work. The right choice depends on your size, your specialties and how much time you want to spend managing billing. Below we compare the two side by side, including when keeping billing in-house is the better option.
In-House vs Outsourced Billing at a Glance
| In-house billing | Outsourced billing | |
|---|---|---|
| Cost | Salaries, benefits, payroll taxes, software, clearinghouse, training and office space | Usually a percentage of collections; software and staffing included |
| Staffing and coverage | Depends on one or two people; claims wait during vacations, sick days and turnover | A team covers your work, so claims keep moving |
| Coding and payer expertise | Limited to what your staff know; training is on you | Coders and billers who work across specialties and payers every day |
| Denials and A/R follow-up | Often falls behind when the office is busy | Every denial worked and every unpaid claim followed up |
| Reporting | Whatever your staff have time to pull together | Monthly reports on collections, denials and open A/R |
| Control | Billing staff in your office | You still see every claim and report and approve key decisions |
| Best fit | Large groups with a full revenue cycle team, or very simple billing | Solo and small-to-mid practices, specialty practices, and practices that want to grow without hiring |
The True Cost of In-House Billing
Salary is only part of it
An in-house billing team costs more than wages. Add payroll taxes and benefits, practice management and clearinghouse fees, coding books and certifications, training on payer rule changes, desk space and equipment, and the time your practice manager spends supervising. Then add the hidden costs: claims that sit unworked during vacations and sick days, and the months it takes to hire and train a replacement when a biller leaves.
Add these up before you compare them with an outsourced fee. Many practices find the real cost of in-house billing is higher than they thought.
What You Get When You Outsource
A full team for the cost of a service
An outsourced billing company gives you coders, billers and A/R specialists instead of one or two people, so work keeps moving when someone is out. You get specialty coding knowledge, denial management and follow-up on every unpaid claim, monthly reports on collections and denials, and help with credentialing.
Most billing companies charge a percentage of what they collect, so they are paid when you are paid. You keep control: you see every claim and every report, and you decide what changes. See our medical billing and coding services.
When In-House Billing Makes Sense
Outsourcing is not right for every practice
Keeping billing in-house can work well for large groups that already run a full revenue cycle team, for practices with a simple payer mix and low claim volume, or when you want staff on site to handle front-desk collections and patient questions.
There is also a middle path: some practices keep coding or patient billing in-house and outsource claim follow-up and denials. Read more about hybrid medical billing.
How to Decide
Questions to ask before you choose
What does billing really cost you today, including staff time? How many claims are denied, and how many are never followed up? How long does it take to get paid? What happens when your biller is out? If you are not sure of the answers, that is a sign to look closer. Our guide on how to choose a medical billing company lists what to check.
Book a free consultation and we will review your current billing numbers with you, whether or not you decide to outsource.
