Healhcare Billing Comparison

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Analysis for healthcare professionals and organizations considering the costs of in house billing versus outsourcing.

Healthcare Business

BILLING ANALYSIS
Taino Consultants Inc.
Dr. Jose I. Delgado

BASIC ISSUE
Cost Effectiveness of outsourcing billing
 Variables under consideration
 Costs Center
 Efficiency

VARIABLES UNDER CONSIDERATION
 Human Resources
 Hardware and Software
 Claims Processing
Employees
IT
Process

HUMAN RESOURCES
* http://www.bls.gov/oes/current/oes433021.htm
Median billing Salary ($16.80/hr) $ 34,944.00
Federal and State Taxes (15%) $ 5,241.60
Health ($500/Month) $ 6,000.00
Vacations & sick $ 1,320.00
Training $ 500.00
Subtotal $ 48,005.60
Billing Personnel (1.5) $ 72,008.40

HARDWARE AND SOFTWARE
Software $229/month/Provider $ 2,748.00
Hardware $ 2,400.00
Subtotal $ 5,148.00

CLAIMS PROCESSING
Patients/day/Provider 20
Working days/month 20
Claims/month/Provider 400
Clearinghouse Cost (.05) $ 20.00
Paper Statements ($7/statement) $ 2,800.00
Costs/month $ 2,820.00
Claims Processing Costs $ 33,840.00

IN HOUSE BILLING COSTS
Human Resources $ 72,008.40
Billing/Hardware $ 5,148.00
Claims Processing Costs $ 33,840.00
Estimated Costs $ 110,996.40

OUTSOURCE COSTS
CollectionsOutsourced Costs
$ 240,000.00 $ 14,400.00
$ 360,000.00 $ 21,600.00
$ 480,000.00 $ 28,800.00
$ 500,000.00 $ 30,000.00
$ 720,000.00 $ 43,200.00
$ 1,000,000.00 $ 60,000.00
$ 1,500,000.00 $ 90,000.00
$ 1,750,000.00 $ 105,000.00
$ 1,850,000.00 $ 111,000.00

COST COMPARISON
Providers 1 5 10
Avg Collection/month $ 30,000.00 $ 150,000.00 $ 300,000.00
Human Resources $ 72,008.40 $ 192,022.40 $ 384,044.80
Hardware/software $ 5,148.00 $ 18,540.00 $ 37,080.00
Claims Processing $ 33,840.00 $ 169,200.00 $ 338,400.00
In house/billing costs $ 9,249.70 $ 44,146.87 $ 88,293.73
Outsource/billing costs $ 1,800.00 $ 9,000.00 $ 18,000.00

OTHER ISSUES TO CONSIDER
 Staff turnover
 Priority of billing versus other tasks
 Expertise and experience
 Collection rate
 In-house 96.3%
 Outsource 99%
 Liability and Compliance
 Outsourcing Risks

SUMMARY
 Outsourcing is more cost effective
 Research company before outsourcing
 Not all billing companies created equal
 Verify key issues
 Collection rate
 Compliance actions
 ICD 10 readiness
 Certified Coders

TAINO CONSULTANTS INC.
19 years in business
Healthcare, IT & Business Consultants
Veteran Owned, USA Based
Small Business Administration Certified
WWW.TainoConsultants.com

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