There are pros as well as cons to outsourcing medical billing, but with a reliable service provider, the benefits would outweigh the risks.

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Outsourcing
Medical Billing
Pros and Cons
Outsourcing
MedicalBilling
ProsandCons
1-800-670-2809www.outsourcestrategies.com
8596 E. 101st Street, Suite H
Tulsa, OK 74133

2. Medical billing is one of the most critical tasks in
medical practice management. Just like every
coin has two sides, there are both pros and
cons to outsourcing the billing process. The
process involves various tasks - patient
enrollment and verification, coding, billing and
reconciling accounts, and accounts receivable
(AR) collections. It’s important to analyze the
various factors involved in order to decide
whether to perform these tasks in-house or
entrust them to a service provider.

3. In-house Process
Managing billing in-house would allow
physicians to be in control of operations and
AR, have trained billers on the job, and
manage and monitor the staff. Issues can be
dealt with as and when they occur and
changes made immediately. The physician
can monitor the entire process.
Now let’s look at the drawbacks of this option:
Higher Costs
More money would have to be spent on software programs, payroll
expenses, and equipment such as computers and software, and
additional storage space for records and other materials
Staff
It is very difficult to find the right staff with excellent billing
knowledge and experience, and good work ethics.
Support
If the department is small, efficiency and returns would depend on
the competency of the billers. The absence of one employee can
have a major impact on the revenue cycle.

4. Outsourced Process
The advantages of contracting out billing
processes are
Expert Team
Professional outsourcing companies have a team of trained and
experienced AAPC-certified coders and billing specialists. These
experts are well-informed about the latest government and payer
regulations as well as prevailing CPT codes and ICD-9 codes, in
addition to being ICD-10 ready.
Time Saving
Physicians get more time to focus on providing quality care to
patients, which improves patient satisfaction. Physicians who are
preoccupied with financial matters would find it difficult to provide
efficient care too.
Accuracy in Claim Preparation and Submission
Physicians get more time to focus on providing quality care to
patients, which improves patient satisfaction. Physicians who are
preoccupied with financial matters would find it difficult to provide
efficient care too.

5. Improved Cash Flow
With the timely and accurate submission of claims and the increased
reimbursements, cash flow improves. Claims are also submitted
faster, with quick collections as the team is not distracted by other
tasks.
Better Consistency
However, these issues can be avoided by partnering with an established HIPAA-
compliant medical billing vendor. A reliable vendor can provide solutions on the
practice software or their own, and allow the physician access to the software to keep
track of the process. They would also provide customized monthly reports to their
clients. An established medical outsourcing company would also provide services
that can help physicians save as much as 30-40% on their costs.
Outsourcing could also have some disadvantages
 Physicians very little direct control over the billing process
 Hidden fees for things like setup, printing statements or contract cancellation.
 Risk of leakage of sensitive patient details
 Lack of access to information and communication between the medical practice
and vendor
Submitting claims and appealing denials would not an issue since
the vendor would have the resources and personnel to manage the
entire process at all times.