Practice Management Alert

Weigh the pros and cons of in-house billing versus outsourcing

The decision of whether to handle your practice's billing in-house or to job out that function to an outside billing company is an extremely important one, so be sure to consider the pros and cons to each approach.
 
Perhaps the biggest advantage (or disadvantage, depending on the practice's preference) to keeping your billing in-house is that practice management remains in full control of the billing. "All the resources for handling issues are at the fingertips of the in-house collector," says Adrienne Rabinowitz, CPC, billing manager with Western Monmouth Orthopedic Associates in Freehold, N.J. For example, they have easy access to patient charts and can easily get clarification from physicians and other staff members, she says.
 
Many physicians don't like the idea of their billing in the hands of someone outside the practice, so obviously they aren't well suited to outsourcing, says Sindi Lash, BS, RN, chief operating officer of Medical Business Management LLC, in Northbrook, Ill.
 
The downside of keeping your billing under your own roof is the price of paying salaries to your billers, Rabinowitz says. For some practices, this can be prohibitively expensive, and it's a determination each practice must make for itself. 
 
If you determine that you can't afford to maintain an in-house billing staff, outsourcing could be your saving grace. Most billing companies take a "relatively small percentage" of the money they make for your practice, Rabinowitz says. In many cases, this works out to be less expensive than paying salaries for an in-house staff, she says.
 
Caution: Given that outside billers are essentially paid on commission, you must ensure you're dealing with an ethical and reputable company that won't bend the rules to make more money, Rabinowitz says. Be particularly wary of any company that claims it can bring in more money than most other services, she says. (For more information on how to choose a good billing company, see Medical Office Billing & Collections Alert, September 2003, page 70.)
 
The major disadvantage of outsourcing is that it makes communication between physicians and billers even more difficult to maintain, says Jennifer Darling, insurance and collection specialist with the Center for Oncology Research & Treatment in Dallas. Therefore, if you decide to outsource, be sure to work out a plan with the company you choose for staying in touch as much as necessary.
 
Tip: If you choose to outsource, make sure you do a background check on the billing company and check its  references to make sure it is reputable - and committed to compliance.