To Bill or Not To Bill


One of the many business questions physicians face is whether to outsource their medical billing to third-party medical billing services or do it in-house with medical billing software. Some physicians would assume outsourcing billing to a medical billing service makes the most sense. After all, they’re the experts with the resources to properly process your claims, right? Others might want to maintain control of collections and do it all in-house. In 2017 many physicians are experiencing difficulty in securing payment for their service from the insurance companies due to the over-reach of political influences. There are many ways to ensure prompt payment from the insurance companies and most medical billing companies are experience at dealing with the issues that insurance companies have with making prompt payment. Below is a breakdown on cost to the physician for billing insurance claim and collection in house and outsourced.

In-House/Outsourced

Billing department costs

$118,000 $4,000

Software and hardware costs $7,500 $500

Direct claim processing costs $3,600 $122,500

Software and hardware costs $5,500 $2,000

% of billings collected 60% 70%

Collections $1,370,900 $1,623,000

Collections costs $129,100 $127,000

Collections, net of costs $1,241,800 $1,496,000

The savings are tremendous and in addition you have a experienced professional who know how to navigate the insurance industry.

Which Approach Should I Choose?

It’s important for a practice to factor in their individual costs and preferences when deciding whether or not to outsource their medical billing. In an apples-to-apples comparison, we found that outsourcing had the higher net income. However, cost isn’t the only issue practices should consider. There are plenty of other factors involved in this business decision that may be as – if not more – important than costs.


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