Outsourced or In-house Medical Billing?

Healthcare providers face constant pressure of providing quality services at a low cost. One of the major yet non-core functions is billing. Electronic medical billing has made it easy for healthcare institutions to process patient bills and claims, but it’s also expensive. The alternative is to outsource the medical billing process, but is it worth the trouble?

In-house Medical Billing

Advantages

Keeping the medical billing process in-house eliminates the challenges that come with outsourcing, especially security risks. Healthcare providers can immediately address problems that may occur.

Disadvantages

In-house electronic medical billing requires two important components - a billing department and a clearing house - both require a huge investment.

The billing department requires staff, regular training, and facilities. The healthcare provider also needs to invest in a medical billing or practice management software. The clearing house will charge for each claim it submits to the insurance company. This can slow down the billing cycle. 

Outsourced Medical Billing

Advantages

Outsourcing entails minimal investment. Outsourcing clients can avail of both skills and infrastructure through offshore staff leasing. The service provider’s expertise can reduce turnaround time and increase claims success rate. As a result, the outsourcing client can focus on their main job - provide quality healthcare to their patients without having to worry about the burden of administrative work.

Disadvantages

Outsourcing entails careful planning, meticulous execution, and diligent governance. Healthcare providers can take advantage of labour arbitrage that comes with offshore outsourcing, but they need to overcome certain challenges. These include cultural gaps and communication barriers. The key is to find a compatible service provider that has access to a wide pool of healthcare professionals from a low-cost labour market.  

Healthcare organisations that can afford to keep their medical billing process in-house can do so. On the other hand, outsourcing can provide manageable costs, flexibility, and resilience to uncertain market conditions.