Medical billing is complex and best handled by experts. Most offices have to deal with multiple plans and therefore multiple payment schedules, different benefits, and variable rules. Medical billing is also a moving target — plan rules change frequently and even CPT codes are updated quarterly. It’s hard to keep up. The implications of doing this job poorly are significant. There is also the time-consuming rework required for claims that are denied. A core benefit to outsourcing is that you are dealing with a bank of professionally managed experts who are focused solely on billing. Because our services are paid on a percentage of collections, we are strongly incentivized to perform well.

In-house billing is time consuming for physicians and clinical staff. Dealing with insurance companies takes so much time away from your practice, time that could be better spent on patient care. According to a study by Lawrence P. Casalino, MD, PhD, of Weill Cornell Medical College, physicians spend three hours a week or nearly three weeks per year on these activities, while nursing staff spend more than 23 weeks per physician per year. The same study noted physicians in solo or two-physician practices (particularly primary care) spent “significantly more hours interacting with health plans than physicians in practices with 10 or more physicians.”

Managing internal billing operations can be cumbersome. In addition to salary and benefits, a billing staff requires oversight to ensure that they are performing optimally, so it’s not just a job to them. Are your accounts really being worked or are they just passing on the hard ones? They will also be prone to any of the normal unspoken overhead of employees — illness, variable job satisfaction, hiring and firing, and ability to mesh with other staff members. Again, another reason to hire an outside billing company.