Evaluating whether to perform the billing “in-house” versus outsourcing represents an increasingly important business decision for medical practices.  We have outlined below a few considerations to evaluate depending upon your current situation.

Established Medical Practice – Billing Currently “In-House”

For practices currently performing their own billing, we believe the following questions are worth considering;

  • Does the current billing situation represent an asset or liability for the clinic Administrator?  Considering time is your most precious resource, does the current billing situation allow you to focus your efforts efficiently?
  • Is your internal billing practice producing results that meet or exceed industry standards for cash collections, insurance and patient aging, etc?
  • Can the practice maintain continuity and longevity with regard to qualified billing and collection staff members?
  • Do your internal billing team members produce timely and meaningful reports for your review?  Are they able to be an objective resource to assist Administration evaluate opportunities for improvement?
  • Is your information technology infrastructure a strength for your medical practice, and are you well positioned for future regulatory changes?
  • Would a system of “pay for performance” be attractive in relation to the revenue cycle?  Given the significance of the revenue cycle to the clinic’s survival, paying based upon actual cash collected results might make better business sense than guaranteed hourly wages irrespective of cash collected.

New Medical Practices

Facilitating cash flow as efficiently as possible is never more vital than the early stages of a new business.  The billing and collection functions are obviously paramount to efficient cash flow, and accordingly, we have outlined below a few issues that warrant consideration in your decision-making process;

  • Have you considered the information technology budget for a practice management system?  Does it make sense to purchase the software and user licenses, pay monthly support and maintenance fees, pay for periodic upgrades, servers and internal networks, etc. associated with a practice management system?
  • Do you have the time and expertise to evaluate practice management systems to determine the best fit for your practice?
  • Do you have the time and resources to effectively hire qualified billing and collection staff members with the experience and expertise to protect your medical practice?
  • Do you have the time and resources to develop appropriate billing and collection policies and procedures, and then monitor performance against such standards?