Wipe Out the Dilemma: In-House or Outsourced Medical Billing Operations?

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Wipe Out the Dilemma: In-House or Outsourced Medical Billing Operations?

A medical practice closely knows how it deals with the patient’s account billing operations and is well aware of the challenges it faces with the different aspects of managing its Revenue Cycle.

Different practices will have different preferences over choosing in-house billing or keeping it outsourced. And as a physician or a practice manager, this one question arises a dilemma and makes it highly decisive to opt for what best suits your healthcare organization. 

Isn’t it?

Well, before digging deeper consider the following factors influencing this crucial decision:

  • Size of the local labor market
  • How long have you been in business
  • The typical state of your practice finances
  • Assess your practice’s costs, volume, and staffing metrics
  • Who can you rely upon associating with a partner

Certainly, there isn’t a one-size-fits-all option available in such a case, thus, one has to clear the conundrum and make analysis over each and every segment of the two choices that are relative to each aspect of medical billing administrative activities.

Outsourcing and Internal Billing Concepts


Outsourced billing is generally relying on a collaboration made between the practice and the third party where the billing services typically incur a cost that is proportional to the percentage of the medical practice’s collections as a charge for handling its entire Revenue Cycle Management.


Here the staff and all the experts that combine a practice’s team or are a part of the Health Department are responsible for orchestrating all the aspects of Revenue Cycle Management. 

Prefer Reading: Benefits of Outsourcing Revenue Cycle Management (RCM)

Outsourced and In-House Billing Considerations

Outsourced Unique Advantages :

For a fresh startup, outsourcing usually incurs fewer expenses.  NetSet Digital offers the following provisions: 

  • Access to experts handling their medical billing and revenue cycle functions
  • The state-of-the-art billing software is automation-enabled and high in delivering accurate results.
  • Access to professionals that are up-to-date with the changing regulations
  • Timely and effective management of the denials, claims and accounts receivable.
  • Supply the practice comprehensive performance reports and data insights over the business progress and revenue generation
  • Implement RPA to eliminate the percentage of manual errors that threats financial success
  • Appeal denials and file resubmission of claims with a certain level of excellence
  • Automate billing codes process to produce error-free results

In-House Unique Benefits : 

In-house billing also offers some unique sets of advantages that are worth investing in.

  • With an in-house team of professionals, providers and administration have hands-on control over the financial operations 
  • Once the healthcare organization purchases the latest billing technology equipment, they nearly get close to the outsourced team in efficiency and productivity
  • With an established infrastructure and a medical billing department, a practical gets high control over refining its day-to-day strategies and processes to generate the best ROI outputs
  • Moreover, accessibility to the coders and billers at instant disposal is one of the major advantages to consider as any crucial issues that arise and need a wise decision can be made observing and addressing the problem altogether
  • Maintaining a patient’s private data is one of the concerning points. In-house billing allows for strict control over patient accounts.

Prefer Reading: Top Tips to Improve Medical Billing Process & Revenue Generation

Potential Negatives of Outsourcing the Revenue Cycle Functions

#Possibility of Hidden Charges: 

Many times it happens that we ignore reading the contract signed and end up witnessing hidden costs or expenses. Usually, due to ignorance, we suffer unpleasant surprises when the invoice arrives.

Statement fee, reporting fee, or cancellation fee might be some costs that might be additionally added to the final charge that might tremble your budget.

#Loss of Control: 

Seen from a more practical management approach, there are high possibilities that you lose control over the entire process handling of your revenue cycle. Further, it also keeps the patient’s data at stake as it targets privacy and poses a threat of loss if shown negligence. 

So before making the decision, ensure that you are completely comfortable handing over control of your billing process to someone else.

#Cost Variations:

Many outsourced medical billing companies charge a percentage of your collection, and as you generate more business, you tend to pay more to the offshore teams working for you.

This can raise questions on earning profits or managing your budget if there are large variations from month to month.

#Patient Communication:

Immediate access to patient billing accounts doesn’t remain the case always when you outsource billing to a third party. Any insurance or billing-related question if aroused from a patient may not allow you to give a relevant specific answer right at hand. 

Thus, this may closely impact patient satisfaction that would require setting up strong communication protocols with the service provider to avoid patient frustrations

While the possibilities of Outsourcing Medical Billing operations delivering less fruitful results stand low as top leaders in the industry like NetSet Digital empower technology at work, leveraging Intelligent Automation.

Possible Disadvantages of Internal/In-House Medical Billing

#Higher Cost:

Clearly there an organization has to take the expenses of employees where it has to pay for their salaries and benefits, equipment/software used to get them to do their jobs, a separate workplace for each to favor individualism, et

These costs are usually higher than the cost of hiring an outsourced medical billing company

#Personnel Issues:

Not always all employees will be available and working on the billing, sick leaves or vacation holidays may reduce the production rate. It can really take a hit in the long run if someone quits and you can’t replace them right away which can stall your operations and cash flow.

#Liability Issues: 

Embezzlement and negligent billing practices are more common with internal operations than with outsourced operations as medical billers have tons of insurance and security protocols to handle. Sometimes shortage of time/knowledge and work burden can lead employees to violate HIPPA privacy and PHI security that are huge liabilities.

The article closely compares the two different choices a practice tends to opt for as per their particular needs and we hope this can help you make a decision that is worthy of the investment.

Prefer Reading: Automate RCM Processes to Reduce Expenses & Debt Collection

So should you Outsource your Billing Department?

“Outsourcing Medical Billing results in higher income, it’s more convenient and much quicker to work with outsourced RCM.”

-John Wick

This is one of the reviews which our client from Virginia, US, gave us after we gained control over the fluctuating AR parameters that ultimately impacted positively on their revenue streams.

Prefer Reading: Gynecology Billing: Gaining complete Control over Fluctuating AR Parameters

The case study will give you clear insights into how we support a healthcare practice in orchestrating Revenue Cycle Management and would certainly influence your decision over opting for Outsourcing Medical Billing.

To know in detail, prefer reaching out to our experts and get answers to each of your related query and how we can swab those with our proven experience and support of technology.


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