Feb 15, 2017

Medical Billing: What’s Right For You?

Updated June 28, 2023  |  Published February 15, 2017 by Alanna Diffendal


Many factors affect a practice’s decision on whether to outsource billing or handle it in-house. When evaluating these options, a practice needs to first answer 3 questions:

  1. What is the size of your practice?
  2. What is your practice’s budget?
  3. What resources do you have available (i.e. number of medical billers)?

After evaluating the answers to these questions, you should be able to narrow down your decision. There are pros and cons to each option, however depending on your answers, the pros of one choice can vastly outweigh the cons.

In-house Billing

When considering bringing your medical billing in-house, it is crucial to have the right employees in place to handle the billing needs of your practice. If this is possible, in-house billing has its advantages. First, your biller(s) are located in your office and are easily accessible. Any issues that arise can be quickly addressed, saving valuable time in the billing process. For doctors running smaller practices and like to oversee the entire practice’s operations, this is an ideal set-up to ensure everything’s running smoothly.

Of course with any upsides, there are downsides. Billing within a practice typically means there are fewer billers as opposed to a billing company. If you are down a biller for whatever reason (i.e. sick, vacation, or family emergency), your billing process can be stalled until that employee returns, which overall stalls the collection process. Also, if you have a less experienced biller on staff, there are multiple errors that could be made, leaving your practice liable for inaccurate billing. Lastly, if your practice doesn’t budget annually for in-house billers, you will be dismayed by the additional overhead costs. You will need to keep up with billers annual salary or hourly pay, and any benefit packages your practice may offer.

Outsourced Billing

Practices that outsource their billing needs experience multiple advantages. For starters, it is more cost-effective for certain practices to outsource. You avoid the overhead cost associated with hiring in-house billers (salary, office space). Also, you have a more reliable staff to handle billing needs if an employee is out, which keeps up the consistency of your billing. Consistency from medical billing companies is important because they routinely send out claims on time.

The cons of outsourcing rely heavily on your answer to the three questions above. If you are a doctor that wants to be hands-on in every aspect of your practice, a medical billing company can inhibit that. It may not be as easy to get in touch with your billers. Although outsourcing reduces your office’s overhead costs, it could end up costing your practice more based on the about of claims you send out on a monthly or annual basis. Most billing companies bill per transaction, so if you are sending out hundreds of claims a month, your bill can quickly add up.

Deciding between in-house billing or outsourcing is a huge debate in many practices, big or small. RXNT can help you with whichever direction you choose to go. We have hundreds of practices that bill in-house using RXNT|PM as well as hundreds of medical billing companies that use our solution to manage their clients. If you have any questions about how RXNT can help you in our decision, please call us at 1-800-943-7968 Option 3, email us at [email protected], or request a demo by clicking the button below!

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