James, yes that what we had thought about when we started our billing outsource. I excused myself from billing involvement at the time. Our billing service company is small and local . We did not pay much attention to all point 1,2,3,4 you mentioned then.
My point is not how expensive the service if you hire a full time billing staff, billing service is more cost effective no doubt about that also no worry about staff turn over, take away most billing headaches. But if solo doc started out with heavy debt or has spousal support (who working for free or in exchange of romantic candle light dinners, not talking about expensive vacations many times a year here) then doc can save 6-8 percent in billing code. For our practical situation, client base almost same due to doc work/life balance issue, all expenses are up.. to the point, gross income is much higher than national average, but net income is much lower. We are not that efficient compared to larger practices.
One example, most ins try to squeeze dry smaller docs. As family PCP we have to stock expensive preventive/treatment injections, but they only pay couple dollars higher then purchased prices, hundred dollar shots are norm. One bottle might be for five shots, but if staff makes mistake then only 3, 4 shots available, wow, we might want to save money on 0ne dollar paper tissues but lost tons of money in med. Drug companies bill us thousand of dollars every month.
Open a can of worms here, any inputs on how to deal with this issue? I am thinking of create an inventory system on med inventory to control ins and outs, like a fancy loss prevention term, but my doc said that might create another burden on staff, but that should be done.
So back to billing question, now you could tell that we don't make enough money and want to take the billing back, temporary at least, until we feel comfortable enough or make same salary like doc working for someone else. Then 5-7% increases in profit. My friend said he doing his billing now later at night but he is still able to manage it without his spousal support. He also said many older docs in area still doing paper submitting themselves, he lives in a smaller town.
As you are an insider, how to re channel all ins info back to us smoothly and only give billing company tree days notice. Like job security everywhere, a fire not that simple, it might back fire.
