Over the last 20 years, we have done our own billing in-house with medisoft, outsourced to the local hospital's billing service, outsourced to a larger national billing service, used an web based billing/emr system, and most recently have been using Office Ally in conjunction with AC. One issue I have had with billing services is being Family Practice, with a majority of my claims being worth less than 100$, we didn't seem to get top priority for tracking down secondaries and such...figure if the service had the choice of assigning one of their employees to work on the 5000$ neurosurg claim or the 50$ family practice claim, needless to say, we got moved to the bottom of the pile. So, the 7 or 8 or whatever percent they are taking actually can add up to a lot more than that when you figure in money they let slip thru the cracks. Of course, on the other side, you can run in to the problem I had today when my staff member that does a majority of the billing dropped the "I found a new job and will be done in two weeks" bomb. In a small office, it can be hard to have a lot of cross over training when you have limited staff, so that usually means the billing falls back to me until I get a decent replacement. Two edged sword, but still, with the experiences I have had so far, I would still say we have been most profitable and felt the most in control with our practice financials when we kept it in house. Plus, patient satisfaction has by far been best with us doing our own billing. Being a small practice in a small town, our patients definitely appreciate being able to deal with us about their bill rather than calling who knows where with some 800 number.
