Dr. Jim,
I have inhouse billing staff. We use a product called Medware and subscribe to its clearing house called Emdeon for approx $50-60 per month. claims go through electronically and we are receiving all major payers via EFT (Electronic Funds Transfer), and thus see rapid turnaround time in our claims payments and helps us keep aging accounts at a minimum. Accounts Receivable over 120 days in our practice was 2.1% last month, which any biller will tell you is good.
I prefer to keep billing inhouse because I can SEE the people everyday who does my billing. And I don't have to remain on hold with someone in India who says they are doing my billing when I have questions. I can go right to the source. i also know they are staying on top of my billing because their jobs depend upon it.
Outsourcing may have the convenience of less worry about whether they will quit or retire or move on to another job. But you have the constant anxiety as to whether they are staying on top of your practice, or letting it slide. And when they send you reports, can you trust they are accurate? Do they charge you 6-8% of what you charge, or of what they collect (that's a HUGE difference and VERY important point to delineate)? Are they billing your secondary payers? are they following up on rejected claims/ dirty claims? Or do they only submit each claim once at 2-3% without followup on any claims data? Do they send statements to patients once, twice, thrice? Do they hound the insurance companies that aren't paying? If so, how aggressively?
Be very careful outsourcing. It's virtually always less expensive to do it inhouse and should afford a much better opportunity to stay ahead of the game. Everyone knows doctors are usually bad business people. Lawyers know it, Medicare knows it, and outsourced billing companies know it. the fewer strangers handling your claims data reduces your exposure to fraud being committed unknowingly on your behalf, or embezzlement against your business.
