From Evan M. Gwilliam DC, MBA, CPC, CCPC, CPMA, CPCO, Senior Vice President at Practisync
Outsourced billing could be the smartest business choice you can make for your practice, but it might also be the completely wrong move.
Before choosing a billing solution, ask yourself a few questions:
- Do you like to supervise every detail and step of the revenue cycle? Or would you like someone else to navigate all the minutia of the process?
- Is your billing process full of exceptions and situations that need attention from someone with firsthand knowledge of every patient and local insurance policy? Or have you developed an insurance collections system that works and you are ready to let someone else run with it so you can focus on other parts of your practice?
- Are you comfortable with handling payroll and benefits for in-house team members? Or do you struggle with turnover or coverage with internal staff?
- Do you enjoy training your team on billing matters and following up with insurance companies? Or would you like someone else to monitor the insurance revenue cycle and keep up on the latest changes and best practices?
Many chiropractic practices assume outsourced billing and in-house billing are interchangeable. In reality, they are different operating models. Neither is inherently better, but one may be a much better fit for your practice than the other.
The Advantages of Outsourced Billing
- Reduced staffing burden and fewer personnel headaches.
- Access to specialized billing expertise and payer knowledge.
- Greater continuity when employees leave or take time off.
- Predictable costs and scalability as the practice grows.
- Allows doctors and staff to focus more on patient care and operations.
Outsourced billing is often a good fit for clinics that want experienced professionals to manage the revenue cycle while the clinic focuses on patient care. These practices are generally comfortable with standardized workflows, communication logs, scheduled meetings, and allowing the billing team to take ownership of the process. But they also understand that the office doesn’t just walk away, rather communication remains key to keeping the process moving.
The Advantages of In-House Billing
- Immediate access to the biller throughout the day.
- Greater day-to-day oversight of claims and denials.
- More flexibility for unusual situations and exceptions.
- Deeper familiarity with clinic-specific workflows and patient circumstances.
- Direct and frequent supervision by the doctor or office manager.
Some clinics are simply better served by an in-house biller. This is especially true when the doctor or office manager wants daily involvement in claim decisions, regularly handles unique billing situations, or prefers direct oversight of the revenue cycle.
The Most Important Question
The question is not whether outsourced billing or in-house billing is better.
The question is whether your expectations match the model you have chosen.
An outsourced billing company can provide expertise, consistency, and efficiency. What it cannot fully replicate is having a biller sitting down the hall who participates in every conversation and every exception. Likewise, an in-house biller may provide more direct control, but often at a higher staffing cost and with less access to specialized expertise.
Practices that understand this distinction tend to be the most successful, regardless of which model they choose.
Making the Right Choice
If you are considering a change, start by deciding whether you want someone to manage the billing process (out) or someone to execute tasks under your team’s daily direction (in).
The answer to that question often reveals which model will serve your practice best.
If you would like help evaluating your current billing workflow, Practisync would be happy to have a conversation. Practisync has set up an affinity relationship with CalChiro, which means you qualify for special pricing.
Sometimes outsourced billing is the right answer. Sometimes it is not. Either way, making the right decision up front is better than forcing the wrong fit later.
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