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How Does Outsourcing Medical Billing Services Maximize Revenue Collection For The Medical Business?


Medical practitioners should responsibly pay attention to their revenue cycle management. Therefore, if the healthcare practitioners encounter challenges in the medical billing services then they should acquire the assistance of medical billing services providers who have complete industrial knowledge and in-depth experience of this field.

Using a traditional approach to oversee revenue cycle management would not help medical businesses to comply with the evolving trends of the fast-pacing healthcare industry. Therefore, they should opt for innovative solutions for medical billing services in order to stay at the competitive-edge.

In this article, I have enlisted hypothetical factors that justify that outsourcing medical billing services can help the medical business to collect more revenue than traditional in-house medical billing department norms.

1. Reduce Expenses Of Maintaining An In-House Billing Staff:

By partnering with a medical billing company, medical businesses can save a huge amount of money that could be spent as salaries, insurance benefits and state & federal taxes. At least, if a medical business has an in-house medical billing department and it comprises of only two employees as medical billers then it may cost average around $118,000 per year.

Depending on the area, with periodic updating training for medical billers, in-house medical billing services can cost about $2,000 per year. Moreover, if we include the expenses of computers and medical billing software then the net cost will be approximately $5,500 annually, even if you exclude any expenditure for initial system purchase.

However, if a medical business partners with a medical billing company then they would have to pay the fixed proportion or percentage out of their net revenue. Hence, in this way outsourcing medical billing services is the more cost-effective approach to pursue increased cost savings, revenue generation and medical billing optimization.

2. Increased Income:

If any healthcare centre would outsource medical billing services to a professional company that have might sufficient resources and equipment to manage revenue transition then they can extract better results than in-house medical billing department. As most of the companies charge from the amount that they collect for your services by filing clean claims. So, to adhere to mutual success goals of both the businesses will motivate them to carefully file claims and earn reimbursements in return.

3. Submission of Clean Claims:

It is the primary responsibility of medical billers to prepare a patient’s “superbill” with relevant data: diagnosis, treatment codes, and other information mentioned on medical bills. Then medical billers forward this superbill to a medical billing clearinghouse. In-house medical billers usually charge for this step: (the cost of single superbill which is sent to the clearinghouse includes a fee that is generally estimated at about $100 per physician per month (x 3) for 20,0000 claims or a total of around $3,600 annually).

If the medical billing staff has prepared a clean claim and clearinghouse has declared it to be billable then it will be moved towards the payer for processing and reimbursement. If a claim is not ‘clean’, then the clearinghouse cleans it and submits (again, for a fee) or returns to the provider, so they can review and rectify the errors in claims. Remember! They will still apply that specific fees, of course.

However, if you outsource medical billing services then they will electronically store and send “superbills” and drive efficiency in the revenue cycle management. A medical billing company would also charge a fee to handle data entry and submission, but they will only charge a percentage and that could be approximately equal to 5%. Certainly, this fees is worth it for healthcare centres that have already busy schedule in their plates.

4. Prevention of Claim Denials and Rejections:

Depending on your needs, a medical billing company can follow up on rejected claims, manage past-due accounts and invoice patients. It can help medical practitioners to save a significant amount of time, money and aggravation.

When considering to outsource medical billing then make sure to match your EHR data to that of the medical billing company, as it is important to exchange information between your systems. Otherwise, it is essential to perform data conversion.

Even if you outsource medical billing services you will still require some essential equipment to maintain a computer and printer. This will help you exchange information and print out documents with your billing partner. Usually, for an average annual amount of around $500, that is almost a small fraction of the net cost that is required to sustain an in-house medical billing department.

5. Maximum Revenue Collection:

For instance, If a healthcare centre comprises of just 3 physicians and 2 medical billers then this practice can normally expect to collect almost 60% of the bills it charges for its overall services. On the other hand, a best medical billing company can even this small practice to generate 10 % more revenue than its current operational capabilities.

Reconsider the above-mentioned example, if the same sized healthcare centre will tend to outsource medical billing services then it’s net revenue can be estimated to almost $1,496,000 as compared to $1,241,800(revenue generated by the in-house medical billing department.)


The healthcare landscape is evolving so rapidly, that medical practitioners should acquire modern solutions to keep pace with this development. Therefore, medical practitioners should acquire the help of professional medical billing companies so they can supervise revenue cycle management with their in-depth knowledge and intuitive industry experience.

It would help you to get relief from the administrative burden and focus more quality patient care services. It will also prevent your revenue from being drowned into the tunnel due to claim denials and rejections. To learn more about how to maximize your practice’s revenue and mitigate medical billing workload. Contact us! To leverage the financial health of your business with maximum revenue collection.