Internal Vs External Billing

Internal Vs External Billing

In-House Vs Full Service Billing

Many medical professionals choose their professions because they want to help people, and with that kind of a motivator behind their career, many would also say they’d love to give their services away for free if they could somehow still make a living. Unfortunately, as we all know too well, it doesn’t work that way. Rarely can we get “something” for “nothing,” and medical services are no different, especially if patients don’t have good medical insurance and end up paying for portions of certain services out of pocket. 

Either way, someone must write the check. To communicate to both your patients and their insurance companies what they owe for services rendered, your practice needs a billing system, whether it’s in-house or outsourced. However, one of these options might just be better than the other. More private practices are turning to third-party billing services instead of internal billing. 

While it would seem like keeping an internal billing department in your practice would be helpful from the standpoint of keeping more aspects of your business under one roof, it’s not always the best solution. In fact, maintaining an internal billing department can be more trouble than it’s worth. 

Why employing an internal billing staff can be a challenge.

One major issue that comes up is the cost of training and maintaining billing staff. Due to the progressive healthcare reform of the previous few years, there have been many changes in the realm of billing that require continued training for billing staff.  When it comes to training new employees, according to a report by the Society for Human Resource Management (SHRM), it costs employers an average of $4,129 to fill an open position, though that number can range from $4,000-$20,000 when factoring in onboarding, training, workplace infrastructure, and retention. The cost of training runs higher and places even greater stress on already struggling healthcare organizations, not to mention the time it takes for billing employees to complete that training. This can severely impact the productivity of a practice. 

Aside from training costs, in-house billing personnel can be expensive to employ. According to Indeed, average medical biller is paid $19.31 per hour. In addition to base pay, the industry average cost to the employer of providing benefits is around $20,000 annually. It’s also likely that you’ll need to employ more than one person in this department in order for it to run efficiently. You can’t have one person in charge of billing, or they will never get to take time off without causing delay and backup in your billing turnover, ultimately affecting the cash flow of your practice. From a yearly expense standpoint, it may cost your practice much more money to employ in-house billers as opposed to outsourcing to a third-party billing service. 

Compliance issues are a critical part of your billing picture. 

It is essential that your billing department operates in compliance with medical coding standards and insurance company contracts. Your billing staff should also have knowledge of these types of regulations specific to your field of practice. Their knowledge also ties back into the issue of training costs. To find and hire an in-house biller who is already trained on how to operate in compliance with industry regulations would be extremely rare, whereas third-party billers have expertise and training programs in place to stay up to date on the latest compliance requirements. 

Accountability and liability matter greatly, make sure you’re covered. 

It is an unfortunate reality that some individuals do not hold the same standard of professional integrity as others, which can create significant issues in an internal billing department. For example, embezzlement, inappropriate claim denials, negligence, and the discarding of claims or bills can run rampant in some, not all, billing departments that are not closely monitored to prevent such issues. Moreover, these types of problems can create legal trouble for your practice which, as the provider, you would be held responsible for. Outsourcing can give you access to thoroughly vetted account managers and people with integrity to make sure your billing is done correctly and ethically. 

How does outsourcing impact practice efficiency? 

 While a third party has many staff members employed for the same purpose of managing your billing needs, you could personally employ two or even three or more people in your internal billing department and it still wouldn’t be enough to manage your practice’s billing needs. As we said before, the more internal staff you employ for this purpose, the more your costs will go up. Outsourcing to a service that has a larger staff dedicated to billing for your practice can lead to increased efficiency as opposed to keeping it in-house.  By outsourcing your billing to a third party, you are able to focus more on growing your practice and increasing your revenue. The energy freed up will allow you to spend more time on marketing, more time on writing, more time on improving your patients’ experience, or even more time not at the office. More availability to focus on increasing your revenue, and reducing employee overhead cost almost always offsets the cost of a full-service billing provider.


ClinicMind provides the transparency that you would have with an internal billing department while also keeping your overhead costs and billing stress low. You would have access to everything we do from start to finish. You would also have a dedicated coach to help optimize your revenue and accelerate the growth of your practice with proven methods from over 20 years of experience. 

To see how ClinicMind could help YOUR practice with medical billing,


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