Many healthcare providers often wonder if outsourcing their medical billing team would be worth it. Keeping things in-house has its advantages; but on the other hand, giving another team the responsibility of handling the billing cycle relieves healthcare teams to be able to focus on other important matters. In today’s world of business, it is not uncommon for companies to outsource specific duties to keep things flowing smoothly, which in turn increases profit—otherwise, what would be the point?

Individuals who work in an office setting within the healthcare sector, no matter which particular field, have enough responsibilities on their plates. They already handle scheduling, patient concerns, supervise staff, maintain medical records, delegate responsibilities, follow office policies and procedures, perform data entry and processing, and much more. Adding the duties of overseeing coding, billing, and collections, as well as submitting statements to patients, claims to insurance companies, and handling rejected or denied claims can be overwhelming. This is especially true when the billing cycle is such a crucial and significant thing that must be timely, accurate, and efficient—not only for the company but for the patient they represent. 

There are many reasons why a healthcare company may be looking into outsourcing its medical billing team. 

In an article from Medical Economics, Dan Schulte, SVP of healthcare at HGS, a global business outsourcing company shares four “trigger events.” If these are occurring in your own practice, it may be time to consider outsourcing. 

  • Your patient accounting system is old and needs replacing.
  • You have chronic problems with credentialing issues.
  • You’re seeing a constant change in reimbursement models.
  • You have weak net revenues and poor cash recoveries based on your expectations.

Of course there may be other reasons to stray away from in-house billing; however, these are some of the more common.

Before the pros of outsourcing are discussed, there are also a few advantages of keeping things in-house. 

  • Some healthcare facilities would rather retain control of their day-to-day billing operations. Some may have trusted medical billing staff that have been working there for a while and managers might be hesitant to go elsewhere.
  • On a similar note, a healthcare manager being in close proximity to their medical billing staff is an advantage, and each individual staff member feel the benefits of this as well. When issues or concerns arise, an in-house billing team can work together easily to ameliorate the situation. 
  • Lastly, medical and healthcare facilites put forth big bucks to train and retain their staff. If a team has already gone through training, using the company’s time and money, not to mention all of the medical billing technology that was purchased, this can seem like a waste to throw it all out the window and outsource instead.  

Consequentially, some of these reasons simply aren’t advantageous enough for a company to retain an in-house medical billing team. 

Next, read about the advantages of outsourcing.

Pros of Outsourcing 

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Overall, the high cost of billing technology, software, employee salaries, and benefits can get overwhelming for a healthcare company. Being able to outsource billing services saves time and money that can best be spent elsewhere. 

A career-related article in Love to Know describes how outsourcing can be less expensive: 

  • Cuts operating costs
  • Allows for cheaper labor
  • Lowers labor training costs
  • Gives access to better technology

Increased Productivity

This should always be the end goal. The more productive a company is, the more money employees make, and the more successful the company is.

By outsourcing, employees can work in shifts to cover 24 hours a day if needed, depending on the need and the location of the employees. Productivity is also increased because there is a set billing team dedicated to billing only. Those who work at the healthcare location can now focus on core business-related duties and not have to focus on the billing aspect of the company. 

Productivity is directly related to profit. If profit isn’t going up, then the system of doing things isn’t as productive as one may have thought. 

The experts at Forbes state:

“Our experience suggests that if a company doesn’t get a return of at least 25% on its sourcing investments, it needs to carefully review and fix its current programs before moving on to new projects.” 

Enhanced Consistency

Choosing to outsource a company’s medical billing team will ultimately increase consistency all around. Once there is a specific group of experienced people solely working on billing services, they can focus only on those duties and responsibilities and not get sidetracked by other tasks. 

Read 4DGlobal’s previous article about 5 benefits of outsourcing billing services to get a better picture. 

Cons of Outsourcing

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When there are advantages to something, there are always disadvantages as well. 

Loss of Control

While this factor may not bother some, many managers might have a difficult time relinquishing control of their billing services. Outsourcing means that employees will not be within proximity; therefore, managers must learn to accept that a certain amount of control will be lost, and finding ways to hold employees accountable, who are overseas, is important. 

Communication Issues

The business experts at Forbes discuss the cons of outsourcing and communication is a key point. 

They advise companies ask themselves these questions before deciding to outsource:

  • What time zone does the person live in and how does this match up with your business hours?
  • What is your preferred method of communication? Phone, email, instant messaging?
  • Does the person have access to a reliable internet connection?

Impact on Company Culture

While there won’t be a negative impact on all individuals within a company, this is something to think about before deciding to outsource. The goal is to keep things positive so that the company can be more productive. 

The same article in Forbes also brings to light the negative impact outsourcing can potentially have on a company. 

  • Upset employees as they may feel they are being replaced
  • Confuse employees who don’t understand why you are outsourcing particular tasks
  • Add challenges to the daily workflow of the company

Again—this may not even be a factor, and it is always good to consider when making a big change.


Whether you have just recently decided on outsourcing your company’s medical billing team or are thinking about it, it is wise to consider both the pros and cons of doing so. However, it is also wise to take some of the advantages and disadvantages with a grain of salt, as all factors may not pertain to you. Ask around, do your research, see how successful companies have made outsourcing work, then make your decision. In the end, the decision should be revolved around what will help make the employees and company be more profitable and successful.

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