Hidden Costs of In-House Medical Billing Specialists

It’s easy to make this mistake. And go on making it for your entire medical career…

The mistake is equating a medical billing and coding specialist with any other administrative position in your practice.

The person that answers the phone, deposits checks, or makes sure your office supplies are in order ≠ medical billing specialist.

Here’s why those are not equivalent:

  1. Answering the phone wrong or poorly MAY lose you a customer or 2
  2. Checks are important – but missing a deposit day or incorrectly recording an amount is a 1 time event
  3. Office supplies? Even medical supplies are also important, but in stock and not in stock is sometimes solvable by Amazon Prime! (not medical supplies of course…yet)

Those position simply don’t have the impact on your wallet that a medical billing and coding specialist does.

Because an experienced, detailed, and motivated specialist can make you more money. And a brand new, poorly trained or just checking-the-box specialist can cost you big.

They cost you in missed opportunities, in payer denials and in outright mistakes.

Why Hiring ONE Medical Billing and Coding Specialist will Cost You

Small to medium sized practices often hire just ONE billing specialist. And that’s understandable, of course, because they may not do the volume to warrant their own in-house billing team.

But you know what it’s like when vacation days, sick days or FMLA come around and there’s only one person doing a job.

The AVERAGE employee takes between 10 and 18 days off work per year – not including vacation days.

And that was before the pandemic.

Who’s doing your billing and coding while during those times?

This hidden cost – having someone not trained or currently practicing coding and billing “fill in” can cost you both in time, because of increased denials, and in money from missed or incorrect coding.

Mission Creep and In-House Coders

Mission Creep happens when you hire someone for a specific job, but their responsibilities increase and change as needs arise.

And your 1-person billing department is notoriously subject to mission creep.

If they’re not busy enough, or even if they are, office staff and management may take advantage by having them sub in for reception or other admin rolls while THEY are out. Remember those 18 days out we mentioned above?

Already, with your billing and coding specialist’s own PTO days you’re going to have an amateur filling in. Add to that the time the specialist fills in for other and you’ve lost a MONTH of the best quality billing possible.

And the reason we’re paying attention to this is because your practice doesn’t get paid for procedures you complete by insurance companies or Medicare when you DO them.  You get paid when you BILL them properly.

So, you’re billing clerk needs to be focused on billing, claims, denials and more. Not splitting their attention with incoming patients, answering phones, or making supply runs.

The more not-billing your employee does, the more likely they are to not do it well.

Hidden costs to mission creep include mistakes made because of lack of focus and increases in denials because of missed details on claims.

Training and Replacement Time

Bringing on new employees costs any business time and money. And your medical practice is no exception.

Hiring costs for a new hourly employee is right around $1,500. That’s according to SHRM (Society for Human Resources Management). But right now, it’s also taking 21-45 days to fill an open position.

We’ve already discussed issues with having “substitute” billing and coding specialists, basically pulling from your already busy staff to “plug in the codes” for payer submissions.

Having a one-person or very small billing department means that if someone quits or is terminated you are up to FOURTY-FIVE DAYS from getting timely, accurate billing done again. That’s going to cost you more than that $1,500 estimate, guaranteed.

Why Professional, Outsourced Medical Billing and Coding Makes Sense

The ideal way to short-circuit 100% of these hidden costs to hiring and in-house medical billing and coding specialist is simple.

Don’t hire one. Hire a professional team outside your practice instead.

Here’s why:

Because you’re not hiring just ONE specialist.

You’re hiring a built in TEAM of professionals. Since we are well-staffed, for example, we have ample qualified coding specialists working all the time. Time off is accounted and planned for so there’s never a dip in activity.

Mission Creep simply doesn’t exist.

All our certified medical coders do – all day – is code and bill. There literally are NO other activities for them to engage in or get pulled into.

Training and Replacement Time

Not only do we have a group of highly trained coders that work IN our offices, but we make sure they are trained better than anyone in the industry. The market in general knows that, so we’re never at a loss for employees and don’t suffer the same turnover.

Your next step is simple – if you want you and your practice to get off the hamster wheel of hiring, training, and managing PTO time vs workload for billing and coding – get in touch.

Integra offers a free billing audit and no obligation conversations about your practice. Give us a call, let’s do the math together and see if outsourcing makes sense for your practice.

Home of the Free Practice Audit

Call (727) 233-2901 or click below.

Like this article?