Outsourcing vs. In-House Billing: What’s the Best Option for Your Behavioral Health Organization?

Billing is the lifeblood of any successful behavioral healthcare organization. Since this service is so important, some leaders are hesitant to turn the responsibility over to a third-party provider.

In some circumstances, keeping your billing in-house may be the right call — but in many other cases, failing to consider outsourcing can put your organization at a financial and competitive disadvantage.

Features & Drawbacks of In-House Billing

Before you decide that in-house billing is the right option for your behavioral health organization, it’s important to give serious thought to both the positive and negative aspects of this choice.

According to Justin Gaines, the founder and president of GreenpointMed, A SimiTree Company, the following are three of the most common reasons for staying with an in-house billing model:

Familiarity: You know exactly who is handling your billing because you recruited, hired, and trained them.
Control: The person who is responsible for billing reports directly to you, so you have full control over how they do their job.
Exclusivity: Your in-house billing staff’s sole job is taking care of your organization’s needs.

The downside, Gaines noted, is that in-house billing can expose your organization to risks such as:

Reliability: What happens when the employee who handles your billing is out sick or on vacation? Do you allow this vital service to lapse until they return, or do you pull another employee away from their responsibilities in an attempt to plug the gap?
Recruiting: When the employee who is responsible for your billing retires or accepts a position elsewhere, you may need to expend a considerable amount of time, effort, and money to find and train an appropriate replacement.
Stability: In addition to the costs noted previously, every time a billing employee leaves your organization, you also risk the loss of vast institutional knowledge, as well as diminished relationships with payers.

Benefits of Outsourcing Your Billing

Opting to outsource your billing requires a slight change in how you view this service and the people that provide it, Gaines said. But this brief period of adjustment is likely to be offset by a significant increase in performance and efficiency.

For example, you won’t have quite the same level of control and familiarity that you had when your billing was managed by an on-site employee. What you will have, though, are features such as:

Expanded support: “When someone uses our service for billing, we’re often able to offer them the support of a five- or seven-person team for what they were paying for one full-time employee,” Gaines reported.
Consistent service: Being supported by an outsourced billing team means you will never experience disruptions or delays due to sick days or vacations. If one member of the team is unavailable for any reason, their colleagues can immediately step in to provide seamless service.
Instant expertise: “When bringing in a third-party biller, you get a team of professionals who are trained in the behavioral healthcare field, who are proficient with the billing system that you are using, and who can hit the ground running on day one,” Gaines said.
Continuous improvement: The billing professionals at third-party billers can share knowledge with each other and gain valuable insights from their work with other clients. This focus on continuous improvement ensures that your billing service will reflect the highest standards and incorporate the most up-to-date best practices.

Reputable third-party billers bring an in-depth understanding of the behavioral healthcare space, as well as a set of time-tested processes and procedures. This allows you to focus your full attention on serving your patients and managing your on-site employees.

“Our goal is to help your practice function at peak efficiency,” Gaines said.

How to Evaluate a Third-Party Behavioral Health Billing Service

Deciding to outsource your billing operations can be an extremely beneficial step for your organization. However, once you’ve made this choice, you still have one more important step to take: identifying the third-party biller that’s right for you.

When evaluating third-party billing services, Gaines advised leaders to focus on the following four areas:

Experience: Does the biller have a history of success with other behavioral healthcare organizations? This field requires special expertise as well as experience handling a higher frequency of billing than most other healthcare specialties.
Transparency: Can the biller explain their processes to you in an easily understandable manner? Are they willing and able to provide you with the details you need to make informed decisions?
Access: How (and how often) will you be able to access updated billing information? If you have a complaint or concern, how quickly can you expect to speak with a representative who can solve your problem?
Expectations: Is the third-party biller making promises that far exceed what other companies are offering, or are they quoting a price that is significantly lower than the standard range? “Remember: If it sounds too good to be true, it probably is,” Gaines cautioned.

Get Help from SimiTree Behavioral Health

Do you need help evaluating the efficiency of your in-house billing operations and exploring your outsourcing options? Reach out to learn how our behavioral health billing and claims management services can help you start capturing more revenue for your business.

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