First thing first, a healthcare professional’s job is to deliver exceptional patient care and not look after administrative tasks like:

  • Medical Billing
  • QA & Auditing
  • Charge Entry
  • Claim Creation
  • Precise Coding
  • Claim Scrubbing
  • Payment Collections
  • Denial Management
  • Credentialing & Enrollment
  • Payment Posting

You’re A Healthcare Specialist

You’re a healthcare specialist or Messiah, specializing in fields like Cardiology, Behavioral Health, General Surgery, Dentistry, Nephrology, and Neurosurgery. Having spent years specializing in a particular industry, doing a house job or residency followed by medical school before becoming a licensed physician is not easy.

Combining your core responsibilities – providing compassionate care to patients – with RCM operations and revenue collection can take a toll on your physical and mental health. Going through piles of paperwork to extract correct reimbursements against your services – after providing unparalleled patient care – can result in burnout and compromise your services.

Overburdened? Time to Prioritize Care with Expert Help

According to research, doctors and physicians in the US spend around 16-20 hours every week on stressful paperwork and billing. Combining this valuable time with huge pressure to perform and give special treatment to every patient means they’re overburdened and overwhelmed.

This stress and undue load can affect the way specialists perform their primary duties. Patients feel it and aren’t satisfied with services provided. If you’re one of these healthcare professionals, you’re not alone. You need expert help!

Why Do You Need Professional Medical Billing Services?

Accept it or not, financial, operational, and clinical issues like loss of revenue, increasing costs, and lack of experience shatter your dreams of a lucrative practice. These factors have made quality healthcare delivery challenging for medical professionals.

Other major factors to seek expert help in the form of trained medical billers and coders are:

  • Changing payor guidelines
  • Regular ICD-10 coding updates
  • Reduced errors
  • Cost-effective RCM services
  • Enhanced revenue generation
  • Cost reduction
  • Better time management
  • Delivery of unmatched care
  • Turn patients into happy patients
  • Scalability & flexibility

These are some of the reasons why doctors and physicians in the US are turning to medical billers and RCM specialists to handle their billing-related matters.

Do as The Romans Do

Or as more than 36% of American doctors plan to do in 2025. Relieve yourself from the hectic tasks and let the professionals do what they are trained and paid for. Jump on the bandwagon! Handover the complexities to medical billing specialists, streamline your workflow and enjoy more revenue than before.

The real dilemma doctors, physicians, and healthcare providers in the US face is whether to hire an in-house team or outsource medical billing to a 3rd party medical billing company. Let’s tell you about the feasible option between the two.

Questions to Ask Yourself

Here are a few questions you need to ask yourself before deciding in favor of in-house medical billing staff or outsourcing the RCM operations to a leading revenue cycle management company.

  • Are the medical billing matters eating up your time that should ideally be spent on patients?
  • Can you tackle all sorts of pesky errors in documentation, coding, submission, and technical communication with other stakeholders?
  • Do you have the capabilities and expertise to cope with the fluctuating billing requirements and insurance guidelines?
  • Can you bear the revenue loss due to denied claims and delayed payments?

You can’t be a jack of all trades. Trying to sail in two ships at once is only going to end in mayhem. Trying to juggle multiple things will leave you short of time, a lack of enthusiasm while seeing patients, and a feeling of burnout. Your social life will also be affected.

Simple Solution?

Let the expert medical billers do what they’re paid for. While you do what you do best – patient care. They’ll eliminate workload and stress from your professional life via error-free documentation, timely claim filing, proactive denial management, and that you receive complete and timely payments.

They’ll relieve you of the arduous administrative tasks and take the headache of technical communication, documentation handling, and all related tasks upon themselves. They can save the day by expertly handling all unique RCM issues of your practice, office, facility, nursing home, ambulatory service center, etc.

What’s more? They’ll accelerate payments, minimize errors leading to denials, and lower overhead costs.

How to Find the Top Talent?

After realizing all the pitfalls hampering your progress and the benefits that can skyrocket your revenue, have you worked out how to find the most skilled medical billers or medical billing company for your medical facility? If not, stress no more!

Tips for Doctors to Find the Right Match for Their Billing Needs

We’ve worked out some crucial tips on how to find the right fit for your medical billing needs in the US. By considering these tips, you’ll be in a better position to decide the perfect partner based on your particular needs.

3E Game in The Industry

There’s no alternative to experience. Like any industry, experience plays a major role in healthcare, too. However, with experience, you also need to focus on their expertise – the ability to handle complex situations – and exposure to different scenarios.

Are they capable of achieving a close to 100% clean claim rate? Can they increase your revenue and lower denial rates? Do they have the skills to cater to your specialty, like Critical Care, General Surgery, Neonatology, Oncology, Pulmonology etc.?

Evaluate their RCM optimization abilities, strategy making, and previous clients. For instance, if you specialize in Urology, it’s better to partner with an RCM company specializing in urology billing. They’re better able to cope with codes and other unique mistakes faced by urology practices.

Proactive Customer Service

You cannot compromise on this factor when selecting the right in-house resource or while outsourcing a medical billing company. Their customer support and how they treat clientele speak volumes about their work ethics. Focus on how they’ll counter the hurdles you face.

Keep a close eye on their communication and problem-solving skills. And how keenly they listen to your problems. Do they have specific feasible solutions to counter them, or are they just selling off-the-shelf solutions? A responsive RCM handling team will focus on your issues and develop well-planned and precise solutions.

Assess Their Industry Standing

Whether you’re hiring an individual to strengthen your in-house team or want to outsource your medical billing processes to a medical billing company, it is better to evaluate their market standing. A strong image among peers helps you make an informed decision based on their efficiency and ability to handle complex scenarios.

So, it is better to do your research before having them onboard. Perform a strong background check. Google My Business review section is one way of learning more about them. Asking about their performance from their present and past clients is another way of verifying about their credentials.

Do They Stay Current with Coding Updates?

In the medical billing world, coding is one of the most integral and complicated part. No or incorrect codes in the documentation and claim forms lead to claim denials or delayed payments. Insurance companies are quick to pounce on any error or discrepancy. So, choosing someone who is acquainted with codes and stays current with coding updates should be your priority.

Whether it is an individual, a team of in-house employees, or a medical billing services provider, they must be familiar with CPT/CDT codes, ICD-10-CM Codes, HCPCS, and their annual, biannual, and quarterly updates, respectively.

Ensure They’re Knowledgeable of Regulations

We all know how fast our healthcare landscape is evolving. If someone doesn’t stay current with advancements, integration of new technology, fluctuating policies, and changing payor policies, they don’t deserve to be your partners or work as your in-house staff.

To be competent in the fast-paced healthcare industry, it is imperative that a service provider stays abreast of these changes, complies with regulatory requirements like HIPAA and coding regulations, and is well aware of the payor guidelines.

Strong Communication Skills

Whether you’re hiring an individual or a team for in-house support or collaborating with a medical billing company, make sure their communication skills are top-notch. Be it interpersonal communication or technical communication with insurance companies, patients, and other stakeholders, their written and verbal skills must be immaculate.

Strong communication is the key to resolving billing disputes, conveying to patients their payment responsibilities, communicating effectively with payors and clearinghouses, etc. So, always select a medical biller or a company that possesses great communication skills for meaningful impact. It also helps you foster lasting and professional relationships with other parties.

Scalability and Flexibility

Healthcare providers always focus on scalability and flexibility and you must also have the same thing in mind. Your medical billing needs may change with time based on your unique attributes like specialty, size, location, patient footfall, pricing structure, and other factors like expansion.

So, it is better that you choose the right medical billing partner that has the ability to adapt to the changes and can scale with time. They must be capable of managing more tasks, working with multiple new insurance companies, and handling more claims than what they’re doing presently.

Workout Their Charges

For many medical practices and hospitals across the US, this is the first and foremost factor they consider before hiring a medical biller or partnering with a medical billing services provider. Allocation of budget allows them to make a better decision.

Hiring someone with extensive experience and the required skill set is always beneficial as they help offload the burden from your shoulders. However, hiring an individual or collaborating with the right agency within your budget is always worthwhile. Ensure that you find someone that provides a combination of affordability, quality and professionalism.

What Options Do You Have When Hiring Medical Billers and Coders?

While hiring the perfect resource, you must keep in mind that medical billing is a vast field and encapsulates various processes. The financial health of any medical facility relies on medical billing and its components like documentation, claim creation, scrubbing, submission, payment posting, etc.

In addition, technical processes like coding, eligibility verification, credentialing etc., mean it is not a one-man job. Managing revenue cycle management for doctors and physicians is like balancing administrative conundrums and financial aspects. It requires expertise, time, knowledge, and resources.

So, healthcare providers, based on their unique requirements, can choose between hiring an in-house medical billing team or attaining the services of a medical billing company. Let’s go through both these options to give you a better idea of which suits you best.

Hiring an In-House Medical Biller or Team

Having an in-house medical billing team means you’ve hired internal staff that works from within your practice, facility, office or hospital. They are on your payroll and manage all medical billing processes. Building and maintaining an in-house team demands a lot from you like hiring, training and retaining medical billers, coders, BOB personnel, denial management experts and enrollment specialists.

Having a professional in-house team gives you more control over proceedings. Chances are that your practice’s financial health will stabilize. However, this option is around 10% more expensive than outsourcing medical billing operations.

According to a survey conducted by MGMA in 2021, in-house billing costs doctors 13.7% against every dollar earned. On the contrary, it is less than 6% when you choose the outsourcing option.

Advantages of Hiring In-House Medical Billers

  • Gives you control
  • A clear oversight
  • Faster issue resolution
  • Enhanced communication
  • Streamlined workflow
  • Flexibility
  • Potential for amplifying revenue
  • More privacy
  • Better data security

Disadvantages of Hiring In-House Medical Billers

  • High overhead costs
  • Staff turnover
  • Lower clean claims rate
  • Limited expertise
  • Expensive than outsourcing
  • Time-consuming processes
  • Compliance and regulatory challenges

Outsourcing to Medical Billing Companies

Outsourcing medical billing processes is another prevalent option for doctors and physicians across the US. This option gives them peace of mind that a trustworthy medical billing company is looking after their billing and revenue extraction matters. When compared with hiring in-house medical billers, this option is more feasible, cost effective and gaining popularity.

At the end of 2025, the global medical outsourcing market is expected to be $20 billion. Outsourcing medical billing to a reputable medical billing agency means they’re working on your behalf and accomplishing processes to collect revenue against it.

Instead of looking after everything by yourself, outsourcing means a 3rd party medical billing services provider will look after complicated, time-consuming, and resource-heavy tasks. Simply put, a medical billing service provider acts as an intermediary between doctors, physicians, and insurance companies.

Advantages of Outsourcing Medical Billing

  • Reduced billing errors
  • Focus on patient care
  • Improved cash flow
  • Satisfied patients
  • Affordable services
  • Enhanced revenue
  • Increased accuracy
  • Access to industry maestros
  • Regulatory compliance
  • Scalability & flexibility
  • Secure patient data

Disadvantages of Outsourcing Medical Billing

  • Lack of oversight
  • Hidden charges
  • Delayed payments
  • Less control over operations
  • No learning for in-house staff
  • Lack of communication

Outsourcing Medical Billing: A Smart Choice for Healthcare Providers

After comparing both options, we suggest you take the outsourcing route. It comes with various long-lasting benefits. The cons or disadvantages associated with it can be overcome with time. In fact, top medical billing outsourcing companies optimize their operations, designate a manager as your dedicated point of contact, and streamline communications for better outcomes.

They don’t replace your in-house staff. Medical billing companies work as an extension of your in-house staff, relieving them of laborious and technical tasks and allowing them to focus more on other goals like patient satisfaction and business expansion. Top RCM companies enhance revenue collection and slash any hidden charges to promote transparency.

9 Crucial Questions to Ask Before Partnering With a Medical Billing Service

Have you decided in favor of a medical billing company to lower your burden and bring in their expertise to enhance revenue for you while minimizing errors and lowering overhead costs? You’ve made the right choice.

However, before selecting a specific medical billing solutions provider, you must assess them based on a few things. Here are a few questions you need to ask to quantify their expertise and capabilities.

1. How Much Will Your Medical Billing Services Cost?

Most doctors, physicians, and healthcare providers are touchy when it comes to costs. According to a rule of thumb, the costs charged by medical billing companies must not exceed 8% of the monthly collections. Most doctors and physicians prefer a percentage over a flat rate. Because the more collections they achieve the less percentage they have to pay.

Before partnering, ask them to disclose their onboarding fees, yearly costs, termination fees, data conversion charges, and any other hidden charges in the fine print. It is important to be on the same page regarding costs before signing the contract, as some agencies charge more for patient collections and other services.

2. Can The 3rd Party Medical Billing Agency Provide References?

Ask for references or testimonials to ensure you’re choosing one of the best medical billing companies near you. It is important to go through their portfolio to get an idea of whether they’ve served the same specialty practices with similar size or patient volume. You have the right to ask for such things. You may even ask them for previous or existing clients’ numbers.

3. Who Retains Ownership of the Billing Data?

Another important query to clarify. Usually, the billing data belongs to the doctor, practice, hospital, or organization. They own it and must secure it if they want to switch service providers or hire an in-house billing team of their own.

4. Is Their Staff Trained? If Yes, Then What Kind of Training Do They Go Through?

Straight up ask if the company invests in regular training of its staff. Are they certified? If yes, what kind of certifications do they have? How would the knowledge help you maximize revenue and minimize errors? Do they stay current with the coding updates?

Are they acquainted with specific insurer guidelines? Do they use the latest resources and guidebooks, i.e., Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding Systems (HCPCS)?

5. Do They Practice Regulatory Compliant Billing Practices?

Before making a decision, don’t forget to ask if they follow regulatory compliance, i.e., they are HIPAA compliant or not. If they follow HIPAA regulations, you can join forces with them, it is a green light. However, if they’re reluctant to answer this question, that’s a clear giveaway and a red flag.

6. Who’ll Be Leading or Working on Your Practice’s Billing and Revenue Generation Operations?

Can you meet the person leading your practice’s medical billing operations or talk to them on the phone? This meeting will help you set clear expectations. You can convey your goals and unique requirements for them to consider. It will definitely help you in the long run.

7. Will They Provide Custom Reports and Ensure Complete Transparency?

Based on your specific requirements, will the medical billing company provide you with custom reports showing the financial health of your practice, facility, clinic, hospital, or organization? Will they provide you with weekly, fortnightly, or monthly reports as per your demand?

How will they communicate the financial progress of your healthcare facility? All these and related questions will ensure transparency and give you a clear picture of where you stand in comparison to your competitors and practices in your area.

8. Do They Use Electronic Data Transmission?

Most medical billing services providers across the US follow electronic data transmission protocols. From document creation to submission, data transfer to BOB, and payment posting, everything comes under Electronic Health Records and transmission. They must also integrate the latest software to ease things and credit card or online payments for convenient payment transfer methods.

9. Are There Any RCM Processes They Don’t Cover?

Many RCM solutions providers in the USA do not cover everything falling under the revenue cycle. Or maybe the rates you’ve settled on will not cover every billing process. Some medical billing companies are flexible and even provide some elements or steps of RCM, i.e., eligibility verification, credentialing, billing, and coding separately based on the client’s demands.

It is better to clear all these things up front to clear any confusion or avoid conflicts going forward.

Hire A Stress-Free Medical Billing Company

Want to increase revenue and relieve yourself of the administrative burden hampering your progress toward financial freedom? You’re one step away from liberating yourself from economic uncertainty and stepping into the future of capital gains.

Outsource your medical billing to a top-tier medical billing company near you and experience accelerated payments, a huge increase in revenue, minimized errors, streamlined RCM, and fewer overhead costs.

If you don’t do it now, you’ll keep on struggling with revenue generation issues. Apart from a large percentage of doctors and physicians already reaping the rewards of outsourcing medical billing to 3rd party RCM agencies, around 36% are planning to collaborate with reliable RCM companies in 2025.

Choose The Best: Choose I-Med Claims As Your Medical Billing Company

Let I-Med Claims offload your worries and relieve you from the hectic and time-consuming tasks diverting your attention from patient care. Owing to our cutting-edge infrastructure and integration of the latest software combined with meticulously crafted bespoke RCM strategies, we guarantee you enhanced revenue. 

Our all-inclusive medical billing solutions include claim creation, coding, medical billing audit, claim scrubbing, claim submission, denial management, AR recovery, payment posting, credentialing, enrollment, patient payment collection, and streamlining your RCM to make it error-free.

Forget about complicated medical billing and let the best in the business simplify your process and ensure a boosted income stream. Get in touch today!