Medical billing is an essential part of operations for any medical facility, but it can be difficult to know whether to hire staff to work in-house or to outsource this part of the business. According to the folk at, there are pros and cons to both scenarios. If you are worried about the HIPAA compliance aspect of coding and billing, you may want to keep billing in-house because it will give you greater control over patient records and minimize the risk of a breach of confidentiality. But if you are eager to keep staff costs down, then outsourcing may be the way to go. Here, we will look at the pros and cons of both.

In-House Billing


If you have your medical billing in-house, you will definitely have more control over the process. You can speak to staff and get answers to queries in real-time, rather than having to contact a third-party representative.

There is no doubt that there is a higher level of staff accountability and transparency when billing is carried out in-house. In addition, with fewer people accessing patient files, the risk of a HIPAA violation is decreased.


It can be more expensive to hire in-house billing staff than to outsource. When you hire someone to work in-house, you will have to pay a salary plus employee benefits. You also need to provide an office as well as equipment and software, which will need to be maintained. It is usually not sufficient to hire just one person to take care of coding and billing because the role will require cover for staff days off.

Although having staff in-house means you may have more control over the billing process, you will also have much more responsibility in terms of patient confidentiality and minimizing billing errors.

Out-Sourced Billing


Outsourcing medical billing can save you money. You would not have to worry about providing a work station or paying salaries plus benefits. There is also no need to worry about staff training or providing cover for staff sicknesses and vacations. With outsourced billing, you know that this part of the business will continue as normal, even if a member of staff quits.

Outsourced billing staff are usually trained to the highest standards and will be kept abreast of all changes to coding and billing rules. It is the billing company’s responsibility to ensure that patient confidentiality is adhered to and that errors on billing are kept to a minimum. After all, their business depends on their efficiency and accuracy.


Perhaps the biggest disadvantage of outsourcing medical billing is the lack of control that you will have over the process. With someone else taking care of billing and liaising with payers, it can make some business owners feel as though they are in the dark. It is much easier to get answers to queries when billing staff are working in-house.

Although some billing companies will charge a fixed fee for their service, others charge a percentage of the amount they collect. This means that the more money they collect for you, the more they will take in a payment. Some companies do not like the variable payments and would prefer to pay a set salary plus benefits.


As you can see, there are pros and cons to both in-house and outsourced medical billing. It really is a matter of preference for whoever is running the medical facility. For larger facilities, in-house staff may be a better option, but for smaller facilities with only a few staff outsourcing is often the better option.