10 Responses to “Murky waters of out-sourced medical billing”


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  1. Top Doc

    Applause to this article! I think this is the best article! I will tell you why. After I read your post, this is the word come out of my mouth. "EXACTLY" yes, that is what exactly they did to me. I had similar problem and I had to pay them for three months fee extra to get out of the their contract. We as a physician need to unite to tell each other’s problem. I appreciate you "SSG" for this website.

  2. Tanya

    I have to say I agree that there are several companies out there that do that,however in a medical billers defense I have to say that not all are like that. I am a Certified Professional Coder and have been in the medical billing industry for over 11 years. I worked for a medical billing company that did just that the skimming. When I first started with them there was only 5 of us and then when I left there was over 65 of us. This is the reason I left is because I was not able to do my job that way it needed to be done. I got the courage to start my own medical billing company. When I started developing my business plan that was one of my biggest pet peves was how can I assure a Physician that his/her accounts were going to be given top priority and I decided that I will not just hire any joe, they must be Certified Coders and that person will never have over two physicians that they are in charge of. I included this in my contract that each physician signs. I go by the core principles that I was raised with and that is to Treat others the way you want to be treated.

  3. Dr.SSG

    If you are doing that, please keep it up as we physicians do need such a service. I have heard of a large practice go bankrupt because of poor handling by an outsourced medical billing company.

  4. Camille J

    How do you deal with a physician that owe you money and terminated the contract. Because she wanted a log of when the claims was mailed, the time I think it will get to the insurance and the date we are getting payment.

  5. Drug rehabilitation

    Medical billing companies are setup to make it easier for them to wade through the murky waters or regulation and insurance company code to ensure proper and timely reimbursement.

  6. cm

    I think we have the same prob with an inhouse billing, since the biller was inexperienced and the person who hired the biller had total faith and didn’t watch the eob’s. When we were able to get into the billing it looked like things were not necessarily downcoded but the modifiers weren’t added, so we went from 60,000 mmothly to 15,000 monthly and I as a provider was blamed for slacking!! I saw as many pts as the other provider. So for us it was the opposite. Our outsourced wanted 10% and in the long run I think we had a good deal.

  7. admin

    Medical Billing in the office has to be watched very carefully. EOBs should not only be reviewed by the medical billing staff but also by managers and even physicians from time to time. It may be confusing to read them at first but eventually you will get the hang of it and will allow you to quickly detect patterns and errors. Once discovered process changes need to be made to reduce these errors.
    Whether outsourcing or doing in house medical billing, reviewing EOBs is a must.

  8. Pk

    Amen to ur article – it is very sad how physicians are taken advantage of and I learned a new word skimming

    Boy was I skimmed. There should be a medical Biller Prison. For healthcare to be such a highly regulated industry and billers not to be regulated is frustrating. Having a bad medical billing experience makes you long for a VA or hospital job…but I will keep fighting the fight of private practice

    Bottom line watch those eobs like a hawk and add one more thing to your exhausting to do list – Check your Biller!

  9. Doc B

    My Google search was, “When medical billers go bad” and your article came up. Thanks. Your explanation is exactly what IS happening to me. The relationship with my out sourced, contracted biller has fallen to the point where she won’t return calls or emails… Also not providing me with patient statements which I doubt ever go out and maybe never did. Meanwhile I have daily claims that I can’t send in. What started out “okay” is now frightening and bad. I am absolutely scrambling now to find an inhouse system. This is hugely time consuming and not easy.

  10. admin

    I strongly recommend that you have a billing personnel in house. That is the most important part of your clinic and no matter how much work it is , outsourcing billing is never a good idea. Never lose control over your account receivables. It may be rough in the beginning but once you find good billers try your best to retain them. I have been in your shoes!

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