Feeling worn out by recurring claim denials? You are not alone! It is quite normal to feel overburdened and stressed due to mounting administrative tasks. But don’t let this stress get in the way of your work! Unfortunately, financial, administrative, and systematic issues, like increasing costs and staffing shortages, have made healthcare delivery increasingly difficult for doctors.
Billing complications, like changing regulations, varying insurance requirements, and coding updates, add to their difficulty. That’s why more and more physicians are turning to professionals to simplify their workload. However, U.S. doctors looking for medical billers often get confused between two options: in-house billing or outsourcing.
Are you also stuck in this dilemma? Let’s solve your confusion! Read this guide to learn the essential tips for choosing the right billing partner.
Why Do Doctors Need Professional Medical Billers?
Ask yourself these three questions:
- Are your administrative tasks cutting into your time for patient care?
- Do you have the expertise needed to handle changing billing requirements?
- And can you afford the financial strain caused by payment delays and recurring denials?
Your answers will help you make the right decision. Nowadays, physicians are expected to be a jack of all trades. But the reality is that they constantly struggle to juggle multiple responsibilities, including keeping up with the latest medical advancements, providing quality patient care, and managing billing complexities. This leads to feelings of dissatisfaction and disconnection from their profession, which eventually results in physician burnout.
Professional billers can help you avoid this stress. By taking responsibility for the most burdensome and time-consuming operations, they allow you to focus on your core task—providing high-quality patient care. Moreover, experienced medical billers file your claims on time, expertly handle your unique issues, and ensure accurate and timely payments.
The benefits of letting medical billers handle your financial operations are endless. But the most important question is: how do you choose the right person for the job?
Essential Tips for Doctors Looking for Medical Billers
Did you finally decide to get some help? Here are some essential tips for doctors looking for medical billers:
Consider Past Experience
Experience is a key factor, but it doesn’t mean you should automatically choose a medical biller with the most years in the industry. Here, by experience, we mean selecting someone with a proven track record, such as a high first-pass claim rate and low denial rates, in your specific medical field.
This includes evaluating their previous cases, billing skills, knowledge, and the types of healthcare providers they have worked with. So, for example, if you are a cardiologist, you should always choose someone with extensive experience in cardiology billing to avoid coding or other mistakes.
Choose a Responsive Biller
For outsourcing, opt for a company with responsive customer service. Pay close attention to their communication skills and ability to address your queries promptly. Remember that a responsive billing team will always prioritize your needs and produce good financial outcomes. It will also keep you involved throughout the billing process.
Evaluate Market Reputation
Reputation is another important factor. A strong market image highlights a medical biller’s reliability and ability to efficiently handle your claim submission process. Therefore, do your research and hire medical billers with a strong background. You can do that by reading reviews or asking for references from their previous clients, including both doctors and practices.
Verify Their Ability to Keep Up with Coding Updates
Coding is perhaps the most important part of medical billing. It is crucial for documenting and billing services/procedures/supplies to insurance companies. Therefore, always choose a medical biller with a high coding expertise.
This includes familiarity with all three coding systems: ICD-10-CM, CPT, and HCPCS, as well as the ability to keep up with their frequent changes—biannual updates for ICD-10, annual updates for CPT, and quarterly updates for HCPCS.
Make Sure They Are Up to Date with Regulations
The healthcare landscape is evolving constantly due to medical advancements, new technologies, and ever-changing government regulations. As a result, payers also frequently update their insurance policies.
A competent medical biller should always be up to date with these changes and comply with the latest coding and insurance guidelines, as well as regulatory requirements like HIPAA.
Prioritize Strong Communication Skills
Communication is an important skill, especially for medical billers. They should possess strong communication skills, including both written and verbal, to effectively resolve billing disputes, clarify patient information, and interact with insurance companies. Therefore, select someone who can maintain good professional relationships and provide frequent updates.
Focus on Scalability & Flexibility
Nothing remains constant! Your billing needs can also change with time, depending on your growth and the types of services you offer. Therefore, pick a flexible billing partner who can easily adapt to your evolving requirements and effectively work with various insurance companies.
Determine the Cost
Cost is often the first thing that comes into anyone’s mind. While it is quite obvious that hiring a professional medical biller can be a good investment, you should still consider your budget. Our advice? Find a professional with reasonable fees or a billing service that balances quality with affordability.
Available Options for U.S. Doctors Looking for Medical Billers
Billing is a core aspect of any healthcare organization, but it is not a one-man job. It includes both financial and administrative components of a practice, requiring significant resources and sufficient expertise. From patient registration and coding to documentation and denial management, you cannot do everything alone.
Fortunately, doctors in the U.S. have two options for medical billing: hiring in-house medical billers or outsourcing to medical billing companies. Let’s take a closer look at both so you can choose wisely.
Hiring In-House Medical Billers
In-house medical billing refers to managing all billing operations within your practice. This includes hiring and training professional medical billers or building an in-house billing team or department.
While this option gives you more control over your financial operations, it is 8.3% more expensive than outsourcing. According to MGMA’s 2021 survey, the cost of in-house billing is 13.7% for every dollar collected. Compared to that, the average cost of outsourcing is 5.4%.
Let’s look at the pros and cons of this option:
| Pros of Hiring an In-House Medical Biller | Cons of Hiring an In-House Medical Biller |
|---|---|
| Close proximity | More expensive than outsourcing |
| Better privacy | Lower chances of first-pass approvals |
| Data security | Limited resources |
Outsourcing to Medical Billing Companies
Outsourcing is another option for U.S. doctors looking for medical billers. In fact, it is the more cost-effective and popular option, as reflected by the sheer size of the global medical outsourcing market (around USD 19.32 billion in 2025).
Outsourcing medical billing means working with a third-party billing company to collect your payments. Instead of utilizing your own resources, you hand over the entire billing process to a billing specialist. In simple terms, these medical billing companies act as a bridge between doctors and insurers. Let’s look at the pros and cons of this option.
| Pros of Outsourcing | Cons of Outsourcing |
|---|---|
| More affordable than in-house billing | Less control |
| Access to billing experts | Hidden charges |
| Reduced administrative burden | Miscommunication |
| Improved clean claim and first-pass rates | – |
| Guaranteed regulatory compliance | – |
MediBillMD: The Trusted Partner for U.S. Doctors
Tired of increasing financial uncertainty? You are not the only one! Did you know that around 36% of medical practice leaders surveyed in MGMA’s Stat poll are considering outsourcing their RCM operations in 2025? If you also believe outsourcing to be the best solution for your practice, consider MediBillMD.
We are an excellent option for doctors looking for affordable medical billers. Our comprehensive suite of billing solutions includes coding, payment posting, AR recovery, and denial management—everything that consumes so much of your time. Our team also offers medical credentialing to reduce reimbursement disruptions and payment delays. Stop worrying about mounting paperwork, and let us handle everything!
