Many of our clients struggled with when was the right time to take billing in-house. The decision to bring billing in-house is multifaceted and can be pivotal for your treatment center’s financial health. The allure of cutting costs is strong, but the transition is not without its complexities.

Here’s what to consider if you’re thinking about taking billing in-house:

Satisfaction with Current Service

• Assess Current Billing Service: Are you happy with the services provided by your current biller? Not just the cost—consider service quality, understanding your financials, and have a partner who works with you to optimize collections.
  
• Understand Collection Issues: If collections are trending down, try to pinpoint the cause. Could in-house billing address it effectively?
  
• Evaluate Outsourcing Alternatives: Sometimes, a change in billing partners may be more beneficial than moving operations in-house. Consider whether issues could be best resolved by finding a more compatible service partner.

Cost-Benefit Analysis

• Calculating Savings: By not outsourcing to a third-party, you could save between 4-10% on costs, depending on your current payment structure. However, these savings should be weighed against the expense of setting up staff and a billing system.
  
• More Revenue Control: In-house billing can give you immediate access and insight into your financial data—setting the stage for better data-backed decision making.

Operational Readiness

• Software Acquisition: Do you own the necessary billing software, like Kipu RCM, or have access to it? Ensure you have a clear understanding of the costs associated with software onboarding and maintenance.
  
• Data Ownership: When owning your own billing software, you’ll have complete ownership of all data as well as unparalleled insight for complete transparency into your financials.
  
• Staffing: Do you have the necessary knowledge and expertise in billing processes and regulations? Assess if you have or can acquire staff with the required knowledge and skill set. Consider the volume of billing your treatment center handles and whether it’s sustainable with an in-house team.
  
• Specialized Functions: Decide if it’s more efficient to outsource complex functions like authorization and U/R, or if your in-house team can manage. Many times, behavioral health specific billing software, like Kipu RCM, can simplify these tasks and make it easy for in-house teams to manage. Being strong in these specialized functions can prove to help with patient outcomes by enabling patients to get ample treatment opportunities.
  
• In-network vs. Out-of-network Billing: Out-of-network processes can introduce an extra layer of complexity. Consider if your team is equipped with the knowledge and software to satisfy it.

Taking the Next Step

Taking billing in-house is a significant strategic move that can have profound implications to the financial health of your treatment center as well as with patient outcomes. You must perform a critical and thorough assessment of your current capabilities and ensure a strong understanding of the potential benefits or drawbacks to create a plan of execution. Be sure to assess the relationship with your existing biller and consider bringing them in to help with the transition. Of utmost important: have a backup plan in case you don’t succeed in bringing billing in-house! With careful consideration and planning, in-house billing can be a step towards greater freedom, autonomy, and financial efficiency that can set the stage to better serve patients in the future.



About the Authors

Dean Fitch serves as the Principal at Kipu Health and is the Co-Founder of Avea by Kipu.