The Affordable Care Act requires physicians, or other eligible non-physician practitioners (NPPs), to enroll in the Medicare Program to order/refer items or services for Medicare beneficiaries. This includes those physicians and other eligible NPPs who do not and will not send claims to a Medicare Administrative Contractor (MAC) for their services. The Centers for Medicare & Medicaid Services (CMS) permits such physicians and other eligible NPPs to enroll for the sole purpose of ordering/referring items or services for Medicare beneficiaries.


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Should Your Practice Outsource Medical Billing?

By Chris Thorman

One of the many business questions physicians face is whether to outsource their medical billing to third-party medical billing services or do it in-house with medical billing software. Some physicians would assume outsourcing billing to a medical billing service makes the most sense. After all, they’re the experts with the resources to properly process your claims, right? Others might want to maintain control of collections and do it all in-house.

Hold on. Don’t make a decision before thinking it through. Both methods of revenue cycle management have benefits and drawbacks. It’s up to the individual practice to weigh the pros and cons before deciding which approach is best.

Following is an analysis of in-house billing and outsourced billing in terms of cost and qualitative factors. You’ll need to weigh the differences carefully when assessing the needs of your practice and decide if outsourcing makes sense.  read more.........