250+
Providers supported
30+
Specialties served
75+
EMR / PM platforms
15
Functions available
What in-house billing actually costs, line by line.
Most comparisons put a biller's salary against an outsourcing fee and declare a winner. That's not the real ledger. These are the lines that usually get left out — including the ones that favour keeping it in-house.
The loaded cost of in-house billing means salary, taxes, benefits, supervision, recruitment, coverage and systems — not salary alone. That full cost doesn't appear on any salary comparison, and it is the reason most practices eventually move.
DEV NOTE: This table is deliberately qualitative. If you add dollar figures, source them and date them — unsourced cost claims are the fastest way to lose a CFO reader.
When you should keep it in-house
We'd rather say this here than three months into a contract that was never going to work.
Four situations where outsourcing is the wrong call
Your billing already works. If your days in AR, denial rate and net collection are where you want them, outsourcing buys you nothing but a new dependency. Fix something that's actually broken instead.
You have a strong biller who knows your payers. Institutional knowledge of local payer behaviour is genuinely hard to replace. If you have it, protect it — consider supplementing that person rather than replacing them.
Your problem is clinical documentation. No billing company can code what wasn't documented. If providers aren't capturing the detail, outsourcing moves the frustration without moving the revenue.
You aren't willing to change the front end. Most recoverable revenue is lost before the claim is created. If registration and eligibility processes are off-limits, the back end can only do so much.
What transfers, and what stays with you
Outsourcing billing shouldn't mean losing sight of your own revenue. This is where the line sits by default.
What an outsourced engagement covers
Take the full function or start with the stage that's costing you most.
Eligibility & authorisation
Coverage and benefit checks before the visit, with authorisation tracked to approval.
Medical coding
Certified, specialty-assigned coders with documented QA sampling and provider query loops.
Charge entry & submission
Encounters reconciled to charges, scrubbed against payer edits, filed within deadline.
Denial & rejection management
Root cause logged, appeals filed in payer windows, causes fed back upstream.
AR follow-up
Aged buckets worked by recoverability rather than age alone, with notes in your system.
Payment posting
ERA and manual EOB posting reconciled against your deposits.
Patient balances
A defined, non-adversarial sequence for patient responsibility — optional if you'd rather keep it.
Credentialing
Applications, revalidations and payer roster maintenance for your providers.
Reporting
Agreed metrics on a fixed cadence, measured against a baseline recorded before we started.
DEV NOTE: link each card to its detailed service page once slugs are confirmed.
Moving billing out without a cash-flow gap
The switch is the risk, not the destination. Functions move in sequence and your existing AR is worked in parallel.
Comparison and baseline
We record your current days in AR, denial rate and net collection so any later claim of improvement can be checked rather than asserted.
Agreement and access
BAA executed, user access agreed at the same time as the commercials, and user accounts provisioned under your control.
Knowledge capture
Your payer quirks, write-off rules and workflow are documented while your current team is still in place — this is the stage practices most often rush.
Parallel run
We work live volume with output reviewed against your standard before anything depends on us.
Staged cutover
Functions transfer in sequence, with your legacy AR worked alongside so the backlog doesn't age while attention moves.
Steady state
Named account owner, agreed SLAs, and reporting against the week-one baseline.
Publish only if real: Verify these durations against your last three transitions, or remove the timing labels.
The three worries that stop practices — addressed plainly
- "We'll lose control." You keep system ownership and full access. We work under credentials you create and can revoke without asking us. Nothing moves to a platform you can't see into.
- "They won't know our payers." True at the start, which is why the parallel-run stage exists. Your payer quirks get documented during transition rather than learned at your expense afterwards.
- "We'll be locked in." Notice period, handover scope, documentation return and data deletion are written into the agreement at signing. If leaving is hard, that's a contract you shouldn't sign — ours or anyone's.
Publish only if real: Name any formal certification you hold, such as SOC 2 or ISO 27001, with its date and scope. Remove any badge you cannot evidence on request.
Who outsources to us
Different reasons, same underlying constraint — the billing function outgrew the people available to run it.
Practices losing a billing manager
Retirement or resignation removes the only person who understood the payers. The most common trigger for a first outsourcing conversation.
Growing groups
Adding providers faster than the billing team can absorb, with each new location doing intake its own way.
New practices
No legacy process to unwind, and no reason to build a billing department before there's volume to justify one.
Organisations changing vendor
Currently outsourced but underserved — usually aged AR that nobody is working and reporting nobody can interpret.
See both columns before you decide
Tell us your current setup and volume. We'll build the fully loaded in-house cost against what an outsourced engagement would actually cost you — and if in-house wins, the comparison will say so.
- A BAA is executed before any data is shared.
- Fully loaded comparison, not salary versus fee.
- Written findings you keep either way.
- We'll tell you if you shouldn't outsource.
Straight answers.
How is outsourced medical billing priced?
Commonly as a percentage of collections, a per-claim rate, or a fixed monthly fee, depending on volume and scope. We quote after seeing your situation rather than publishing a rate that wouldn't apply. What we commit to up front is that the basis is fixed in writing before signing, with no variable fees appearing later.
Is outsourcing actually cheaper than in-house?
Often, but not always, and anyone who answers this without seeing your numbers is selling. It depends on volume, current staffing, and how much of your AR is currently going unworked. Small practices with one efficient biller sometimes come out ahead in-house.
Will we lose control of our revenue?
You keep system ownership and full access to every claim. We work under credentials you create and can revoke instantly. If a vendor requires you to move into their platform to work with them, that's worth questioning.
What happens to our current billing staff?
That's your decision and worth planning before you start. Some practices redeploy billers into front-end and patient-facing roles where their payer knowledge still pays off; others reduce headcount by attrition. We'd rather you handle it deliberately than discover it mid-transition.
Do we have to change our software?
No. We work inside your existing PM and EHR, which means no migration, no retraining, and no data sitting somewhere you can't reach.
What about our existing aged AR?
It's scoped explicitly and worked in parallel during transition. Old AR is where most switching losses actually happen — a vendor focused only on new claims lets the backlog age past recovery.
How long until we see results?
Front-end and coding changes show within one or two claim cycles. AR recovery and denial-rate movement take longer because they depend on payer response times. A specific percentage promised before anyone has seen your data is a guess.
What if it doesn't work out?
Notice period, handover scope, documentation return and data deletion are agreed at signing rather than negotiated when you want to leave. You should hold every vendor you speak to — including us — to that before signing anything.