Our Medical Billing Services

What Outsourcing Your Billing Actually Changes

The pitch for outsourced billing is usually framed as saving money on salaries. That is the least interesting part of it. What actually changes is who is watching the claim after it leaves your office.

In most small practices, claims go out and the next contact with them is a remittance weeks later. Denials get worked when someone has time. Underpayments — where the payer paid, just less than the contract says — are almost never caught at all, because nothing on the remittance flags them. A claim paid at 80 percent of the contracted rate looks identical to a claim paid correctly unless somebody is checking against the fee schedule.

A billing team's real job is the follow-up: working the denial queue daily rather than weekly, appealing inside the payer's window rather than after it closes, and reconciling payments against what the contract actually entitles you to. That is where recovered revenue comes from, and it is the part hardest to sustain with one person who is also answering the phone.

Who We Work With

Solo providers, small and mid-size groups, and multi-specialty practices across the United States — both practices that have never outsourced before and practices leaving a billing company that stopped following up.

Specialty matters more than size, because each one fails in its own way. Anesthesia claims turn on time units and the correct conversion factor. Therapy turns on the 8-minute rule and the annual KX threshold. Surgical practices turn on global periods and modifier accuracy, and Medicare-heavy practices on documentation that survives review. A biller who does not know your specialty's failure modes will submit clean-looking claims that deny for reasons nobody ever diagnoses.

How Pricing Works

Outsourced billing is normally priced as a percentage of what you actually collect — not a flat fee, and not a charge per claim. That structure matters: if we are paid on collections, an unworked denial costs us too. A flat-fee biller has no financial reason to chase a 60 dollar claim. A percentage-based one does.

The rate depends on specialty, claim volume and average claim value, which is why nobody honest quotes a number before seeing your data. What should always sit inside the percentage — and does with us — is denial management and appeals. If working denials is billed as an extra, the incentive is backwards. Ask any billing company you are evaluating whether appeals are included or charged separately; the answer tells you most of what you need to know.

What Switching Involves

Two to four weeks for most practices, and the sequence matters more than the speed.

Week one is access and verification — system access, a credentialing check, and confirmation that payer enrolments and EFT/ERA setups are genuinely current. Practices are often surprised here: lapsed enrolments and stale payer records cause denials that look like coding problems for months.

Week two onward runs in parallel. We submit alongside your existing process rather than switching everything overnight, so nothing falls through the gap between two systems. Meanwhile your existing accounts receivable is worked, not written off — claims already submitted still have appeal rights and open filing windows, and that backlog is usually the fastest money available in the first month. If you are still weighing the decision, see in-house versus outsourced billing and what medical billing actually costs.

Frequently Asked Questions