ANSWERS · PRACTICE FINANCE

In-house billing vs. outsourcing: which is right for my practice?

In-house billing gives you control and lower marginal cost at scale but depends entirely on one or two people; outsourcing trades a percentage of collections (typically 4–9%) for capacity and continuity. The real question isn't either/or — it's which parts of the revenue cycle each option actually does well, because most billing companies focus on clean-claim throughput and quietly ignore the denied and underpaid tail.

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What actually matters

  • In-house: full control and knowledge of your patients, but fragile — biller turnover or a leave can stall cash flow
  • Outsourced: capacity and continuity, but you pay a percentage and lose some visibility, and quality varies widely
  • Most billing companies optimize for first-pass claims; the aged, denied, and underpaid tail is where they under-invest because it's labor-intensive
  • A hybrid is common: keep front-end and posting in-house, and use specialists for the parts that need scale (denials, underpayments, old A/R)
  • Judge any option on net collection rate and the over-90 A/R, not on how fast clean claims go out

Common questions

How much do medical billing companies charge?

Most charge 4–9% of collections, sometimes higher for small or complex practices. Some charge per-claim. Watch what's excluded — many don't work denials or underpayments as part of the base fee.

Where Volari fits: Volari isn't a replacement biller — it works the denied and underpaid tail your team or biller can't get to, and you only pay on what it recovers.

Related answers
How do I lower my practice's denial rate?How do I reduce days in A/R?How do I know if I'm being underpaid by insurers?How do I renegotiate payer contracts for better rates?How do I fix my prior-authorization workflow?How do I hire and keep a good medical biller?

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