The "in-house vs outsourced" debate gets a lot of opinions and not enough math. Here's the math.
In-House: True Cost
- Biller/coder salaries + benefits + payroll taxes
- Software (PM, claim scrubber, denial management tools)
- Training, turnover, and onboarding
- Management overhead
- Lost revenue during staff vacancies
For a 3-provider practice, true in-house cost is typically 6 to 9% of net collections.
Outsourced: True Cost
- Billing fee (typically 4 to 8% of net collections, depending on volume)
- No software licensing
- No training/turnover risk
- Lower management overhead
When Outsourced Wins
If your practice has under 5 providers, high turnover, or limited management bandwidth, outsourced typically wins on both cost and collections.
When In-House Wins
Very large practices with dedicated RCM management and sophisticated payer contracting may find in-house competitive, though hybrid models often outperform both.
Get a free apples-to-apples comparison for your specific practice.