Put your own numbers in, and see the arithmetic.
Two questions worth answering before you talk to anybody: how much revenue is stuck in denials and aged claims, and whether billing in house is actually cheaper. Nothing you type is sent anywhere.
Doctor, put your own numbers in
Two questions worth answering before you talk to anybody: how much revenue is stuck in denials and aged claims, and whether billing in house is actually cheaper. Move the sliders. Nothing is sent anywhere.
Collections divided by billed charges. If you do not know it, 80 to 85% is typical for a practice without dedicated A/R follow up.
A clean operation runs under 5%. We treat everything above 5% as addressable, and assume 65% of that is actually winnable.
Benchmark is 35 days. Each day above that is counted at 0.12 points of collection rate, capped at 3 points.
$10,872 per month, from a collection rate moving +7.6 points.
An estimate, not a quotation or a promise. It assumes denials above a 5% benchmark are 65% winnable and caps the improved rate at 97%, because no practice collects 100% of billed charges. Your real figure depends on payer mix, documentation quality and how old the A/R is. The free audit produces the real number.
A 28% load is added on top for payroll tax, insurance, paid leave and turnover.
Billing only starts at 3.49%. Full revenue cycle, including coding and denials, starts at 4.49%.
$70,875 across a year, on collections of $122,400 per month.
This compares direct cost only. It does not price the recruitment, training, cover during leave, or the revenue lost while a billing seat sits vacant, all of which fall on the in house side. It also does not assume any collection rate improvement, which is calculated on the other tab.
Every assumption behind that number
A calculator you cannot inspect is a guess with a currency symbol. These are the four that move the result most.
A clean operation runs under a 5% denial rate. Everything above that is counted as in play, and only 65% of it as actually winnable, because some denials are correct.
Each day your average days in A/R sits above a 35 day benchmark is counted as 0.12 points of collection rate, capped at 3 points. Beyond that the relationship stops being linear.
No practice collects 100% of billed charges. A model that implies otherwise is selling something.
On the in house comparison, salary is not the cost of a biller. Payroll tax, insurance, paid leave and turnover are added on top.
The in house comparison prices direct cost only. It does not price recruitment, training, cover during leave, or revenue lost while a billing seat sits empty, all of which fall on the in house side and would make the comparison look better for us. It also assumes no collection rate improvement at all, which is calculated separately on the other tab.
This is an estimate, not a quotation. Your real figure depends on payer mix, documentation quality and how old the A/R is. The free audit produces the number this page can only approximate.
Get the real number instead of the estimate
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.