04/06/2026
Your in-house biller works hard. I'm not here to question that. But hard work and optimized billing aren't always the same thing.
I've done billing audits for dozens of practices over the years.
And one of the hardest conversations I have is with a practice owner who realizes their long-time biller - someone they trust, someone who shows up every day and genuinely tries - has unknowingly been leaving money on the table for months. Sometimes years.
It's not about blame. Billing is complicated, payers change their rules constantly, and one person can only do so much.
But here are 3 warning signs worth paying attention to:
1. Your denial rate is above 5% and denials aren't being worked consistently. The national average clean claim rate is around 95%. If yours is lower and denied claims are sitting in a queue for weeks, that's revenue you've already earned just waiting to expire.
2. You're not getting regular reports on AR aging. If you can't quickly answer "how much do we have outstanding over 90 days?" that's a visibility problem. Unworked old AR is often written off quietly, not recovered.
3. Your biller is doing everything alone. Billing, posting payments, handling appeals, credentialing, front desk questions. One person wearing all those hats means something is always getting deprioritized. Usually it's follow-up on denials.
Here's something worth understanding about how outside billing services work β and why it matters for you.
As a third-party billing service, we're compensated based on what we actually collect. Not a flat salary. Not a monthly retainer regardless of results. That means we have every incentive to chase down denied claims, work old AR, and make sure nothing falls through the cracks, because if you don't get paid, neither do we.
It's a true win-win. The harder we work your revenue cycle, the better the outcome for your practice and for us. That alignment is something an in-house employee β no matter how dedicated β simply can't replicate by the nature of how they're paid.
Again, this isn't about your biller being bad at their job.
It's about whether the system around them is set up to actually protect your revenue.
If any of these hit close to home, I'm happy to take a look at your numbers - no pressure, no pitch. Just a fresh set of eyes.
Feel free to DM me or drop a comment below. I respond to everyone.