By Brandon Seigel, Chief Problem Solver · August 11, 2026 · 7 min read
The real cost of in-house billing
In-house billing looks cheaper because you only see salaries. But the full cost includes benefits, turnover, training, software, coverage for vacations and sick days, and the cost of mistakes nobody catches.
The biggest risk is the single point of failure. When your one biller leaves, your cash flow leaves with them.
Where outsourcing goes wrong
Many practices have been burned by billing companies. The common complaints are the same: no visibility, rotating contractors, offshore teams who don't know your payers, and data pulled out of your EMR into systems you can't see.
Outsourcing only works when the partner works inside your system, with a stable team, every business day.
Questions to ask any billing partner
- Are your team members employees or contractors? Where are they located?
- Do you work inside my EMR, or pull data out?
- How often is my account worked?
- Who reviews coding quality, and how?
- Do you call my patients? How do you communicate with them?
- What does it take to leave if it isn't working?
How we answer those questions
Our team is US-Based W2 employees, averaging over 8.5 years of retention. We work inside your EMR every business day. A Chief Billing Officer leads quality review, and AAPC-certified coders are available for audits. We never call your patients — we communicate by email or text so there's a written trail. And our contracts are built to earn your business, not imprison it.
Quick answers
Is it cheaper to outsource therapy billing?
Often, once you count benefits, turnover, software, coverage, and missed revenue. The right answer depends on your practice size and how well your current process is performing.
See exactly what's included in our medical billing services for therapy practices, how our percentage-of-collections pricing works, or browse common questions from practice owners.
Want this handled inside your EMR, every business day?
Our US-Based W2 employees work your claims daily. Tell us about your practice.
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