Last Tuesday, I received a frustrated call from Dr. Martinez. “I’ve had my medical biller for eight years. She understands my practice, is familiar with my patients, and consistently shows up. Why would I ever take her place?
I asked “Have you calculated what she actually costs you?” Quiet. “No, just salary,” I went on. “The real cost. Everything.”
Together, we ran the numbers for an hour. Dr. Martinez was amazed as he gazed at the spreadsheet after we were done. He was paying $44,800 a month for his “affordable” in-house biller, and that didn’t account for the money she was leaving behind.
His practice collected $52,000 more than his devoted biller ever did and saved $26,000 per month three months after partnering with RBS Innovators LLC. Same number of patients, same services, but a completely different financial reality.
The $45,000 Question That No One Is Asking
You most likely think, “Salary: $42,000 a year,” when you consider the cost of your medical biller. That comes to $3,500 a month. 6% of collections is far less expensive than outsourcing. However, that is not the true cost of her. Not even near. Let’s examine the actual figures for a typical primary care practice with three physicians that makes $1.5 million a year.
The Expenses You Can See (That You’re Already Underestimating)
Base Compensation
- Salary $42,000/year = $3,500/month;
- Payroll taxes (7.65%) $3,213/year = $268/month;
- Health insurance $12,000/year = $1,000/month;
- Paid time off (15 days + holidays): $3,200/year = $267/month;
- Workers’ compensation: $840/year = $70/month
Subtotal: $5,105/month
Technology & Infrastructure
- Practice management software: $600/month
- Coding software subscriptions: $150/month
- Clearinghouse fees: $250/month
- Office space (150 sq ft @ $25/sq ft annually): $313/month
- Equipment(computer, desk, phone): $125/month amortized
- IT support allocation: $200/month
Subtotal: $1,638/month
Training & Compliance
- Annual audit costs: $2,400/year = $200/month
- Continuing education: $1,200/year = $100/month
- Certifications renewal: $600/year = $50/month
- Compliance updates training: $800/year = $67/month
The monthly subtotal is $417.
Monthly Total Visible Costs: $7,160. Is it still less expensive than 6% of collections ($7,500/month for a $1.5M practice) Hold on. We have only just begun.
The Hidden Costs (That Are Destroying Your Bottom Line)
1. The Turnover Time Bomb
Most medical billers don’t stick around for long. Usually, they stay just a year or two, three if you’re lucky. That biller who’s been with you for eight years? Total outlier. Let’s say you’ve beaten the odds and only replace someone every four years. Here’s what you’re paying every time you have to hire a new biller:
- Recruitment: $3,000
- Training and onboarding (three months, not up to speed): $8,000
- Lost productivity during the handoff: $6,000
Knowledge walking out the door and the mistakes that follow: $8,000 All together, that’s $25,000 every four years. Break it down, and you’re losing about $521 a month, even when things go well. And let’s be real, things rarely go that smoothly. Plenty of practices go half a year or more with rocky billing and lots of dropped balls whenever someone leaves.
2. The Productivity Gap
MGMA says the average overhead for a full-time employee is $83,523. But that number misses something big: all the things your biller never gets to. There’s only so much one person can handle. Here’s the list on their plate:
- Charge entry
- Claim submission
- Payment posting
- Denial management
- Patient billing
- Calls to payers
- Responding to patient billing questions
- Keeping credentialing updated
That’s a lot for one person, and chances are, some things slip through the cracks. When you go with a professional billing company, you get a real team behind you.
- There’s someone who just focuses on coding, so your claims go out faster and with fewer mistakes.
- If an insurance company pushes back, you’ve got denial management pros who know how to win appeals.
- For unpaid accounts, A/R specialists don’t let anything slip through the cracks, they follow up hard.
- And when it comes to collecting from patients, you’ve got people who know how to have those tricky money talks.
Your biller handles about 25 to 30 claims a day. A professional team? They crank through 50 to 75 claims per biller, and they do it right. That boost in efficiency and accuracy saves you anywhere from $3,000 to $5,000 every month.
3. The Error Tax
Billing mistakes add up fast. Hospitals lose around $68 billion every year because of them, and smaller practices take the hit too. Even your best in-house biller slips up sometimes. Here’s what that really looks like:
Common errors and what they cost:
- Coding mistakes eat up 3–5% of your claims. That’s $3,750 to $6,250 gone every month.
- Miss a modifier? There goes another $2,000 to $4,000 in underpayments.
- If you don’t follow up on documentation, expect $4,000 to $6,000 in denied claims.
- Miss a deadline, and you lose $1,000 to $2,000 (money you’ll never get back).
Put it all together, and billing errors cost you about $10,750 to $18,250 a month. Just to keep things simple, let’s call it $12,000 a month on average.
4. The Collections Deficit
This part stings the most. Sure, in-house billing usually runs you 7–10% of your net collections, but the real problem is the money you’re missing out on.
How your in-house biller stacks up:
- They get clean claims out the door 82–87% of the time, about average.
- They work most denials, but some get written off as “hopeless.”
Chasing patients for payments? Most billers don’t love it. They’ll settle for payment plans without much pushback.Your accounts receivable ages too, expect to wait 52–60 days on average to get paid. Now, compare that to a professional billing company:
- They hit a 95–98% clean claim rate.
- When claims get denied, they appeal over 80% and win about half the time.
- Patient collections are handled by pros who don’t shy away from tough conversations.
- Payments come in faster, with A/R aging down to 30–38 days.
What’s that actually mean for your bottom line? If your practice should collect $1.5 million a year:
- In-house, you’ll probably bring in around $1.35 million (that’s a typical 90% collection rate).
- With a pro team, you’re looking at $1.47 million (98% collection rate).
- That’s a $120,000 difference every year, $10,000 extra in your pocket each month.
5. The Opportunity Cost
When your biller handles everything on her own, she just can’t keep up. She can’t track every single payer’s latest rules. She misses out on those coding workshops that could really sharpen her skills. Building real connections with payer reps? Forget it, there’s just no time. She doesn’t have the bandwidth for advanced analytics or to try out fresh billing strategies, either. Here’s what happens when you keep billing small:
- practices with fewer than five billing staff end up with a 14.7% cost to collect, while bigger teams drop that to 12.6%.
- Scale isn’t just a buzzword; it saves you real money.
- Your lone biller is basically stuck at max inefficiency.
Opportunity cost: $4,000–$6,000 every month.
Also Read: Why Medical Claim Get Rejected: Top 15 Errors and How…
6. The Complacency Premium
Now, here’s the tough part nobody likes to talk about: your “loyal” biller has gotten comfortable. She’s not doing anything shady. She’s just human. After years in the same chair with the same routine, things slip:
- She lets tough claims slide ($60 isn’t worth sitting on hold for 45 minutes)
- Writes off denials she could probably overturn (“they always deny these anyway”)
- Skips checking for new codes (“I’ll get to it when I can”)
- Avoids pushing doctors for better documentation (“I don’t want to hassle them”)
That comfort? It’s expensive. The comfort tax: $8,000–$12,000 per month.
The Real Cost: It’s Bigger Than You Think
Let’s put the real numbers together:
- Visible costs: $7,160/month Turnover: $521/month
- Productivity gap: $4,000/month
- Error tax: $12,000/month
- Collections deficit: $10,000/month
- Opportunity cost: $5,000/month
- Complacency premium: $10,000/month
TOTAL REAL COST: $48,681 every single month. That’s $584,172 a year. If your practice brings in $1.5 million, that means nearly 39% of your revenue is getting swallowed by “affordable” in-house billing. Let that sink in.
What Does Professional Billing Really Cost, and Deliver?
RBS Innovators LLC charges 6% of what you collect for full-service medical billing. So, let’s say your practice brings in $1.5 million a year. At 6%, that’s $90,000 a year, or $7,500 a month. But here’s the thing, we don’t just cut your costs. We actually help you bring in more money.
Here’s how we typically perform:
- Our clean claim rate sits at 96-98%.
- We collect 98% of what you should be reimbursed.
- Your average days in A/R drops to 32-36 days.
- Our denial rate is just 3-5%, way lower than the industry average of 10-15%
So, for that $1.5 million practice, we’ll collect $1.47 million (at a 98% rate). Most in-house teams only manage about 90%, so you’d get just $1.35 million. Now, look at the numbers:
You pay RBS Innovators LLC $7,500 a month. That’s way less than the $48,681 a month you’d spend on a “loyal” in-house biller. Plus, you pull in an extra $10,000 a month just from better collections. Add it up, your total monthly benefit is $51,181. Over a year, that’s $614,172.
Seriously, that’s not a mistake. Switching from your in-house biller to RBS Innovators LLC means you keep over $600,000 more every year.
“But My Medical Biller Is Different”
I hear this all the time. People tell me, “My biller is amazing. She’s certified, she’s got years of experience. These numbers don’t apply to us.” Okay, let’s give your biller every possible advantage:
Best-case in-house setup:
- You’re paying $7,160 a month (no way around that)
- She never quits, so there’s zero turnover
- She barely makes mistakes, but you’re still losing $6,000 a month to tiny errors
- Collections are great, but you’re still missing $5,000 a month
She stays sharp, no complacency. Add it up: $18,160 a month, even in this dream scenario. Now, check this out: RBS Innovators LLC charges $7,500 a month. Plus, they bring in an extra $10,000 each month. That’s a net benefit of $20,660 a month. So even with the absolute best biller you could imagine, you’re still missing out on $247,920 a year.
The Evidence Is Everywhere
The numbers don’t lie. Outsourcing medical billing can cut your costs by up to 40% compared to doing it in-house. Most healthcare providers save 30-40% on operations by handing off their billing. About 90% of the time, outsourced billing actually delivers better results than in-house teams.
Here’s the kicker, In-house billing usually eats up 7-10% of your monthly collections. Outsourced pros? They charge just 2-5%, and you don’t have to worry about fixed overhead. You can try to argue, but the math never really changes.
Why RBS Innovators LLC Does What In-House Teams Just Can’t
1. Real Specialists on Your Side
We’re not asking one person to juggle everything. Here’s what you actually get with us:
- Certified coders who know your field inside and out
- Denial management pros who spend their days fixing and appealing claims — that’s their whole job
- A/R experts who understand every payer’s odd rules and loopholes
- Patient collections teams trained to have those tough financial conversations
2. Better Tech, Fewer Mistakes
Most practices can’t afford the latest medical billing software. We can, and we use it every day:
- AI tools that help our coders work faster and smarter
- Automated claim scrubbing that catches mistakes before they cause problems
- Real-time eligibility checks so you’re not guessing
- Analytics that spot denials before they happen
- Dashboards that actually make sense of your billing data
3. Big Scale, Real Support
We handle claims for dozens of practices. That means:
- We’ve built strong relationships with payers
- Our professionals know exactly what each payer wants (and what annoys them)
- Our efficient team has the muscle to push for faster payments
- You pay less per claim, thanks to our scale
4. No More Staffing Drama
- If your biller calls in sick, your claims still go out on time
- If she quits, you barely notice, we make the switch smooth
- If she’s on vacation, we’ve got backup
- If your workload jumps, we just handle it
5. Results Matter, Or You Don’t Pay
Your in-house biller keeps her job no matter what. We have to deliver:
- Clean claims (we guarantee at least 95%)
- Days in A/R? We keep it between 30 and 35
We aim to collect at least 98% of what you’re owed
- Denials stay under 5%
- If we fall short, you don’t pay, or we keep working for free until we hit those numbers.
Why Do You Still Have That “Loyal” Medical Biller?
It’s not about the math. You probably haven’t even crunched the numbers until now. It’s about:
- Comfort: she’s familiar and change feels risky
- Guilt: she’s been with you for years, and letting her go feels wrong
- Control: you like being able to walk down the hall and talk face-to-face
- Trust: she knows your practice
I get it. That’s all completely normal. But you have to ask yourself: are those feelings really worth $600,000 every year?
Also Read: ICD-11 is Coming: What Medical Billers Should Know Before It’s..
What Happens Next: Two Choices Ahead
Path 1: Stick with Your Trusted Biller
- Keep paying $48,681 every month (year in, year out).
- Settle for 90% collection rates because, well, that’s just how it’s always been.
- Watch other practices with professional billing teams start to outpace you.
- Cross your fingers that your biller doesn’t leave, taking years of know-how with her.
- Miss out on $614,000 in extra revenue every single year.
Path 2: Work with RBS Innovators LLC
Pay just $7,500 a month for full-service revenue cycle management.
- Hit 98% collection rates, thanks to our team and top-tier tech.
- Move your biller into patient care or scheduling, she stays, your patients win.
- Rest easy knowing billing experts have your back.
- Add $614,000 to your bottom line, every year.
Ready to See What You’re Really Spending?
No two practices are the same. Maybe your numbers are higher, maybe lower, but almost nobody guesses their real costs correctly. Get a Free Financial Impact Analysis from RBS Innovators LLC.
We’ll dig into your details:
- Uncover every hidden cost in your current billing setup
- Spot gaps in your collections
- Show exactly how much you keep with RBS Innovators LLC
- Project your annual financial improvement
- Lay out a plan for a smooth transition
Here’s what we’ll need:
- 30 minutes to talk
- Your last 6 months of collection data
- A rundown of your current staffing and tech expenses
Here’s what you get:
- A clear, detailed breakdown of all your costs (no surprises)
- Performance gap report
- Head-to-head financial comparison
- Honest, pressure-free recommendations
Reach Out to RBS Innovators LLC. Call us to set up your free analysis or Email our team. You can also request your assessment online.
Loyalty matters, but losing $600,000 a year? That’s a hard habit to keep.