Should I Outsource Dental Billing?

Should I outsource my dental billing?

It comes down to one of three situations. Your insurance is a mess and you cannot find or afford someone competent to clean it up. It costs less to have someone else do it, which is true most of the time. Or you need the person currently doing it working on things that grow the practice instead.

Is a practice ever too small to outsource billing?

Not really, outside of a brand new practice with a handful of patients. It depends on how much time your staff spends on insurance. If someone is spending five hours a week on claims, those are five hours they could have spent getting patients in the door.

When should I hire someone instead of outsourcing?

When it is genuinely cheaper. In some parts of the country you can still hire a competent person for sixteen dollars an hour, the way you could before 2020. If you have that and they are doing a good job, no billing company can beat it and you should keep it in house. We have told practices exactly that.

In-house biller or a billing company. Which is better?

Whichever costs less for the same result. In most markets a person capable of doing this correctly costs twenty-five to thirty-five dollars an hour, plus benefits and turnover risk. At that rate you are paying business-development money for administrative work. But the answer genuinely depends on your local labor market.

Run that against what dental billing actually costs.

How much time does insurance actually take?

The better question is how much time it takes to do correctly. A carrier can deny a claim in three seconds with automated review. Fixing that denial could take a person an hour on the phone. Most practices are not doing that work, which is why the loss shows up as money rather than as hours on a schedule.

What do owners get wrong about what their insurance person does all day?

They underestimate the phone time badly. Doing this properly means chasing denials, appealing downcodes, and sitting on hold. Especially now, with AI review. It's a ton of work. And the result is a ballooning A/R and lower collections.

If that second part sounds familiar, look at how A/R recovery actually works.

What can go wrong when a practice outsources billing?

Loss of control is the main one. Adjustments get made without anyone in the office being asked. Old A/R stops being worked and quietly stacks up. Communication breaks down, so the front desk cannot answer a patient question without waiting on the vendor. Roughly half the practices we saw come back from other billing companies had worse A/R than when they started.

Why do practices leave their billing companies?

A/R that is not being worked, balances written off without approval, mistakes, and communication that has broken down. Bad communication is the most common single reason. About a quarter of the practices that come to us are switching from another company, and it is rarely one thing. It is usually several at once.

If that's you, switching is not a six-month project.

Why did quality drop at some billing companies?

Workload, not competence. We have hired people who came from other companies and they are excellent. What changed is the ratio. To hold costs down, some companies pushed individuals or small teams up to fifteen or twenty accounts. There is only so much work a person can do properly, and past that something breaks regardless of how good they are.

Ask the ratio before you hire. That's one of three questions that actually matter.

What happens to my insurance coordinator if I outsource?

Their workload drops but the role does not completely disappear. You still need a person to explain things to patients, and they still handle patient billing, over-the-counter payments, walkout statements, and checkout. Most practices repurpose that person to chase incomplete treatment, which makes money rather than recovering it.

How do I tell my team we're outsourcing billing?

Tell them you're adding a team member. Not a vendor, not a service. A specific person with a name and a face who knows your practice and works remotely.

That framing is accurate if the company you hire actually works that way, and it avoids the reaction people have when they think a function is being taken away from them. If you're hiring an operation where your team will be dealing with a ticket queue, that's a different conversation, and you may want to rethink the choice rather than the announcement.

What should my front desk be doing instead of insurance work?

Taking care of patients, keeping them, and filling the schedule. Most practices have a wide open front door and a wide open back door, spending heavily on new patients while existing ones quietly leave. Reactivation, following up on unaccepted treatment, and scheduling the family members of existing patients all return more than chasing a claim.

What's the real cost of an understaffed front desk?

Most front desks are built to handle incoming work only, the patient in front of them and the phone that is ringing. The outbound work, reactivation and treatment follow-up, tends to get dropped due to overload. That is where the growth is however.

Is it harder to hire a dental insurance coordinator now?

Not harder, more expensive. You can still find people, but good ones are going to cost you. The problem is if you hire an insurance coordinator who is not competent, you won't find out until months later, when your accounts are already a mess. That lag is expensive.