Salary is about two-thirds of the answer. Here is the rest of it, and how the full figure compares to a percentage of collections.
An in-house biller costs salary plus payroll burden of commonly 18 to 28%, plus billing software and clearinghouse fees, plus management time. A $52,000 salary is typically $80,000 or more all in. Compare that total against the fee, not the salary against the fee.
The visible number, and the one most comparisons stop at.
Employer taxes, workers compensation, health insurance contribution, paid leave. Commonly 18–28% on top of salary depending on what you offer and where you are.
Billing module, clearinghouse fees, any eligibility verification tool. Often a few hundred a month and easy to forget because it is already being paid.
Yours. The hours spent answering billing questions, reviewing reports, chasing a payer problem. Real whether or not you account for it — and if you are a provider, the opportunity cost is a clinical hour.
Take a biller at $52,000 with 22% payroll burden, $350 a month in software and clearinghouse, and eight hours a month of your time valued at $150.
Against $100,000 a month in collections that is an effective 6.8% of collections — which lands in the middle of what billing companies charge. The comparison is much closer than the salary figure alone suggests, in both directions.
Change the inputs and the answer moves a long way. The calculator runs it with your own numbers and will tell you when in-house is cheaper, which it often is.
Both sides have costs that resist estimation, and it is worth naming them rather than pretending the arithmetic is complete.
Excluding these makes the in-house figure conservative. The true number is usually higher than the example above.
Run the calculator with your numbers, then send us an aging report. We will tell you what we would charge and what is included, so you are comparing like with like rather than a percentage against a salary.
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