Your biller is at capacity and something has to change. Here is how to work out which direction is right, with your own numbers rather than a rule of thumb.
For a small practice outgrowing one biller, the deciding factors are claim count rather than collections, whether the current biller is strong, and what happens during absence. A second hire doubles your fixed cost and your single-point-of-failure risk stays if either person leaves.
One biller covered it when there was one provider. With two, claims are going out late, denials are piling up, or your biller is working extra hours and telling you it is fine. All three are the same signal.
The instinct is to hire a second biller. Before doing that, it is worth being precise about what capacity problem you actually have, because the answer changes the decision.
More claims than one person can process. A second person genuinely adds capacity, and the arithmetic is straightforward — run it in the calculator with two FTEs and compare.
Claims are going out fine but denials are not being worked and nobody is checking underpayments. A second generalist does not fix this. You need specialised attention on the back end, which argues for outsourcing that part rather than adding a head.
Most practices in this position have the second problem and diagnose it as the first. The audit framework separates them in about an hour.
A second biller at $52,000 with 22% payroll burden is about $63,400 a year before software or management time. Against collections of $100,000 a month, outsourcing at 6% is $72,000.
So on cost alone they are close, and which wins depends entirely on your claim count. Below roughly $100,000 a month in collections the second hire usually looks expensive; well above it, outsourcing starts to. Put your real figures in the calculator rather than trusting that generalisation — it moves a long way with payroll burden and claim mix.
These are example figures to illustrate the shape of the decision, not a quote.
With one biller you have a single point of failure. With two, you have two single points of failure for different halves of the work, which is not the improvement it sounds like — and when either leaves you are back to the emergency, with more claims.
Outsourcing moves that risk off your payroll. Whether it is worth the cost difference depends on how much a month of disrupted billing would hurt you, which only you can judge.
Run the calculator, then send us an A/R aging report. We will tell you which problem you actually have — volume or complexity — and what we would do about it.
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