Billing is one of the most essential functions of an oral surgery practice. Claims need correct coding, proper submission, tracking, and follow-through for payment. When billing falls behind, cash flow tends to follow.
Some practices successfully manage internal billing, whereas others benefit from outsourcing some or all of the revenue cycle. The right choice depends on the size of your practice, staffing, growth, and the complexity of your billing needs.
The True Cost of In-House Billing
Salaries are only a portion of the equation when comparing in-house and outsourced billing. The actual costs of maintaining an internal billing department include:
- Salaries, payroll taxes, and employee benefits
- Recruiting, onboarding, and training
- Ongoing coding and billing education
- Billing and practice management technology
- Clearinghouse and other administrative expenses
- Vacations, illness, and extended leave coverage
- Management time spent overseeing billing
Turnover can be particularly costly in internal billing departments. When an experienced biller leaves, valuable institutional knowledge often leaves with them, and claims, denials, and outstanding accounts still need handling.
Lost or delayed revenue is also a less visible cost. Coding mistakes, incomplete claims, inconsistent follow-up, and growing accounts receivable can affect collections even when the practice’s direct staffing costs appear manageable.
Before comparing the costs of in-house and outsourced billing, practices need to consider the full expense of maintaining an in-house billing function, not just salaries.
What a Dental and Medical Billing Company Actually Does
Outsourcing dental and medical billing (RCM) is not simply handing over your claims for another company to manage. A full-service revenue cycle management provider can handle processes throughout the life of a patient’s account. Services may include:
- Verifying insurance benefits
- Applying appropriate dental and medical codes
- Preparing and submitting claims
- Posting payments
- Tracking unpaid claims
- Following up on insurance denials
- Managing outstanding accounts receivable
- Monitoring billing trends and financial performance
- Providing revenue cycle reports and analytics
Experience with both dental and medical billing is particularly important for oral surgery practices. Depending on the procedure, diagnosis, and patient coverage, services often involve dental benefits, medical benefits, or a combination of both.
Outsourcing can also be flexible, to supplement existing billing staff, address staffing gaps, manage parts of the revenue cycle, or fully outsource billing.
Signs Your Oral Surgery Practice Has Outgrown In-House Billing
In-house billing that worked well in young practices is often difficult to sustain as the practice grows. It may be time to reevaluate if:
- Billing positions are difficult to fill or retain.
- Claims or payment posting regularly fall behind.
- Accounts receivable continue to grow.
- Denials increase or recurring issues persist.
- Staff lack time to follow up on unpaid claims.
- Billing requirements become difficult to manage.
- Billing problems demand too much management time.
- Practice growth outpaces billing capacity.
- Revenue cycle reporting is unreliable or inadequate.
These are not necessarily a sign that your practice should eliminate its internal billing team. They are signs that it may be worth examining whether additional resources, better processes, or outside support could improve performance.
In-House vs. Outsourced: A Side-by-Side Comparison
Neither model is inherently right for every oral surgery practice. Comparing how each approach affects staffing, costs, expertise, and oversight can help determine which best fits your organization.
| Consideration | In-House Billing | Outsourced Billing |
|---|---|---|
| Staffing | Practice recruits, trains, and manages billing personnel | Provider supplies and manages billing personnel |
| Expertise | Depends on experience and training of internal team | Can provide access to specialists in dental and medical billing |
| Control | Direct day-to-day oversight of staff and workflows | Requires clear communication and defined reporting |
| Continuity | Vacancies and absences may affect workflow | Can provide greater coverage during staffing changes |
| Scalability | Growth may require additional hiring and training | Services can generally expand as billing volume grows |
| Technology | Practice purchases and maintains necessary systems | Technology may be incorporated into the service |
| Costs | Includes payroll, benefits, training, technology, and management | Typically structured around contracted service fees |
| Reporting | Depends on internal systems and processes | May include regular RCM reporting and analytics |
Some practices may ultimately find that a hybrid approach works best. Keeping experienced internal staff while outsourcing selected functions can provide additional capacity without completely changing the practice’s existing structure. Broader practice coaching can also help identify staffing, workflow, and operational issues affecting revenue cycle performance.
How to Transition Without Disrupting Collections
Concern over disrupting cash flow can make practices hesitant to change billing models. A carefully planned transition helps keep claims and collections moving while responsibilities shift. A smooth transition starts with a clear picture of your current revenue cycle and a plan for transferring responsibilities, such as:
- Access to practice management and billing systems
- Secure transfer of necessary information
- Existing payer and insurance information
- Responsibility for outstanding A/R and older claims
- Claim submission and payment-posting procedures
- Communication between the billing provider and practice staff
- Reporting expectations and performance monitoring
Continue monitoring claims, payments, denials, and accounts receivable during and after the transition. Clear responsibilities and regular communication can help identify problems before they interfere with collections.
Frequently Asked Questions
Should I outsource my dental billing?
It depends on your practice’s staffing, billing complexity, costs, and current revenue cycle performance. Practices struggling with turnover, growing A/R, frequent denials, or limited billing capacity may benefit from outsourcing all or part of the revenue cycle. Others may prefer to retain an experienced internal team while adding outside support where needed.
How much do outsourced dental billing services cost?
Dental billing services cost varies based on the scope of services, billing volume, practice needs, and the provider’s pricing structure. When comparing costs, consider outsourced fees against the total cost of in-house billing, including compensation, benefits, recruiting, training, technology, management time, and coverage during staffing gaps.
What should I look for in a dental and medical billing company?
A company with experience in your specialty, knowledge of both dental and medical billing, clear reporting and communication processes, and the ability to work with your existing practice management systems. Ask how the company handles denials, outstanding A/R, staffing coverage, data security, and performance reporting.
Time to Re-Evaluate Your Billing Model? Contact Practice Metrix Today!
Whether you need additional billing support or want to outsource your entire revenue cycle, Practice Metrix can evaluate your current processes and help you find an approach that supports reliable cash flow while reducing administrative demands. Book a demo by calling 610-922-8890 or contacting us online. Located in Plymouth Meeting, Pennsylvania, we proudly serve oral surgery practices nationwide.