Should I Hire an Hourly Biller or Outsource Billing?

An hourly biller can be a good choice when you need defined work and can manage the time, priorities, and handoff. Ongoing outsourced billing can fit a practice that wants a team responsible for the agreed workflow. The decision depends on what you are buying: hours of help, an employee role, or an ongoing service.

When does paying a biller hourly make sense?

Hourly work can fit a bounded project: reviewing an old accounts-receivable report, reconciling a known payment-posting backlog, training office staff, or investigating a set of claims. Agree on the deliverable, estimated hours, spending limit, and what needs approval before the work expands.

It can also fit ongoing work when the practice has a capable billing manager who assigns priorities and checks completion. The practice then retains the management role. Some owners want that control; others are trying to reduce the time they spend managing billing.

What are the disadvantages of hourly billing support?

The invoice depends on time worked, so a difficult payer problem can increase expense without producing payment. A spending cap creates a second question: who continues working when the authorized hours run out?

One person’s availability also matters. Ask what happens during leave, who checks filing deadlines, and how another person can take over unresolved work. These questions apply to any small vendor as well; team coverage is something to verify rather than assume from a company name.

How do I compare hourly cost with a percentage fee?

For an illustrative contractor charging $60 an hour, 10 hours cost $600 and 20 hours cost $1,200. A 4% fee on $20,000 in eligible net collections is $800. At that collection level, $800 buys about 13.3 hours at the hypothetical hourly rate. These are examples, not wage estimates or proof that either option performs better.

If you hire an employee, wages are only one input. Add applicable employer costs, benefits, tools, supervision, recruiting, and coverage. If you buy a contractor’s time, identify what systems and management remain your responsibility. Compare the same tasks and period before deciding.

Does a percentage fee reward efficiency?

A collections percentage does not automatically increase because resolving a claim takes longer. That creates a reason for the billing team to work efficiently toward appropriate payment. However, a poorly managed percentage service can still miss follow-up. Ask for evidence of completed work and unresolved exceptions.

Bomi prefers a collections-based fee where permitted because it gives both teams a financial interest in payment reaching the practice. We use the applicable per-claim arrangement where percentage compensation is prohibited. The agreement should identify the work and price before either team relies on it.

What should I ask an hourly biller before starting?

Ask for a sample work log that records useful completed actions without exposing another practice’s patient information. Define how time is recorded, what updates you receive, who can approve more hours, and how access and unresolved claims transfer at the end.

For a cleanup, ask for a final list of resolved items, remaining balances, deadlines, and next owners. For an ongoing hire, define who handles eligibility, submissions, denials, payment posting, and patient questions. A low hourly rate is not a complete plan for those responsibilities.

Related questions

Bomi’s reasoning for percentage pricing

See Bomi’s current pricing or talk through your practice’s billing needs.

Frequently Asked Questions

Is an hourly biller always cheaper than outsourcing?

No. Total hours, employer or contractor costs, management time, tools, and included services determine the comparison.

Can I pay hourly just for old-claim cleanup?

You can seek a project quote with defined scope and a spending limit. Confirm how it fits any current billing agreement so two teams do not submit or work the same claims without coordination.