Is outsourcing worth it for a practice our size?

Sometimes not, and we would rather say so. It depends on your claim volume, how much you are currently writing off, and how much time billing takes someone who has other work. We look at your recent claims first and tell you honestly.

Do we have to change systems?

No. We work inside the Practice Fusion you already have.

Do you handle patient balances?

Yes. Statements and patient follow-up are included.

What access do you need?

User access with billing permissions, plus the payer portals you are enrolled with. Your practice stays the account owner.

Billing is 4-8% of collections depending on volume and specialty. Credentialing is per application, per provider. All rates are published on our pricing page.

Practice Fusion Billing Services

For small practices on Practice Fusion weighing up outsourced billing. We work inside the system you already use - and we will be straight with you about whether it pays for itself at your size.

What does not change

You keep Practice Fusion and everything set up in it.
Your providers document exactly as they do now.
Your scheduling and check-in are untouched.
Your data stays yours. Nothing of yours leaves with us if you go.

What we run inside your Practice Fusion

Claims from your existing documentation

We work from what your providers already complete. Nothing goes out before the note supports it.

Eligibility checked before the visit

The cheapest denial is the one that never happens, and coverage problems caught beforehand are a phone call instead of a write-off.

Denials appealed instead of written off

Small practices write denials off because nobody has time to fight them. That is the single largest recoverable loss at this size.

Patient balances followed up

Statements and follow-up on what patients owe, which is usually the first task to slip when there is no billing staff.

A/R worked in age order

Oldest first, because those claims are closest to their filing deadlines.

How the switch works

We review your recent claims first
This is also how we tell you whether outsourcing is worth it for you. If the numbers do not support it, we would rather say so than take the work.
Access, not migration
You give us user access to the Practice Fusion you already have. Nothing moves.
We check your enrolment
Enrolment done once and never revisited is the most common hidden cause of denials in small practices.
New claims start immediately
Current visits flow to us straight away so nothing stalls.
Then whatever is outstanding
Old unpaid claims get worked, oldest first.

What your staff still do

Document visits as they do today.
Schedule patients and collect at the desk.
Tell us when a patient’s coverage changes.
Answer anything a payer needs the treating provider to confirm.

Where practices like yours lose money

At low volume, outsourcing does not always pay

A percentage of collections has to be less than what the billing currently costs you in write-offs and time. Below a certain claim volume it is not, and we will tell you when that is the case.

Written-off denials never appear in any number you look at

Nobody records the claims they gave up on. The loss shows up only as collections being lower than they ought to be, with no line item to explain it.

A free or cheap system does not mean cheap billing

The software cost and the cost of getting paid are unrelated. Practices sometimes economise on the first and lose far more on the second without connecting the two.

Compare what is included, not the headline rate

Eligibility checks, patient statements and A/R follow-up are sometimes bundled and sometimes charged separately. A lower percentage with extras billed on top can cost more.

Questions we get asked

Is outsourcing worth it for a practice our size?: Sometimes not, and we would rather say so. It depends on your claim volume, how much you are currently writing off, and how much time billing takes someone who has other work. We look at your recent claims first and tell you honestly.
Do we have to change systems?: No. We work inside the Practice Fusion you already have.
Do you handle patient balances?: Yes. Statements and patient follow-up are included.
What access do you need?: User access with billing permissions, plus the payer portals you are enrolled with. Your practice stays the account owner.
What does it cost?: Billing is 4-8% of collections depending on volume and specialty. Credentialing is per application, per provider. All rates are published on our pricing page.