Full-service outsourced medical billing for US healthcare providers. The standard: 96% clean claim rate, 24-day average AR, HIPAA-compliant, BAA signed. Performance-based pricing — we only earn more when you collect more.
Medical billing services are outsourced revenue cycle management operations that handle the full claim lifecycle on behalf of a healthcare provider — from charge capture and claim submission through denial management, AR follow-up, and patient collections. Outsourcing medical billing to a specialized company typically costs 3–10% of monthly collections versus 8–15% for in-house operations, while simultaneously delivering higher clean claim rates and faster reimbursement.
Every claim reviewed against payer rules before submission. We target a 96%+ clean claim rate on first pass — above the 85% industry average.
Same-day denial identification, root cause analysis, and appeal submission. Most denials resolved within 14 business days.
Systematic follow-up on all unpaid claims from day 1. We maintain average AR below 24 days — versus the 35–45 day industry average.
Accurate payment posting with EOB reconciliation. Every payment verified against your payer contracts for underpayments.
Professional patient statements, payment plan setup, and follow-up — preserving the patient relationship while collecting balances.
Monthly performance reports with KPIs, denial analysis, payer mix, and AR aging. Full visibility into your revenue cycle at all times.
| Metric | Industry Average | Top Quartile |
|---|---|---|
| Clean Claim Rate | 82–88% | 96%+ |
| Average Days in AR | 35–50 days | 24 days |
| First-Pass Resolution Rate | 70–80% | 88–93% |
| Net Collection Rate | 92–95% | 97–99% |
| Billing Cost as % of Collections | 8–15% (in-house) | 3–10% |
Industry averages sourced from MGMA 2025 and HFMA benchmarks.
We audit your current billing workflow, identify revenue leaks, and build a custom transition plan. Typical onboarding takes 30–45 days with zero disruption to cash flow.
Your clinical data flows to our billing team. We verify CPT, ICD-10, and modifier accuracy before any claim is created — catching errors before submission, not after denial.
Every claim is scrubbed against payer-specific edits before submission. We submit electronically and track acknowledgment to confirm receipt.
Payments posted same day. Denials identified, categorized, and appealed immediately. Contract variances flagged for underpayment recovery.
Monthly KPI reports with denial root cause analysis, payer performance, and AR aging. We identify systemic issues and fix them proactively.
BAA signed before work begins. Encrypted data transmission. HIPAA-trained staff. Annual audits.
Founded by Ajay with 17+ years in revenue cycle management across all major US specialties.
Look for percentage-of-collections pricing — no flat fees, no hidden charges. The billing partner's revenue stays tied to yours.
DME, dental, behavioral health, pain management, primary care, cardiology, orthopedics, and more.
Most practices don't realize how much revenue their billing is leaking until they see a benchmark comparison. These five signals are the most reliable indicators that your billing operation — in-house or outsourced — is costing you money it should be collecting.
The national average denial rate is 10–15%, but high-performing practices run under 5%. A denial rate above 10% means your front-end processes — eligibility verification, prior auth, demographic accuracy — have systemic gaps. On a practice collecting $2M/year, the difference between a 12% denial rate and a 4% denial rate is approximately $160,000 in annual uncollected revenue.
The industry average is 35–50 days. Top-performing billing operations average 24 days. When AR ages, collection probability drops sharply: claims over 90 days old collect at roughly 50–60 cents on the dollar. Claims over 120 days are frequently written off entirely. Days in AR above 45 means your follow-up cadence has broken down somewhere in the pipeline.
Net collection rate measures the percentage of collectible revenue you actually collect — after contractual adjustments but before write-offs. Industry average is 92–95%. Top performers hit 97–99%. A net collection rate below 95% almost always indicates a combination of high denial rates, slow AR follow-up, and inadequate patient collections — all of which are fixable process problems, not industry inevitabilities.
If your billing company — or your in-house team — cannot show you a monthly report with denial rate, days in AR, clean claim rate, net collection rate, and AR aging by payer, you cannot manage what you cannot measure. The absence of reporting is itself a red flag: high-performing billing operations generate these reports automatically because they're constantly monitoring them.
If your patient volume is growing but revenue is flat or declining, billing is almost certainly the cause. The most common culprits: rising denial rates that aren't being appealed, a growing pool of aging AR that's quietly being written off, underpayments that aren't being caught in contract variance reviews, and patient balance backlogs that go uncollected. A free RCM audit will find the specific leak within 15 minutes.
Written & Reviewed By
Ajay — CEO, Aayur Solutions
17+ years in US medical billing and revenue cycle management across DME, behavioral health, dental, pain management, and multi-specialty practices. Founder of the American Billing Association resource hub. All content on ABA is written or reviewed against real billing operations — not keyword tools.
How to reduce your denial rate to under 5% and recover revenue from denied claims.
GuideReduce days in AR and recover aging balances with a systematic follow-up process.
GuideThe true cost comparison including all hidden costs most practices miss.
Get a free 15-minute RCM audit. We'll identify your top revenue leaks and show you exactly what outsourcing would look like for your practice.