In-House Billing vs. Outsource Billing

In-House Billing
Solo Practice/Individual Provider
Monthly In-House Cost California Medical Billing Cost Real-Time Cost
(Enter your own values)
Employee Salary (per employee)
$16.50 per hour x 40 hours per week = $660
$660 x 52 weeks = $34,320
$34,320 ÷ 12 months = $2,860
$2,860 = one month gross pay
$2,860.00 7% of Average of $30,000.00
Net Receivables from Insurance

$2,450.00 per month
per physician
Medical Benefits
Average PPO plan $315.00 (26-36 yrs. of age)
(50% Employer’s portion of dues)
Full Time Employee (30-40 hrs. per week)
$157.50 NONE
Sick Leave
Based on mandatory California
24 hrs. days per year
Paid Sick Time NONE
Vacation Leave
Based on a one-week paid Vacation per year
Paid Vacation NONE
Retirement Plan 401K Safe Harbor
Based on a 3% Employer Contribution per month
$85.80 NONE
Workers Compensation
Based on $0.95 per $100.00 on payroll
California policy minimum $500.00
$41.67 NONE
Payroll Taxes (Estimated)
14.5% gross wages

7.25% Employer Tax Due
Social Security, Medicare, State Unemployment
$207.35 NONE
Practice Management Software
Average cost for monthly ASP model
$300.00 per provider per month
$300.00 NONE
Electronic Claims Submission Fee
@ $0.47 per claim line
Based on 70% of the total monthly claims
(est. 500 claims/ provider)
$164.50 $164.50
Paper Claims (Cost of Supplies & Postage)
@ $0.55 per claim
Based on 30% of the total monthly claims
(est. 500 claims/provider)
$82.50 NONE
Patient Statements
(Cost of Supplies & Postage)

@ $0.75 per statement
Estimate 40 per month
$30.00 $30.00

TOTAL COST PER MONTH

$3,929.32

$2,644.50
Your Total:


ADDITIONAL COSTS FOR IN-HOUSE BILLING

Office Space Lease - Office Equipment (Computer System, Phone, Fax, Scanner, Copier, Filing System) - Billing Software & IT Support - Coding Books - Updates - Training - File Storage Space - Electricity - Phone Charges - Copy Charges - Office Supplies (Claim Forms, Statement Forms, Envelopes) - Printer & Copier Ink - Postage

Employee Salary Increases & Bonuses

THIS COULD ADD UP TO THOUSANDS!!

California Medical Billing