For practice owners, administrators, and hospital revenue cycle leaders

What does billing really cost you? Most practices count salaries and stop there. The honest number includes payroll taxes, benefits, HR overhead, software, space, turnover, and the revenue that quietly leaks away when no one is motivated to chase it. Use this calculator to compare the three ways practices handle billing – in-house staff, offshore outsourcing, and the co-sourced model we built Optimal Billing Solutions around. Every assumption is editable, and the defaults are labeled industry-typical figures with sources at the bottom of the page.

Run your numbers

Your practice

In-house hidden costs

Outsourced alternatives

In-house team

$0
0% of collections

Before management time, turnover, vacation and sick coverage, and denied claims nobody owns.

Co-sourced (our model)

$0
0% of collections

Offshore vendor

$0
0% of collections

Lowest sticker price. See the risk column below before believing it.

What the math doesn’t show – and why we co-source

Optimal Billing Solutions exists because the in-house vs. outsourcing choice was always a false one. Co-sourcing puts a dedicated, professional billing team inside your operation without the payroll, and without shipping your patients’ data overseas.

  • Payroll, fringe, and HR overhead disappear. No salaries, benefits, payroll taxes, recruiting, or coverage juggling for billing staff. That cost line simply leaves your books.
  • US-based, US-certified people – not offshore. Offshore billing means your patients’ most sensitive data crosses borders. That is HIPAA exposure, data-theft and fraud risk, and no discount makes it worth it. Our staff are based in the United States and hold recognized billing and compliance certifications.
  • The work happens 100% inside your own systems. We work in your EHR and practice-management platform, under your access controls. Your data never leaves your environment to be re-keyed into someone else’s system.
  • The incentives finally point the right way. An in-house team often hires several people for the same job, and no one inside has a built-in motive for a perfect job. A co-sourcing partner is motivated to keep your costs low, to hire the best-qualified people for your account, and to prove it in your numbers every month – that is how we keep the account.

The honest word on offshore pricing

Offshore vendors win on sticker price, and the calculator above shows that honestly. What the sticker leaves out: compliance and HIPAA exposure when PHI is handled overseas, the risk of data theft and fraud, communication drag across time zones, and turnover you never see. A cheaper percentage of a smaller, riskier collection is not a savings.

Sources and assumptions

  • Default billing-staff salary: U.S. Bureau of Labor Statistics median pay for medical records specialists, about $51,140 (May 2025): bls.gov/ooh
  • Default benefits load: BLS Employer Costs for Employee Compensation – benefits run roughly 30% of total compensation for private-industry workers: bls.gov/ecec
  • Default outsourced fee ranges: industry surveys commonly cite 4% to 9% of collections for full-service outsourced medical billing, varying by specialty and scope (example: verorcm.com/medical-billing-cost).
  • Every input is editable – use your own payroll and contract figures for a real comparison. Co-sourcing engagements are scoped to each client; this tool illustrates the cost structure, not a quote.

Educational illustration only. Not a quote, a fee schedule, or financial advice. Every Optimal engagement is scoped individually – talk to us about yours.