Scaling Your Therapy Practice: Efficient Billing vs. Outsourcing—What’s Right for You?
- Essential Speech & ABA Therapy
- Sep 18
- 4 min read
As your ABA, speech, or occupational therapy practice grows, managing the business side—especially billing—can quickly become overwhelming. From tracking authorizations and correcting claim denials to ensuring consistent cash flow, billing inefficiencies can act as a barrier to growth. A disorganized revenue cycle doesn’t just affect your bottom line—it impacts your team’s workload, client satisfaction, and your ability to scale sustainably.
Whether you're looking to streamline internal billing processes or outsource to experts, understanding your options and optimizing your systems is critical to long-term success.
In this guide, we’ll explore how efficient billing can fuel growth, the advantages and disadvantages of outsourcing, and how to decide what’s best for your practice.
Efficient Billing Systems: Your Foundation for Scalable Growth
As your client volume increases, so does the need for a structured and well-oiled billing process. Inefficiencies like manual claims entry, inconsistent follow-ups, or lack of denial tracking can pile up and slow your practice down just when you’re ready to grow.
Here’s how refining your billing operations internally can help you scale smarter:
1. Automation Is Key
Manual billing methods are not only time-consuming—they're also prone to human error. As your caseload grows, so does the risk of lost revenue due to small mistakes. Automating key billing processes minimizes these risks.
Tips:
Choose a billing platform that integrates with your practice management and scheduling system. This enables:
Auto-submission of claims
Real-time eligibility verification
Automatic reminders for missing documentation or expiring authorizations
With automation, your team can focus more on client care and less on repetitive admin work.
2. Standardize Your Billing Workflow
Every billing touchpoint—from intake to payment—needs to be consistent. A standardized process reduces training time for new staff, minimizes mistakes, and ensures nothing falls through the cracks.
Tips:
Develop a billing protocol or checklist that covers:
Intake verification
Authorization tracking
Timely documentation completion
Claims submission steps
Follow-up and denial management
Train every staff member to follow this system, and revisit it quarterly to refine as needed.
3. Track the Right Metrics
If you’re not measuring your billing performance, it’s impossible to improve it. Keeping track of key performance indicators (KPIs) helps you identify where bottlenecks are happening and where to invest your time and resources.
Tips:
Start with these essential metrics:
Days in Accounts Receivable (A/R): Lower is better.
First Pass Resolution Rate (FPRR): How many claims are paid on the first submission.
Denial Rate: The percentage of claims denied on first submission.
Review these numbers monthly and set improvement goals.
4. Reduce Denials Before They Happen
Denied claims waste valuable time and money. Efficient billing processes allow you to identify patterns that cause denials and proactively address them.
Tips:
Conduct monthly denial audits. Common issues may include:
Expired authorizations
Incorrect codes or modifiers
Missing documentation
Use these findings to update workflows and train staff, reducing repeat mistakes.
5. Build a Billing Team That Supports Growth
If you're managing everything in-house, ensure your billing staff has defined roles, is cross-trained, and can handle increased volume as you grow.
Tips:
Consider dividing responsibilities like:
Intake and eligibility
Claims submission
Denial follow-up
Reporting and analysis
This prevents burnout and creates a scalable structure you can build upon.
Outsourcing Billing—Is It the Right Move?
Once your practice reaches a certain size or complexity, you might begin to consider outsourcing billing to a specialized company. Outsourcing offers the appeal of handing over the reins to professionals who live and breathe insurance billing—but it also means giving up some control.
Let’s break down the pros and cons of this route.
Pros of Outsourcing Billing
More Time for Client Care
Your clinical and admin teams can spend more time on patient engagement, care coordination, and growing programs—rather than managing claims.
Tips:
Use the time saved to:
Offer new services
Build stronger client relationships
Train your team on clinical best practices
Access to Industry Expertise
Billing companies stay current with payer trends, coding changes, and compliance requirements. This often results in fewer claim errors and faster reimbursements.
Tip:
Choose a company with direct experience in ABA, speech, and OT billing for the most efficient results.
Built-In Scalability
Outsourced billing solutions can handle increasing volume without needing you to hire and train new staff internally.
Tip:
As you open new locations or expand your client base, outsourcing gives you the flexibility to grow without major internal restructuring.
Cons of Outsourcing Billing
Less Control Over Processes
When you outsource, you rely on a third party to manage your cash flow and sensitive patient data. If they make mistakes, you may not know until it’s too late.
Tips:
Set up regular reporting schedules and check-ins. Require transparency around:
Weekly claim submissions
Denials and resolution timelines
A/R aging reports
Make sure they provide you with login access or dashboards you can view at any time.
Additional Costs
Billing services typically charge a percentage of collections (often 5–7%). While this may seem steep, it may still cost less than internal staff turnover, training, and billing mistakes.
Tip:
Compare outsourcing fees against your current internal costs—including delayed payments, denials, and time spent on billing errors—to make an informed decision.
Which Path Is Right for You?
Ultimately, the best billing model depends on your practice’s current size, structure, and growth goals. Here's a quick guide to help you decide:
Scenario | Best Option |
You’re a solo or small group practice with limited admin support | Start with outsourced billing + evaluate with scale |
You have recurring denial issues and don’t have time to resolve them | Consider outsourcing to gain expertise |
You’re growing rapidly and don’t want to hire or train more billing staff | Outsource for scalability |
You want full control over every financial process | Stay in-house and invest in internal systems |
Need help deciding? No problem! Contact our team today to see what the best path is for your business.
