Outsourced medical billing means a third-party billing company does the work between the patient visit and the deposit in your account: eligibility checks, coding review, claim submission, payment posting, denials, and follow-up on every unpaid claim. Maximum Billing, LLC is a billing outsourcing company for medical, mental and behavioral health, and dental practices in twelve states. Our certified billing and coding specialists work inside the software you already use, as your back-office billing team.
Schedule a consultation or call 800-820-0364.
What Our Outsourced Billing Services Include
You can outsource the full revenue cycle, or only the part that is falling behind.
- Eligibility and benefits verification before the visit, so coverage problems are caught before a claim exists. See our insurance verification services.
- Coding review of CPT, HCPCS, ICD-10-CM, and CDT codes and modifiers against the note.
- Claim submission through your clearinghouse, with clean claims sent promptly after the visit.
- Payment posting line by line from ERAs and paper EOBs, with underpayments flagged against your contracts.
- Denial management and appeals, worked to the cause rather than resubmitted unchanged. See our claims denial management.
- Outsourced accounts receivable follow-up on every open insurance claim, oldest and largest first, before timely filing limits pass. See our accounts receivable management.
- Patient statements and answers to patient balance questions.
- Credentialing and payer enrollment, because claims only pay when every clinician is enrolled. See our credentialing and payer enrollment.
What a Third-Party Billing Company Does
A third-party billing company is an outside business that bills insurance on a practice’s behalf. It is not your insurer and not your software vendor. It works under your provider numbers and in your systems, and the payments go to the practice, not to the billing company. Because it handles protected health information, a third-party biller is a business associate under HIPAA and has to sign a Business Associate Agreement before it sees any patient data.
The practice keeps control of the parts that need it: clinical documentation, fee schedules, payer contracts, and decisions about patient balances. The billing company handles the repetitive, deadline-driven work that keeps cash coming in.
Signs It Is Time to Outsource Billing
- The share of your aging report past 90 days rises month after month.
- Visits from last week still have no claim attached to them.
- Rejected claims go back out with the same error, or sit untouched.
- Cash flow drops every time your biller takes time off or resigns.
- Clinicians or front desk staff squeeze billing in between appointments.
- Nobody can say what your clean claim rate or days in accounts receivable are.
- The practice is adding providers, locations, or payers faster than billing can keep up.
In-House Billing vs. Outsourced Billing
Neither model is right for every practice. Weigh claim volume, the staff you already have, and what happens to collections when your billing person is unavailable.
| Billing done by your staff | Billing done by an outside company | |
|---|---|---|
| Continuity | Rests on one or two employees; claims wait when they are out | Several billers share the accounts, so work continues through vacations and turnover |
| Staffing | You recruit, train, and replace billers yourself | Recruiting and training stay with the billing company |
| What you pay for | Wages, benefits, payroll taxes, software licenses, and desk space | A service fee, often a percentage of collections or a set monthly amount |
| Experience | Limited to the payers and problems your own staff has seen | Drawn from many practices, specialties, and payers |
| Oversight | Supervised in person | Supervised through reports, system access you grant and can revoke, and a written agreement |
| HIPAA | Falls under the practice’s existing policies | Needs a Business Associate Agreement before any data is shared |
A hybrid is common. Your front desk gathers insurance information and collects copays, and the billing company takes verification, claims, posting, denials, and follow-up.
How to Compare Billing Outsourcing Companies
Most medical billing companies list the same services. These questions show the difference:
- Who will work my claims? Ask whether the people doing the work are certified billers and coders, and whether they are in the United States.
- Do you know my specialty? Mental health, dental, and medical billing each have their own codes, payers, and denial patterns.
- Will you work in my software? A company that requires you to switch systems adds cost and disruption before it collects anything.
- What will you report, and how often? At a minimum: collections, clean claim rate, days in accounts receivable, aging over 90 days, and denials by reason.
- How is the fee calculated? Ask what the fee applies to, such as insurance payments only or patient payments too, and whether old accounts receivable is priced differently.
- Who owns the data if we part ways? Your claims, reports, and patient records should stay in your system and remain yours.
- Will you sign a Business Associate Agreement? Any billing company that handles patient information has to.
Our guide on how to choose a medical billing company goes into each question in more detail.
Practices We Bill For
- Medical practices: physician practices, specialty groups, and small practices. See our medical billing services and dermatology billing.
- Mental and behavioral health: psychiatrists, psychiatric nurse practitioners, therapists, counselors, and group practices. See our mental and behavioral health billing services.
- Dental practices: general dentistry, oral surgery, and orthodontics. See our dental billing services.
We bill for practices in Florida, Texas, Georgia, Colorado, Illinois, Missouri, New York, New Jersey, Connecticut, Pennsylvania, North Carolina, and South Carolina.
Why Practices Outsource Billing to Maximum Billing
- Experienced leadership. Maximum Billing was founded in 2018 by Gina Abrotsky-Salvatore, CPCS, MHT, who has more than 20 years of experience in insurance billing and revenue cycle management.
- Results you can measure. As of 2026, our clients’ claims reach a 91% clean claim rate, and their accounts receivable average 34 days.
- No software change. We work inside the system you already use, including SimplePractice, Sessions Health, TherapyNotes, InSync, Eaglesoft, Dentrix, Dentrix Ascend, and Open Dental.
- Protected patient information. We sign a Business Associate Agreement with every client, and every team member completes HIPAA certification. See our HIPAA compliant billing services.
- Billing and credentialing together, so enrollment problems do not turn into denied claims.
Frequently Asked Questions
What are outsourced billing services?
Outsourced billing services are billing work done by an outside company instead of practice staff. For a medical practice, that usually includes eligibility checks, coding review, claim submission, payment posting, denials and appeals, accounts receivable follow-up, and patient statements.
Is a third-party billing company HIPAA compliant?
It has to be. A billing company that handles patient information is a business associate under HIPAA and must sign a Business Associate Agreement with the practice. Ask for one before sharing any data.
How much does outsourced medical billing cost?
Billing companies commonly charge a percentage of collections or a flat monthly fee. The right price depends on your specialty, claim volume, payer mix, and how much of the revenue cycle you outsource. We quote each practice after reviewing its volume and needs.
Can we outsource only part of our billing?
Yes. Some practices outsource only accounts receivable follow-up, denials, insurance verification, or credentialing, and keep the rest in-house.
Can you take over our old accounts receivable?
Yes. We review the aging report, work the oldest and largest balances first, and tell you which claims can still be collected and which cannot.
Will we have to change software?
No. We work inside the practice management system you already use.
Talk to Us About Outsourcing Your Billing
Tell us about your practice, your payers, and your software, and we will review your aging report and recent denials with you. Contact us to schedule a consultation, or call 800-820-0364.