Should I do my billing myself or outsource it?
Do it yourself if you have few claims, time to work denials weekly, and know the payer rules. Outsource when billing is eating your week or errors keep costing you money. Either way, you stay responsible for the claims, so ask who fixes denials and who meets deadlines.
This is a trade-off between your time and your control.
In-house works when:
- Your volume is small.
- You know your program’s codes, modifiers and deadlines.
- You can check authorizations and work denials every week.
Outsourcing helps when:
- Denials pile up faster than you can fix them.
- Billing is keeping you from care, hiring or sales.
- Filing deadlines are slipping. Georgia’s is as short as six months from the service month.
Before you hand it off, ask:
- Who fixes errors, and at whose cost?
- Who watches the filing deadlines?
- Do I see every claim and remittance?
- What happens to my data if I leave?
- Is any promise in writing, and what does it exclude?
You are still the enrolled agency, and claims go out under your name. A trade article notes small agencies often see denial or rejection rates of 20 to 30 percent, so the real question is who owns the fix.
Run a trial on real data before you switch.
How CareBravo® helps
Managed Billing covers claim work for 4.47% of eligible billed revenue, and the Parallel Promise™ lets you run it beside your current system for two weeks before anything switches.
Sources
- Georgia Code 49-4-145: Time limitations on claims for assistance · Official Code of Georgia (via Justia)
- So You Want to Bill Medicaid · Home Care magazine
- Georgia Medicaid Common Denials webinar (Feb 2021) · Georgia DCH / GAMMIS
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
How CareBravo’s Billing agent handles this
Want to see where this is costing your agency money? Four minutes, your agency’s name on the answer.