Should I Outsource My Physical Therapy Billing?

Many practice owners walk the fence on the decision of outsourcing their billing and do their best to try and weigh the pros and cons. Their goal is to have efficient and accurate billing with steady cash flow and no headaches. While many owners are hesitant to turn over their billing operations because of fear of lack of control, there are many benefits in doing so. After all, you were not trained as a biller. So, keeping it in-house can be difficult to manage the systems of billing when you are not well versed in the intricacies of physical therapy billing. In addition, oftentimes management of billing personnel can be difficult because there is a lack of reality as to what it takes to do the job. Not to mention, the situation owners find themselves in when employees turnover or out-ethics actions happen on their money lines can be more challenging. 

That being said, we are confident in saying if you are a large multi-site operation like a corporate or franchise group that can afford a highly trained billing management team with a quality control officer and benefits from the economy of scale across many offices, in-house is probably the way to go.  

Alternatively, one might want to consider outsourcing their billing to a third party to manage. This option comes with its own set of risks that one should be aware of prior to pulling the trigger. Here are some questions to ask and considerations to be made.

Questions to Ask a Third-Party Billing Partner

  • Are they proficient with multiple EMR Systems? 
  • Are they exclusively billing for physical therapy?
  • Will you have a dedicated team leader managing your account?
  • Do they have experience managing multiple sized practices?
  • Will you have a monthly reporting meeting with your team to review your A/R, unbilled and progress on your accounts?
  • Will they take the time to train your front desk based on the errors report each month?
  • Do they manage by statistics and KPI’s (key performance indicators) in order to set targets to be met monthly for your practice? 
  • How do they enhance their team members?


  • Do not go with a medical billing company that is not exclusively for physical therapy. They will typically miss a lot of the nuances of physical therapy billing and it’s much lower dollars than medical billing so they leave behind low dollar follow up. 
  • Be wary of software EMR companies that offer billing services at a discounted rate. They are a software company and billing for you is an afterthought. You get what you pay for.
  • Do not work with a company that does not assign a team leader and hold themselves accountable to targeted metrics each month with a sit-down meeting. 
  • Do not work with a company charging less than 5% on collections. First of all we all know you get what you pay for and secondly, that rate is typically break even for the billing company so look out for higher rate bump ups in the near future and or shotty services from low wages employees.

There are many pros and cons to outsourcing your billing beyond the questions and red flags we have listed for you here. 

Some of the Pros and cons of outsourcing include:


  • Savings. Managing a full-time biller on staff can be costly when you consider their paid time off, benefits, computers, software, office equipment, office space, postage, printing toner, paper, and copier supplies. 
  • Less Responsibility. We were NOT trained in billing so it becomes very difficult to know what to believe when your biller is giving you excuses as to why things are the way they are. 
  • Greater Reliability. Outsourced billing companies have teams of billers, so you know that your billing will be taken care of daily, even if someone is out on vacation. You don’t have to worry about staffing crisis if someone is sick, using paid time off, or moves away.
  • Professional Services. Physical therapy-only professional billing companies must remain up to date on all the latest changes in healthcare and strive to be innovative by creating greater efficiencies year over year
  • Time management. By turning over your billing you now gain more time to spend on the areas of your practice where growth comes from as opposed to managing clerical duties of billing.


  • Learning curve. Most physical therapy practices are used to one way of doing things and to change over can require a bit of a learning curve. If proper expectations are set, both parties will work as one and before you know it, the process will be seamless. 
  • Control. If you’re not ready to turn over control of your billing process to an outside entity, outsourcing your billing may not be for you – after all, you’re relying on an outside group to take over all billing and collections and thus all the cash flow. 

If you would like more information on training options for your in-house billing team, or which EMR systems our team recommends; contact us and we can take a look at your stats and let you know if outsourced PT billing is right for your practice. 

Physical Therapy Billing Test

Recent Blogs

Go to Top