What does the 4.5% outsourced rate include?

End-to-end RCM: eligibility, prior authorization, coding (with credentialed coder review), claim submission, denial management, A/R follow-up, payment posting, patient statements, and KPI reporting. Software included; no separate license fee.

Is direct cost the right way to evaluate outsourcing?

It is one input, not the whole answer. Operational gains (denial-rate reduction, A/R-days reduction, scalability without hiring) usually drive the larger ROI signal than direct cost arbitrage. Use this calculator alongside the ROI calculator.

What about hybrid models?

Common. Many groups keep coding in-house and outsource A/R follow-up and denial management, or vice versa. Run the calculator on the workflow being outsourced rather than the whole RCM stack to size the targeted engagement.

Free tool

Billing Cost Comparison

Name: Medonix MSO
Address: 300 Delaware Ave Suite 210, Wilmington, DE, 19801, US
Telephone: +1-302-520-5413
Price range: $$

In-house vs. outsourced billing TCO calculator. This calculator is free, requires no signup, and runs entirely in your browser. Medonix never receives your inputs unless you opt in to receive a personalized report by email.

Result

In-house annual cost

$202.3k

2 FTE × $72.0k × 1.28 (loaded) + software.

In-house % of collections

3.4%

MGMA typical band: 6–10% of net collections.

Outsourced annual (Medonix)

$270.0k

Blended 4.5% of net collections.

Annual savings

$-67.7k

Direct cost difference, before operational gains.

Cost-only basis favors in-house. Outsourcing case rests on operational improvements (denial rate, A/R days, scalability).

Methodology

In-house cost: FTE wages × 1.28 (benefits + payroll tax loading per BLS Employer Costs for Employee Compensation), plus annualized software cost.

Outsourced cost: blended 4.5% of net collections, the median engagement size across Medonix client base spanning solo through 30+ provider groups.

Direct cost is one input among several; denial rate, A/R days, and scalability often drive the larger ROI signal.

Frequently asked

About the Billing Cost Comparison.

Bureau of Labor Statistics Employer Costs for Employee Compensation reports total compensation as roughly 1.28× of base wages for civilian healthcare workers, accounting for benefits, payroll taxes, and paid leave. Vary it for your geography if needed.

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Billing Cost Comparison

About the Billing Cost Comparison.

01Why a 1.28× FTE multiplier?

02What does the 4.5% outsourced rate include?

03Is direct cost the right way to evaluate outsourcing?

04What about hybrid models?

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