Kaylie vs. hiring it out
An office in this much billing pain is not shopping for software. It is shopping for a person.
That instinct is right more often than software companies admit. A person can hold on the line for forty minutes, argue an appeal, and talk a patient through a balance they did not expect. Software cannot do any of those things.
What software can do is make sure the person you are already paying never spends another morning reading a benefit breakdown off a portal and typing it into a chart. So here is the honest comparison: what an extra hire costs, what a billing service costs, what each is genuinely better at, and where we would tell you to hire instead of buy.
There are three doors, and they are not interchangeable
Most offices try them in this order, one at a time, and discover the trade-offs the expensive way.
Hire an insurance coordinator
One person at a desk in your office, on your payroll, who verifies benefits, files claims, works the aged report and answers the phone when a patient disputes a balance.
Outsource to a billing service
A remote team, usually paid a share of what it collects, that takes some agreed slice of the billing work off your office entirely.
Automate the keystrokes
Kaylie logs into the payer's own portal, reads the full benefit breakdown ahead of the appointment, writes it into the patient's plan in your practice management system, and prices the treatment plan from what it found.
What each one actually costs
Run the arithmetic on a single-location office collecting $80,000 a month from insurance. Substitute your own numbers — the shape of the answer is what matters.
| An extra hire | An outsourced billing service | Kaylie | |
|---|---|---|---|
| How you are billed | A wage, plus payroll tax and benefits, every month regardless of production. | A share of what it collects for you, with a monthly floor for smaller offices. | A flat monthly fee per office. |
| An office collecting $80,000 a month from insurance pays | $45,760 in wages at $22 an hour full-time, which is $53,000–$59,000 once you add 15% to 30% for payroll tax, benefits and cover for time off. | $2,800 a month at 3.5% of insurance collections — $33,600 a year. | $300 a month for verification automation, $600 with write-back into your practice management system. |
| Your best year ever: collections up 30% | Same wage. The same person is now 30% busier, and something gets dropped. | The invoice rises with the collections. $104,000 a month crosses the top of that card's 3.50% band, and the rate steps down above it — the card does not say whether the lower rate applies to the whole amount or only to the part above $100,000, so the bill is somewhere between $3,120 and $3,620. Either way it is more than the $2,800 at $80,000. | Unchanged. |
| A quiet month: a doctor out, collections down 30% | You pay in full. | You pay less. This is a real advantage and we are not going to pretend otherwise — on a percentage, they only get paid when you do. | You pay in full. |
| Time to useful | Four to twelve weeks to learn your PPOs, your software and your patients. | Onboarding in days; several weeks before their team knows your plans well. | Days. What it needs from you is a portal login per carrier and a connection to your practice management system. |
| When they leave | Every plan quirk they had memorised leaves with them, and the next hire relearns it at your expense. | You are assigned someone new. The account survives the individual. | Not applicable. What was learned about a plan is stored against that plan. |
| Who is accountable when a claim goes out wrong | The person at the desk, and they are sitting right there. | Your account manager, and you can phone them. | You are — with a record that shows, months later, exactly which payer screen or eligibility response each number came from. Traceability is not the same thing as somebody to blame, and if what you want is somebody to blame, hire a person. |
Where these numbers come from
The 3.5%. An outsourced dental billing service publishes its rate card: $1,400 per location per month for offices under $40,000 of monthly insurance collections, 3.50% of insurance collections between $40,000 and $100,000 a month, and 3.00% then 2.50% on the collections above that. Read on dentalbilling.com/pricing on 10 September 2026. Rates differ between companies and by what is in scope, so use the quote in front of you, not ours.
The wage. $22 an hour full-time is $45,760 a year before payroll tax, benefits or cover for time off; the loaded range above adds 15% to 30% to that. Both are arithmetic, not a salary survey — wages for this role vary widely by market, so put your own in.
Our own price. The $300 and $600 figures are the verification and write-back module prices published on our Open Dental page; treatment planning and claims are separate modules with their own published prices. All of it is quoted per office for an average-size practice; larger offices pay more, and we will tell you the number before you ask twice.
Where a billing service is the better buy — genuinely
Six things a service does that we do not. If your problem is mostly on this list, a service is the right purchase and we will say so on the call.
Aged A/R that needs a human on hold
If your 90-day report is a five-figure pile nobody has touched since spring, do not buy software first. Buy hours. Nothing automated is going to wait thirty-five minutes for a representative to explain why one claim has been pended for review since March.
Appeals that need a clinical argument
A denial that turns on necessity is won by a person who reads the chart, picks the right radiograph, and writes a narrative a dental consultant will accept. Assembling the evidence can be automated. Making the argument is a judgment call.
The conversation about a patient's balance
Someone has to phone a patient who believed the estimate, is now looking at a bigger number, and is upset. That call decides whether they come back. It should be a person, and preferably one who knows them.
Posting payments and reconciling the day
Matching an EFT, an ERA and a virtual card to the right claims in the ledger, and closing the day so the numbers agree, is real work with real judgment in the exceptions. A billing service will do it. We do not.
Credentialing and PPO fee negotiation
Paperwork, follow-up, and a relationship with a network representative. There is no version of this that a subscription performs for you, and offices that try to automate it lose months.
Covering a resignation tomorrow
When your coordinator gives two weeks' notice, a service absorbs the gap this month. Software does not. That single fact is why plenty of offices buy a service, and it is the right call.
A percentage of collections also has one clean virtue that a subscription cannot match: in a bad month, the bill is smaller. Anyone who tells you otherwise is selling.
Where the software wins outright
Six things that do not improve by adding people, because they are not limited by effort. They are limited by patience, memory and the number of hours in a morning.
The bill does not grow when you do
A percentage of collections means your best quarter is also your most expensive one. On $80,000 a month of insurance collections, a 3.5% rate is $33,600 a year; on $100,000 a month the same 3.5% is $42,000. A flat per-office fee moves for none of that.
Every appointment, not the ones there was time for
A person triages: today's arrivals get verified properly, next Thursday's get a category percentage and a hope. Automation runs tomorrow's whole schedule every night, primary and secondary, and flags the ones it could not finish.
What it learns, it keeps
The frequency limit that cost you a $400 write-off once is stored against that plan and applied to every patient on it afterwards. Staff turnover does not erase it, and nobody has to remember to write it on a sticky note.
It lands in the chart, not in an inbox
Coverage per procedure code, remaining maximum, deductible applied, frequency history, downgrade and missing-tooth clauses — written into the patient's plan in CareStack, Open Dental and the other practice management systems we connect to, rather than into a PDF somebody re-types.
You can audit the work
Every value traces back to the payer portal screen or the eligibility response it was read from, and the source is kept. When a patient disputes an estimate from four months ago, that is the difference between an argument and a receipt.
It is the same on 27 December
No notice period, no flu, no holiday cover, no retraining. The offices that feel this most are the ones that lost a coordinator in a busy month and still remember it.
You can check the coverage claim without talking to us: every carrier we verify, counted live.
What most offices actually end up with
Both. Not because it is a nice compromise, but because the work splits cleanly down the middle, and almost nobody notices until they draw the line.
Work only a person should do
Judgement, argument, and any conversation a patient will remember.
- Phone follow-up on claims past 60, 90 and 120 days
- Appeals that turn on necessity, and the narrative behind them
- Talking a patient through a balance, and keeping them
- Posting payments and closing the day
- Credentialing, network paperwork, fee negotiation
Work no person should have to do
Repetitive reading, transcription, and remembering. All three are things people are measurably bad at by the fortieth patient.
- Verifying tomorrow's whole schedule, primary and secondary
- Reading the full breakdown out of the payer's own portal
- Typing it into the patient's plan in your practice software
- Pricing the treatment plan from what the plan actually says
- Watching claim status and reading the EOBs that come back
If you already pay a percentage of collections, this is a useful question to put to your service: which items in the left-hand column are they doing for you today? That is what the percentage is for. The right-hand column is what we take, and it is the half that gets quietly skipped when a busy week arrives.
Read this part before you book anything
What Kaylie will not do for you
Six limits, written down so you can hold us to them. If a salesperson tells you otherwise on a call, this page is the version that counts.
We do not phone patients about balances, and we do not run a collections queue for you.
We do not do credentialing, and we do not negotiate your PPO fees.
We do not post payments to your ledger or close your day.
We are not a clearinghouse. If you file claims and send attachments through one today, keep it — that is a different job, and we do not ask anyone to drop it to work with us.
We cannot verify what the payer will not state. Where a portal holds no history and the eligibility response returns only a category, we record that the value is unknown instead of filling it in with something plausible. A guess shaped like a fact is how a $400 write-off happens.
We need real access. A working portal login per carrier and a connection to your practice management system, gathered with someone at your office in the first week. There is no version of this that works from the outside with no credentials.
A flat number, published, per office
Not a share of your collections, and not a number that appears after two discovery calls.
Automation
Verification runs ahead of the appointment, gathering from EDI feeds, clearinghouses, EOBs and the payer's own web portals, with every value traceable to its source.
Automation + Write-Back
Everything above, written into the patient's plan in your practice management system — coverage per procedure code, remaining maximum, deductible, frequencies and downgrades — so nobody re-types it.
Priced per office for an average-size practice, and covering verification and write-back; treatment planning and claims are separate modules with their own published prices. Larger offices and groups pay more; ask and we will tell you the number on the first call.
Bring us the quote you were about to sign
Send the rate card and one month of your collections, and we will do the arithmetic with you on the call. If a billing service or an extra hire is the right answer for your office, we will say so — and we will tell you which half of the work to give them.