Systems Before Outsourcing - A Smarter Way to Scale

Systems First, Outsourcing Second: The Smart Way to Scale Your Collections

You know how some people hire a billing company because they just want it handled? I get it. The idea of handing over the hard stuff sounds freeing… until it isn’t.

Here’s the thing no one tells you: outsourcing your billing without solid systems in place doesn’t remove stress. It multiplies it.

I learned that the hard way in Alabama. That office had a billing company before they had a financial policy. The result? Total confusion. Refunds were being posted as adjustments, which made their production look inflated for six months. Not because the billing team was bad, but because they were guessing.

And that’s the truth of it… most billing companies aren’t villains. They’re just operating without your blueprint.

The Core Truth: Billing Companies Should Fit Your System, Not Rewrite It

A billing company should adapt to your process, not redesign it. You’re not hiring a boss, you’re hiring a partner.

Think of it like building a house. You wouldn’t hand a contractor a pile of bricks and say, “Figure it out.” You’d hand them a blueprint.

Your systems, your financial policies, workflows, and permissions, are that blueprint.

Without them, you’re basically saying, “Do whatever you think is best,” and hoping it aligns with your values, numbers, and promises to patients. Spoiler: it won’t.

Step One: Build Your Blueprint

Before you hire help, you need structure.

That means two financial policies… one for your team, one for your patients.

Your patient-facing policy is how you communicate refunds, balances, and insurance expectations to patients.

Your staff-facing policy is the guide your team (and billing partner) follows for how payments are posted, how overpayments are handled, and how refunds are processed.

Then, make sure your software permissions reflect your boundaries. Who can post? Who can edit? Who approves refunds?

And most importantly, have one single “source of truth”… your written policy. Not an email chain. Not a “we’ve always done it this way.”

Because if your refund protocol isn’t written, your billing company will invent one. And that’s when your numbers start lying.

Step Two: Vet Your Billing Partner Like a Financial Partner

When you hire a billing company, you’re not buying a product. You’re building a relationship that touches your money.

Ask hard questions up front:

• How do you define success?

• What KPIs do you report on monthly?

• How do you track unresolved claims, refunds, and overpayments?

• How do you communicate issues… weekly meetings, email, or a shared dashboard?

• Will you adapt to our policy, or do you only work within yours?

If they can’t answer confidently, they’re not a partner. They’re a vendor. And vendors don’t protect your bottom line.

A good billing company won’t resist those questions. They’ll love them, because they want clarity too.

Step Three: Measure the Relationship

You can’t manage what you don’t measure.

That’s not micromanaging. That’s leadership.

If you want to know whether your billing company is truly helping your practice, track it. Watch these numbers:

• Days in AR

• Percentage of claims over 90 days

• Overpayment balance totals

• Refund queue volume

• Collections by provider

• Production vs. collection accuracy

Those numbers tell the truth. If refunds are climbing or write-offs are spiking without reason, that’s not a system win… that’s a red flag.

Hold your billing partner accountable with data, not emotion. The goal isn’t to find fault, it’s to find clarity.

The Leadership Lesson: Accountability Isn’t Distrust

Holding your billing company accountable isn’t about control, it’s about partnership.

The right company will want your feedback, will celebrate your wins, and will treat your financial system as sacred.

A great billing partner doesn’t want blind trust, they want alignment, clarity, and proof they’re helping you hit your goals.

You can’t delegate chaos and expect peace.

You can’t outsource confusion and expect clarity.

So before you hand over your collections, build the foundation that keeps your numbers honest and your team empowered.

Final Thought:

You deserve a billing partner that fits your freak… one that honors your financial promises to both your patients and your team.

Get your systems right first. Then find a company that respects them.

Because outsourcing should never mean losing control. It should mean amplifying what already works.

If your kindest people are burning out trying to make broken systems work, it’s time to look at the framework, not the faces.

Let’s fix the system together: SKFPracticeSolutions.com