Stop deciding whether to outsource billing.
Start deciding what to keep.
The in-house versus outsourced question bundles three separate decisions — technology, staffing, and accountability. Answer them together and you sign a commitment. Answer them separately and you keep the option to change your mind.
A field perspective for independent and specialty laboratories, built on percentage-of-allowed benchmarks, a seven-line-item ROI framework, and a self-assessment you can run before you take a single vendor call.
What's Inside
The three decisions
What each one actually determines, and what it costs to reverse.
A seven-line ROI framework
Including the two line items most comparisons leave out entirely.
Five red flags in a vendor evaluation
The signals that a pitch will never reach workflow.
Seven questions to answer internally
A self-assessment that needs no vendor at all.
$4B
—
Less paid by Medicare for lab services since PAMA cuts began in 2018
41%
—
Of providers report denial rates above 10%, up from 30% in 2022
30-40%
—
Annual turnover in billing roles, at $25K–$50K to replace a biller.
97%
—
Of healthcare organizations already outsource at least one revenue cycle function
What is your current billing software costing you?
Slide to your lab's annual net collections and see what TELCOR's published improvement range is worth in real dollars.
Written for the person who has to defend the decision
This is not a case for outsourcing. In-house billing, executed well, produces the best economics available to a lab, and the paper says so plainly — along with the three conditions a lab has to meet to get there.
What it argues is narrower and more useful: that the staffing question should be answered for the lab you are today, the technology question for the lab you might be in three years, and that bundling them is what turns a reversible choice into a permanent one.
Most lab billing problems aren't effort problems, they're tooling problems. A system built for physician practices can't see what a lab loses. TELCOR RCM was built to find it.
"There's no wrong decision. It really is about the decision that best suits your organization. It comes down
to how you want to execute
that control."
KWAMI EDWARDS, CHIEF OPERATING
OFFICER, TELCOR
Contributors
Kwami Edwards — Chief Operating Officer, TELCOR
Sarah Stewart — Vice President, Revenue Cycle Services, TELCOR
Download
In-House, Outsourced, or Both
Read it before your next vendor call. The self-assessment in section seven takes twenty minutes and will change what you ask for.
PDF, 18 pages. An easy, direct download so that you have it on file.
TELCOR: A Great Place to Work™
TELCOR customers see the value of choosing a vendor who has been recognized as a Great Place to Work. This prestigious certification is based on direct feedback from TELCOR employees, reflecting their positive workplace experiences. With decades of POC and RCM leadership, customers trust TELCOR for our transparency, responsiveness, and ability to turn complex processes into reliable measurable financial performance. It's not just software, it's a team committed to elevating every facility it serves.
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TELCOR
Collections Performance
6-12% Increase, Up to 95% of Allowed AmountsOwnership Model
Client-Owned License, No Percentage of CollectionsDenial Management
Highly Configurable Rules EngineCustom Billing Rules
Payer-Level Configuration Tailored to Lab WorkflowsReporting & Analytics
Real-Time Dashboards; Client-Editable ReportingImplementation Support
Red-Carpet Rollout; Consistent Team Through Go-LiveSystem Flexibility & Ease of Use
Built with Lab Input for Practical UseClearinghouse Integration
Works with Client's Preferred ClearinghouseCustomer Support Responsiveness
Direct Responsive Access to Billing ExpertsPricing Transparency
Clear, Upfront Licensing and Billing -
Vendor 1
Collections Performance
Strong, but Proprietary Metrics; Varies by ClientOwnership Model
Revenue Share (%) ModelDenial Management
Advanced Tools with Payer-Specific Denial WorkflowsCustom Billing Rules
Some Customization, Often Requires Vendor InvolvementReporting & Analytics
Rich Reporting, But Not Always Client-AccessibleImplementation Support
Scaled Support Model; Varies by Client SizeSystem Flexibility & Ease of Use
Powerful but Known to be Rigid and ComplexClearinghouse Integration
Limited to Preferred Vendor PartnersCustomer Support Responsiveness
Tiered Model; Slower Response Times ReportedPricing Transparency
Opaque Pricing Tied to Revenue Share and Additional Fees -
Vendor 2
Collections Performance
Competitive but Variable; Depends on ConfigurationOwnership Model
Mix of License & Revenue Share Depending on Client SizeDenial Management
Good tools but less flexible without custom developmentCustom Billing Rules
Custom Rules Available But Less Client-DrivenReporting & Analytics
Strong Executive Reporting; Varies by ImplementationImplementation Support
Mixed Reviews Depending on Contract and Internal ResourcesSystem Flexibility & Ease of Use
Flexible, but Often Requires Vendor-Led ChangesClearinghouse Integration
Supports Multiple, but Integrations can be ComplexCustomer Support Responsiveness
Mixed Experience Based on Assigned Support TeamPricing Transparency
Generally Transparent, but Variable Across Agreements
Or Start With Your Own Numbers
If you already know something is wrong and you would rather not read eighteen pages to confirm it, we will look at your numbers with you: percentage of allowed by payer class, touches per claim, and where the backlog sits.