In home care, the administrative backbone of your agency is only as strong as the people managing it.
For most agencies, a reliable biller ensures steady cash flow, accurate claims, and timely payments.
But what happens when that key biller goes MIA, whether due to illness, vacation, or an unexpected departure?
In this post, we’ll break down the hidden costs of losing a biller, how it affects your agency’s bottom line, and why a dedicated external billing partner can be the solution to avoid operational disruption.
The Financial Impact of Losing a Biller
Let’s face it: losing your biller, even temporarily, can lead to costly interruptions. On average, home care agencies bill between $100,000 and $500,000 monthly, depending on size and services offered. With this level of volume, even minor delays in billing can mean serious cash flow issues that put agency operations at risk.
Here’s what’s at stake:
Delayed Cash Flow: Without someone to manage claims, payments get delayed, and your agency’s cash flow can suffer quickly. This disruption may impact payroll, vendor payments, and the overall financial stability of your agency.
Increased Denials and Errors: Claims processing is complex, and even the smallest mistakes can lead to denials. A dedicated biller is skilled in spotting errors and managing the nuances of claims, so without them, the chance of mistakes—and subsequent denials—skyrockets.
Loss of Revenue: When claims are denied or not submitted on time, revenue takes a hit. Lost or denied claims can cost thousands each month, eroding profits and impacting long-term sustainability.
Higher Workloads for Other Staff: If other team members have to step in and cover billing, their core responsibilities may suffer. This juggling act can lead to burnout, decreased efficiency, and a decline in client satisfaction.
Why a Dedicated Billing Service Can Help
A dedicated external billing service can serve as a safety net, providing expert support that helps agencies maintain seamless billing operations. Here’s how it can help minimize the impact of a missing biller:
Consistent Claims Submission: With a reliable external team managing claims, you can be confident that billing won’t fall through the cracks, even if your in-house biller is unavailable. This consistency keeps cash flow steady and helps maintain financial health.
Expertise in Reducing Denials: An external billing partner brings a specialized skill set to prevent common claim denials. They understand the ins and outs of Medicaid and Medicare billing, as well as private pay requirements, so they can optimize claims for faster, error-free processing.
Scalable Resources: Unlike a single in-house biller, an external service offers scalability. Whether you need full-service billing or a temporary backup, a dedicated billing partner has the flexibility to adapt to your needs.
Improved Focus for Your Staff: With billing covered, your team can focus on providing excellent care. This also means greater peace of mind knowing that billing is handled by experts who can prioritize claims and maximize reimbursement.
Calculating the Cost of Downtime
Imagine your agency loses a biller for just a month. With an average monthly billing target of $200,000, delays or errors can result in a 10-15% drop in collections due to denials, missed claims, or slower processing. This would mean a potential revenue shortfall of $20,000–$30,000 in just one month.
When compounded over time, the financial impact becomes even more significant. Having a backup plan in the form of an external billing partner can be the difference between a temporary setback and a full-blown cash flow crisis.
Final Thoughts
Losing a biller can be costly, stressful, and disruptive—but it doesn’t have to be. By partnering with a dedicated external billing service, home care agencies can safeguard their cash flow, improve accuracy, and ensure billing continuity even when in-house resources are unavailable.
Whether it’s for a short-term fill-in or long-term support, an external billing service can be a reliable solution to maintain financial stability and keep operations running smoothly.