[This post was originally published on 13th January 2022. It has been updated on 12th May 2025]
Chiropractic billing is one of the most crucial components of running a profitable and sustainable practice. However, it’s also one of the most time-consuming and complex aspects, especially as your practice grows.
Many chiropractors eventually find themselves asking:
“Should I outsource my chiropractic medical billing?”
“Is itcheaper to outsource chiropractic billing?”
Let’s explore the pros, cons, and latest trends around outsourcing chiropractic billing services vs. keeping billing in-house, and help you make the right decision for your practice in 2025.
When Do Most Chiropractic Clinics Start Outsourcing Billing?
Most chiropractors begin by handling billing in-house, either doing it themselves or having an administrative staff member manage claims. But as the practice expands and patient volume increases, so does the complexity of billing and insurance follow-ups. Here’s when many practices consider outsourcing:
- When patient visits exceed 100–150/month
- When claims processing and denial rates become hard to manage
- When hiring, training, and retaining billing staff becomes expensive
- When in-house billing starts affecting focus on patient care
If your practice is generating over $50,000 annually and you’re feeling the burden of managing billing and collections, it might be time to outsource chiropractic billing services.
Pros of Outsourcing Chiropractic Billing Services
1. Cost Efficiency
Outsourcing eliminates the need for payroll, employee benefits, software licenses, and ongoing training. Most chiropractic billing outsourcing companies charge between 4%–8% of collections, which is often cheaper than in-house staff when factoring in hidden costs.
Example: If you collect $20,000 per month and pay a 5% fee, your cost is $1,000, less than what you’d pay for even a part-time biller with benefits.
2. Time Savings
When you outsource your billing, your team is instantly freed from the mountain of admin work tied to insurance claims, rejections, and follow-ups. No more long hold times with insurance companies or digging through EOBs, your front desk can finally breathe.
Instead of juggling billing tasks, your staff can focus on what truly grows your practice: building stronger relationships with patients, improving check-in experiences, and ramping up your marketing or recall efforts.
3. Access to Trained Experts
Chiropractic billing isn’t just data entry, it’s a complex dance of codes, modifiers, and payer rules that change constantly. When you outsource, you gain access to certified billing pros who live and breathe this stuff.
Billing experts know how to avoid coding pitfalls, ensure proper documentation, and submit claims that get approved the first time. They keep up with CPT Codes and ICD-10 changes so you don’t have to, ensuring every dollar you’ve earned gets reimbursed, fast.
4. Faster Payments and Lower Denial Rates
Outsourced billing teams work quickly, and more importantly, consistently. They follow up on denied or delayed claims within days, not weeks, and rework rejected submissions efficiently to minimize delays.
The result? Reduced accounts receivable (AR) days, a healthier revenue cycle, and fewer “where’s the money?” headaches for your practice.
[Must Read: How zHealth Helped A Chiropractic Clinic Reduce AR By 32.8% In Just One Week]
5. Detailed Reports and Transparency
Think outsourcing means losing visibility? Think again. Top-tier billing companies provide clear, consistent reporting, weekly, biweekly, or monthly, so you can track performance, spot issues early, and make data-driven decisions.
From claim volume to payer trends and denial reasons, you’ll always have a clear picture of your financial health without spending hours inside your billing software.
6. Scalability
Planning to add a new provider? Launching another location? Increasing patient visits? With an outsourced billing partner, scaling is simple. You don’t need to scramble to hire, train, or onboard new staff just to handle extra claims.
Billing companies are built to scale with your practice. Whether you see 100 or 1,000 patients a week, your billing operation remains seamless, and stress-free.
B. Cons of Outsourcing Chiropractic Billing
1. Variable Cost Structure
Most outsourced billing services charge based on collections, so your cost may increase in high-revenue months. However, this is usually offset by the increased efficiency and fewer claim denials.
2. More Flexibility
Whether you want to change the billing process, improve the coding practices, or introduce new payment methods, it is easier to pass on
instructions to the billing team working in-house and execute procedures with greater flexibility.
3. Choosing the Right Partner is Critical
Not all chiropractic billing companies are equal. Some lack experience with chiropractic-specific codes, don’t offer real-time reports, or charge high fees. Always vet a billing company by asking key questions like:
- Do they specialize in chiropractic billing?
- What’s their average claim denial rate?
- What’s their turnaround time for rejected claims?
- Can they integrate with your EHR or practice software?
Tip: Start with a company that has experience in chiropractic billing and is transparent about fees, reports, and communication.
Is It Cheaper to Outsource Chiropractic Billing?
In most cases, yes. Outsourcing your billing can reduce your total cost while improving cash flow, especially if your in-house billing isn’t efficient or you’re managing billing yourself.
Here’s a quick cost comparison:
| Billing Option | Monthly Cost Estimate | Staffing Issues | Claims Follow-up | Coding Updates |
| In-House (1 Biller) | $3,000–$5,000+ | Yes | Often Delayed | Risk of Errors |
| Outsourced Billing | $800–$1,500 (based on 5–7%) | No | Timely | Always Updated |
Trends in Chiropractic Billing for 2025
As we move into 2025, here are key trends influencing chiropractic billing:
- Increased payer scrutiny of documentation and coding
- Rising costs of employee salaries and software licenses
- Higher patient volumes from insurance and personal injury cases
- Increased demand for cash-based and membership models
- Growth of hybrid practices (chiropractic + acupuncture or massage)
Outsourcing helps practices handle these complexities without overloading their internal staff.
Conclusion: What’s Right for Your Practice?
Outsourcing chiropractic billing is becoming a smart, scalable, and cost-effective option for clinics looking to improve collections and reduce administrative burdens. In-house billing may work well for smaller clinics with low patient volumes, but once you cross 100+ visits/month or $50,000+ in annual revenue, outsourced chiropractic billing services often deliver better ROI.
Still unsure what’s right for your practice?
Talk to our billing specialists about how you can improve your revenue cycle, so you can focus on patient care.
Next reads:
5 Chiropractic Medical Billing Strategies to Boost Your Monthly Revenue
A Complete Guide to Chiropractic Billing and Coding
Top 8 Free Chiropractic Medical Billing Resources
Maximize your Revenue with Free Chiropractic Billing Calculator
5 Chiropractic Medical Billing Strategies To Boost Your Monthly Revenue
