Dental billing services vs AI software vs in-house
An in-house team does the billing by hand in your practice system, an outsourced dental billing service does it for you, and AI billing software automates the volume while your team handles the exceptions. The right choice depends on who you trust with decisions, how fast you need payments posted, and whether you keep the data and the know-how.
Book a demoBy Dr. Maya Arnaout, DDS, VP of RevenuePublished Updated 6 min read
Key takeaways
- In-house means your staff do the billing in your practice system. A billing company does it for you. Software automates the work and leaves the exceptions to your team.
- The three differ less on what gets done than on who decides, how fast it happens, and who knows how your billing works.
- Check the scope: many billing companies submit and follow up claims; much billing software starts once the payer has paid.
- Whatever you choose, make sure the data, the logins and the history stay yours.
- Many practices combine them: software for the volume, people for the judgment.
The three ways to run dental billing
Dental billing is the work after the visit: claims to send and follow, insurance payments to read and post, patient balances to collect, deposits to match and books to close. See dental revenue cycle management for the whole cycle. Someone has to do each part, and there are three ways to arrange it.
In-house
Your own staff do the billing in your practice management system, often a dedicated biller in a larger office or the office manager and front desk in a smaller one.
An outsourced billing service
An outside team does the billing for you, usually logged into your practice system remotely. DayDream, for example, is a full-service dental billing company: according to its website, a US-based team with AI help verifies insurance, submits and works claims, posts payments and follows up with patients. See ScoutIQ vs DayDream.
Billing software
Software works on top of your practice system and does the volume itself: reading remittances, posting them, matching deposits, sending reminders. Your team keeps control and handles the exceptions. The best dental billing software guide compares fourteen tools, and how ScoutIQ AI is priced explains what a software quote is built from.
Billing company vs software vs in-house, compared
None of the three is better at everything. Here is how they differ on the things practices ask about most.
| Compared on | In-house | Billing company | Billing software |
|---|---|---|---|
| Who does the work | Your staff, in your practice system | An outside team, usually logged into your practice system | The software, on top of your practice system; your staff handle the exceptions |
| How it is paid for | Salaries, benefits, training, and cover when someone is out | Usually a percentage of collections or a fixed monthly fee; check each contract | Usually a subscription per location or seat, or a share of what it processes |
| Control | Full: you set every rule | Rules and day-to-day decisions sit with the outside team | You set the rules; the software follows them and shows every change |
| Speed | Depends on staffing; work piles up when someone is out | Depends on the service level; ask for it in writing | Runs as remittances and payments arrive |
| Who handles exceptions | Your staff | The company’s team | Your staff, from a queue with the reason attached |
| Claims submission and follow-up | Your staff | Often included; check the scope | Depends on the product: some start only once the payer has paid |
| Data and know-how | In your systems and your team’s heads | In your systems, but notes and process may sit with the company | In your systems, with reporting on top |
| Adding a location | Hire or stretch the team | Extend the contract | Connect the location |
Check the scope before comparing
When each one fits
In-house fits when
You have an experienced biller who stays, volume one or two people can keep current, and you want every decision made inside the office. The risk is that the process lives in one person: when they leave or are out, the work stops.
A billing company fits when
You have no one to do the billing, or keep losing the people who do, and you want the whole job handled, often including claims and patient statements. The trade is control and visibility: ask how you will see the work, and what happens if you leave.
Billing software fits when
You have a team, but it spends its days keying EOBs, matching deposits and chasing balances. Software takes the volume and leaves the judgment calls to people who know your patients. It needs someone to own the exceptions.
Questions to ask before you decide
Ask a billing company
- What exactly is in scope: verification, claims, posting, denials, patient statements, reconciliation?
- How fast is each remittance posted after it arrives, and is that in the contract?
- Who on your team works our account, and how do we see what they did today?
- Do we keep every login, and can we export the work notes and history if we leave?
- How are you paid, and what counts toward the percentage or the fee?
- Will you sign a Business Associate Agreement?
Ask a software vendor
- Which of our practice management systems do you post into, not just read from?
- What share of payments match with no human review, and what happens to the rest?
- Where does your work start: before claims are sent, or once the payer has paid?
- Do you reconcile to the bank and to our accounting system?
- How long until we are live, and what do we have to provide?
- Will you sign a Business Associate Agreement?
Combining them
The choice is rarely all or nothing. Common combinations: software posts payments and reconciles the books while an outside team works claims and appeals; software runs in-house and an outside team is brought in to clear a backlog; or a billing company runs its work on software the practice can see.
Whatever the mix, write down where each side’s work starts and stops, and keep the logins, the data and the history in your own systems. That is what lets you change the arrangement later without starting over.
Where ScoutIQ fits
ScoutIQ is billing software, not a billing company. It works on top of 59 practice management systems and starts once the payer has paid or denied a claim: it does not submit or resubmit claims. It reads every ERA and paper EOB, including paper sent to a ScoutIQ PO Box, and posts them; 95% of insurance payments match their EOB with no human review. Short pays and denials go to your team with the payer’s reason and the days left to appeal.
It also collects patient balances and reconciles every payment to the bank and QuickBooks or Xero: see reconciliation. Your team keeps control and handles only the exceptions. Most practices are live in 48 hours.
ScoutIQ product
Insurance Billing Automation
Insurance Billing Automation
ERAs and EOBs read; EFT, check and card payments reconciled.
See Insurance Billing Automation