Home / Ask Remi / Should you outsource billing, hire, add remote staff, or fix the process?
Remi · Decision · Updated October 2026
Should you outsource billing, hire, add remote staff, or fix the process?
Five answers, each a band. Remi ranks the five options, shows who on the bench disagreed, and tells you what would flip the call. One of the five is "stay in-house", and it wins more often than a billing company would like.
Practices under about $300,000 in collections with a simple payer mix are usually better off in-house. Above that, the decision turns on the denial rate and on who owns the whole cycle today, which is what the questions below establish.
Remi is built by Recura Health, which sells RCM and remote staffing. The Skeptic’s seat argues against that in every call. No AI model: rules written from this site’s published guidance. For practice operations, not clinical advice. If you are a patient in crisis, call or text 988.
Ask first
If a band that changes the answer is missing, Remi asks it before making a call. "Don't know" is always an option and only lowers the confidence label.
Every number has a source
Dollar figures come from the pricing page and the service pages, each with the date it was last checked. A figure with no source is not shown.
In-house is always on the list
The Skeptic’s seat argues for keeping billing in-house. When that argument wins, the memo says so and no vendor appears.
Questions practices ask about this decision
When should a behavioral health practice keep billing in-house?
When collections are under roughly $300,000, the payer mix is simple, and first-pass denials are under 10%. At that size a vendor's monthly floor dominates the percentage, and the knowledge stays with your own staff.
When is outsourcing billing the right call?
When first-pass denials run over 20% or more than 30% of AR is older than 90 days and nobody owns the whole cycle. Below those marks, fixing the process with the staff you have usually moves the numbers first.