Three questions, fifteen seconds
Answer three questions to see which jobs to outsource first, and how much you'll save versus doing the same work in house.
HelpSquad Health
What to outsource in your practice
helpsquad.com/what-to-outsource/
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Three questions, no email, no sign-ups to get your answer.
You get one assistant, not a call pool. They are on our payroll, trained on how your office actually works, with a US manager over them and cover for the days they are out.
“Patient outcomes are fundamental to a medical practice, but there is also the business side of it. You only have so much time and energy to make key and critical business decisions. Fortunately, our call center has become one of those things that we don't have to deal with at all because it just runs perfectly.”
“HelpSquad feels like part of our practice - not an outsourced team.”
In business since 2014 · US-managed from Doylestown, PA
Vascular Surgery·Patient intake and call center
1.5 yrs consecutive front-line team stability
A fully managed intake department. Dropped calls eliminated.
One intake team covers 13 offices across three states, with a US account manager, a dedicated team lead, a QA program and a migration off legacy PBX onto Zoom Phone. Clinical staff stopped being pulled off the floor to answer the phones.
Vascular and Vein Institute of the South·Memphis, TN·Ongoing engagement
Cosmetic & Surgical Dentistry·Front desk, scheduling and billing
$100K+ aged AR recovered in 60 days
A six-figure A/R recovery in 60 days.
The practice was sitting on a Dentrix aging report with hundreds of thousands of dollars uncollected past 90 days. A dedicated team worked the backlog and rebuilt the insurance and patient billing workflow at the same time.
Imagine Advanced Dental Arts·Lawrenceville, NJ·Since January 2020
Vascular Surgery·Patient intake and call center
1.5 yrs consecutive front-line team stability
A fully managed intake department. Dropped calls eliminated.
Referral coordination and patient intake moved off the clinical floor at a 13-office surgical group, with a US QA program checking the work and custom weekly analytics showing what came through.
Vascular and Vein Institute of the South·Memphis, TN·Ongoing engagement
Medical·Patient chat and lead capture
9+ yrs continuous patient communication partnership
Nine years of on-brand patient chat.
Every website chat is captured, qualified and written into the client record, and messaging or protocol changes roll out in hours instead of weeks. The engagement has run continuously since January 2017.
Restore·Oak Brook, IL·Since January 2017
Cosmetic & Surgical Dentistry·Front desk, scheduling and billing
$100K+ aged AR recovered in 60 days
A six-figure A/R recovery in 60 days.
Three dedicated dental assistants handle inbound and outbound calls, patient scheduling and Dentrix entry for a practice whose front desk could not cover appointment calls after hours.
Imagine Advanced Dental Arts·Lawrenceville, NJ·Since January 2020
Cosmetic & Surgical Dentistry·Front desk, scheduling and billing
$100K+ aged AR recovered in 60 days
A six-figure A/R recovery in 60 days.
Dentrix data entry and the insurance workflow moved off the in-house team, with the assistants trained on the practice management system from day one rather than learning it on live patients.
Imagine Advanced Dental Arts·Lawrenceville, NJ·Since January 2020
Cosmetic & Surgical Dentistry·Front desk, scheduling and billing
$100K+ aged AR recovered in 60 days
A six-figure A/R recovery in 60 days.
Three dedicated assistants cover inbound and outbound calls for this practice, which has held around the clock patient coverage without adding in-house staff since January 2020.
Imagine Advanced Dental Arts·Lawrenceville, NJ·Since January 2020
Vascular Surgery·Patient intake and call center
1.5 yrs consecutive front-line team stability
A fully managed intake department. Dropped calls eliminated.
The work here was intake and call handling, not billing. What you would get is the same setup: a US account manager, a dedicated team lead and a QA program checking the work, which is what we put behind verification, prior authorization and AR too.
Vascular and Vein Institute of the South·Memphis, TN·Ongoing engagement
Vascular Surgery·Patient intake and call center
1.5 yrs consecutive front-line team stability
A fully managed intake department. Dropped calls eliminated.
Dropped calls and missed referrals were routing patients to regional competitors in a high-stakes subspecialty market. Closing that leak is what this engagement was bought to do, through 20 to 30 percent annual growth.
Vascular and Vein Institute of the South·Memphis, TN·Ongoing engagement
Healthcare / In-home care·Patient intake and scheduling
~50% reduction in operating cost
Nearly 50% cost savings. Better patient experience.
Six patient service representatives and a dedicated team leader cover intake, appointment scheduling and inbound questions across phone and email for a practice with more than 25 providers.
Anonymous in-home care practice·Tennessee, USA·Ongoing engagement
Healthcare / In-home care·Patient intake and scheduling
~50% reduction in operating cost
Nearly 50% cost savings. Better patient experience.
Records, scheduling and patient questions came off a team that was stretched between administrative work and patient communication, and the new team was handling patients proficiently inside two weeks of go-live.
Anonymous in-home care practice·Tennessee, USA·Ongoing engagement
Healthcare / In-home care·Patient intake and scheduling
~50% reduction in operating cost
Nearly 50% cost savings. Better patient experience.
The work here was intake, scheduling and patient questions rather than billing, and it still took nearly half the operating cost out. Six representatives ran it under a dedicated team leader, which is how we staff verification, claims and AR too.
Anonymous in-home care practice·Tennessee, USA·Ongoing engagement
Healthcare / In-home care·Patient intake and scheduling
~50% reduction in operating cost
Nearly 50% cost savings. Better patient experience.
A practice with more than 25 providers was falling behind on patient questions across phone and email. Six representatives and a team leader cleared that backlog, and the patient experience measures moved with it.
Anonymous in-home care practice·Tennessee, USA·Ongoing engagement
Healthcare / White-Label Medical Billing·Full revenue cycle staffing
100+ claims processed per rep per day
30+ billers. 100+ claims per rep per day.
We source, train, supervise and QA a billing floor of more than 30 people under the client name, so the client manages an outcome rather than a headcount.
Anonymous medical billing company·United States·Ongoing engagement
Healthcare / White-Label Medical Billing·Full revenue cycle staffing
100+ claims processed per rep per day
30+ billers. 100+ claims per rep per day.
Billers, payment posters, VOB specialists, UR coordinators, negotiators and appeals specialists cover the whole revenue cycle, all recruited and supervised by us and embedded directly in the client workflow.
Anonymous medical billing company·United States·Ongoing engagement
Healthcare / White-Label Medical Billing·Full revenue cycle staffing
100+ claims processed per rep per day
30+ billers. 100+ claims per rep per day.
The entire back office runs under the client name. Sourcing, training and quality assurance sit with us rather than with them, which is the part a billing company cannot buy off a job board.
Anonymous medical billing company·United States·Ongoing engagement
Healthcare / White-Label Medical Billing·Full revenue cycle staffing
100+ claims processed per rep per day
30+ billers. 100+ claims per rep per day.
Inconsistent quality and turnover were eroding productivity across the revenue cycle. Sourcing, training and quality assurance moved to us, and the team grew from a straight replacement into more than 30 people.
Anonymous medical billing company·United States·Ongoing engagement
Questions on any of these numbers? Call 877-775-3667 or email info@helpsquad.com.
HIPAA compliant with the BAA signed by us. US-managed from Doylestown, PA. In business since 2014.
How the board is scored
Outsource now
A payer, a clearinghouse or HIPAA already defines the steps. The process rules travel with the task, so an outside assistant can run it in week one without you writing anything down. Prior authorization, eligibility, claims, AR and records requests all sit here.
Your steps first
Someone else can do this, but you decide how. Your booking rules, your triage script, your provider templates. We write those steps down during onboarding, from your call recordings and whatever you already have. That costs you a few hours once, and then it is done.
Stays with your team
Licensure, clinical judgment or internal management. Clinical triage, treatment planning, case review and staff management. No vendor should take these, and one who offers to is telling you something about how they operate.
One answer moves work between the first two columns: whether your front office is written down. Practices that have written theirs down can move everything at once. Practices where the process lives in the office manager’s head cannot, and pretending otherwise is how outsourcing engagements fail in month two.
Before you hire anyone
We get paid when you hire people, so take this in the spirit it is offered. Three tasks on the list have a routine path your existing software probably already handles, and paying a person to repeat it is paying twice. What is left once that path is automated is exception work, and that is the part worth staffing. Check both before you check our pricing page.
What to check: Real-time eligibility (the 270/271 transaction) is built into most practice management systems and clearinghouses.
What is left worth staffing: Staff the exceptions: plans your system cannot reach, benefit detail the response does not carry, and anything needing a phone call to the payer.
What to check: Electronic remittance (ERA, the 835 file) auto-posts most payments if your clearinghouse is configured for it. Many practices pay for this and never turn it on.
What is left worth staffing: Staff the reconciliation, the paper EOBs, and the denials that fall out of auto-posting.
What to check: Automated SMS and email reminders are standard in most major PM systems and cut no-shows on their own.
What is left worth staffing: Staff the exceptions only: the confirmations nobody answered, the reschedules, and the patients who need a human call.
If your system already handles the routine path on all three, you have removed a meaningful slice of the load without adding headcount, and faster than hiring for it. What remains is exception work: the payer phone calls, the denials that fall out of auto-posting, and the patients who need a human. That is where a trained assistant earns their rate.
The full scoring table
What we show for each row is the default for a practice whose process is not written down. If yours is, every row that needs your steps first moves to the first column.
Read the hours as ranges, because that is what they are. Each row shows how its range was derived, and the published benchmarks behind those derivations are listed under the table. Rows marked as a planning estimate have no source behind them and say so. Every number is time actually spent doing the work, per provider per week, unless it says coverage. If one of them looks wrong for your practice, yours is the right number and ours is the wrong one. The section below this table tells you how to measure your own in a week.
Every hour below is time actually spent on calls, not hours of coverage. A practice open 40 to 45 hours a week has to answer a phone for all of them whether the volume is light or heavy, and one seat is 40 hours, so coverage is a separate decision from workload and always the larger number.
| Task | What we would do | Lane and rate | Hours per week |
|---|---|---|---|
| Answering inbound patient calls Highest volume, highest interrupt cost to clinical staff. About 40% of 32 to 53 inbound patient calls a day at 4 to 6 min each [5][6] | Your steps first | Patient-facing, $10 to $13/hr | 4.5 to 10.5 hr/wk per provider |
| Scheduling and rescheduling Needs your provider templates and booking rules written down. About 30% of the same inbound call volume [5][6] | Your steps first | Patient-facing, $10 to $13/hr | 3 to 8 hr/wk per provider |
| Reminders and no-show follow-up A person should only work the exceptions your reminder tool misses. Planning estimate against 90 to 110 appointments a week [3] Check your software before you staff this | Your steps first | Patient-facing, $10 to $13/hr | 1.5 to 3 hr/wk per provider |
| New patient intake and registration Revenue-critical. Bad demographics here become denials later. New patients at about 15% of 90 to 110 visits, 10 to 15 min each [3] | Your steps first | Patient-facing, $10 to $13/hr | 2 to 4.5 hr/wk per provider |
| After hours, evening and weekend calls Coverage, not headcount. Scales by hours open, not by provider. After-hours call volume only. Not the same as covering your open week | Your steps first | Patient-facing, $10 to $13/hr | 3 to 6 hr/wk coverage, not per provider |
| Portal messages and patient inbox Non-clinical replies transfer. Clinical replies stay with you. 15 to 25 patient messages a day at 2 to 4 min each [7] | Your steps first | Back office, $8 to $10/hr | 2.5 to 5 hr/wk per provider |
| Prescription refill requests An assistant can handle these up to your standing orders, but the approval stays clinical. About 10% of inbound call volume [5][6] | Your steps first | Back office, $8 to $10/hr | 1 to 2.5 hr/wk per provider |
| Task | What we would do | Lane and rate | Hours per week |
|---|---|---|---|
| Insurance verification and eligibility Run it 48 hours ahead of the visit. Verifying on the day of service is where the denials come from. 63 to 99 checks a week at 4 min electronic to 8 min by portal [1][3] Check your software before you staff this | Outsource now | Back office, $8 to $10/hr | 5 to 12 hr/wk per provider |
| Prior authorizations The single biggest recoverable block of provider time. 39 prior auths a week at 16 to 24 min, staff share of the 13 hr total [1][2] | Outsource now | Back office, $8 to $10/hr | 6 to 12 hr/wk per provider |
| Claims submission and denial follow-up Hold it to two numbers: days to submit, and share of denials worked inside 14 days. 90 to 110 claims a week, 8 to 12% denied and reworked at 12 to 25 min [1][3][8] | Outsource now | Back office, $8 to $10/hr | 3 to 8 hr/wk per provider |
| AR follow-up and patient collections Aged AR is the fastest place to show payback on a first hire. 20 to 40 claim status inquiries at 10 min by portal to 25 min by phone [1] | Outsource now | Back office, $8 to $10/hr | 3 to 8 hr/wk per provider |
| Payment posting and EOB processing Check your clearinghouse for auto-posting before you staff this. 20 to 40 remittances a week at 5 to 9 min each [1] Check your software before you staff this | Outsource now | Back office, $8 to $10/hr | 1.5 to 4 hr/wk per provider |
| Credentialing and payer enrollment Bursty work. Usually a slice of a seat rather than a whole one. Planning estimate. Episodic work, not weekly | Outsource now | Back office, $8 to $10/hr | 0.5 to 2 hr/wk per provider |
| Task | What we would do | Lane and rate | Hours per week |
|---|---|---|---|
| Documentation and scribe support Needs per-provider templates and a shadowing period first. 1 to 2 hr of the 157 min daily clerical EHR load, per clinic day [9] | Your steps first | Back office, $8 to $10/hr | 5 to 10 hr/wk per provider |
| Medical records requests and release The 30-day HIPAA response clock runs whether or not anyone is watching it. Someone has to. Planning estimate | Outsource now | Back office, $8 to $10/hr | 1 to 3 hr/wk per provider |
| Referral coordination Depends on your referral network and your specialists preferences. Planning estimate: 9 to 11 referrals a week at 15 to 25 min | Your steps first | Patient-facing, $10 to $13/hr | 2 to 4.5 hr/wk per provider |
| Lab and imaging result routing Routing and chasing transfers. Interpreting never does. Planning estimate against 90 to 110 visits a week [3] | Your steps first | Back office, $8 to $10/hr | 1.5 to 3.5 hr/wk per provider |
| Task | What we would do | Lane and rate | Hours per week |
|---|---|---|---|
| Recall and lapsed patient outreach Usually the first thing dropped when the front desk is underwater. Planning estimate | Your steps first | Patient-facing, $10 to $13/hr | 1.5 to 3.5 hr/wk per provider |
| Review responses and reputation Templated replies plus your escalation rule for anything negative. Planning estimate | Your steps first | Back office, $8 to $10/hr | 0.5 to 1.5 hr/wk per provider |
| Outbound campaigns and payer lists Project work. Staff it in blocks rather than permanently. Planning estimate. Project work, not steady state | Your steps first | Patient-facing, $10 to $13/hr | 1 to 4 hr/wk per provider |
None of this can leave your practice at any price, so there are no hours and no rate against it. It is here because a staffing plan that pretends this work does not exist is a plan you cannot keep, not because there is anything to quote.
| Task | What we would do | Lane and rate |
|---|---|---|
| Clinical triage of symptom calls Licensure. An assistant can take the call and route it, never assess it. | Stays with your team | Keep in house |
| Staff scheduling, payroll and HR Internal management. Delegating it outward costs you the culture. | Stays with your team | Keep in house |
| Treatment planning and case review This is clinical judgment, so it cannot be handed off at any price. | Stays with your team | Keep in house |
Twelve published benchmarks: ten behind the hours, two behind the dollars. The arithmetic on each row above shows how we used them, and rows labeled a planning estimate are not covered by any of these, which is why they say so.
Coverage is the one number no benchmark here answers. We assume a practice is open 40 to 45 hours a week, which is an assumption and not a measurement, because no public dataset we could find reports mean hours of operation for US medical offices. The nearest measured anchor is the 33.2-hour median of scheduled patient time in source 4, and a front desk is open longer than that.
The five real objections
One of these five is usually the actual blocker, and it is rarely the one people lead with on a call. Find yours and read our answer before you book anything.
Here is the whole number. A patient-facing assistant runs $10 to $13 an hour and a back-office assistant runs $8 to $10, billed on hours worked. There is no upfront cost, no implementation fee, and no charge to replace an assistant who is not a fit.
The comparison that matters is not our rate against a US wage. It is our rate against what the unanswered calls and the aged AR are already costing you. Bring one month of AR aging to the call and we will do that math together.
HelpSquad signs the BAA as the company, not the individual assistant. Your assistant works inside a HIPAA-compliant virtual desktop, so patient data never lands on a personal machine and access is revoked centrally the moment it needs to be.
We are a business associate, not a covered entity. We handle your data under your rules, inside the systems you already use. Bring your compliance lead to the call.
That is the right objection, and it is the one most outsourcers dodge. Training is our job, not yours. We write your process down ourselves, from your call recordings, whatever you already have and a period of shadowing your staff. The assistant learns from that.
It is also why the middle column exists. Anything governed by payer rules moves in week one without you writing a word. Anything governed by your preferences needs a few hours of your time up front, once, and then never again.
You are describing the churn loop: hire, train, lose them, start over, and every cycle costs you the institutional knowledge that lived in that person’s head.
We manage the employment relationship, the QA and the backup coverage. If your assistant is out, someone who already knows your account covers. If the fit is wrong, we replace at no cost. The written process stays even when a person does not.
The scoring table on this page is the answer to exactly that. Some of it cannot be, and we put that in writing rather than pretending otherwise.
The split is usually the reverse of what people expect. Work that feels most practice-specific, like scheduling, is mostly your rules written down once. Work that feels most technical, like prior authorization, is governed by the payer and transfers almost immediately.
What to do Monday
Our benchmarks are a starting point. Yours are the real thing, and getting them costs you four small tasks and one week of nobody changing their behavior. Do this before you talk to any vendor, us included. It is the difference between buying a staffing plan and buying a guess.
Pull the call report from your phone provider for the last full month: total inbound, answered, abandoned, and average time to answer. Almost every VoIP system has this and almost nobody looks at it. Abandoned calls are the cleanest revenue proxy you have.
Pick the single task that feels worst, usually prior authorization or the patient inbox. Have whoever does it log start and stop times for one week. Do not estimate from memory. Estimates from memory are the reason most staffing plans are wrong.
Total AR, then the 90-plus bucket as a share of it. If the 90-plus bucket is over 20 percent, AR follow-up is your highest-payback lane regardless of what the rest of this page says.
Take the job from step two and write the steps as bullet points. Thirty minutes, no formatting, no polish. If you can do that, the job can move to the first column right away. If you cannot, you have found the real bottleneck, and it is not staffing.
At the end of the week you will have four numbers: abandoned calls, hours on your worst task, your 90-plus AR share, and whether you can write a process down. Those four decide the staffing plan. Everything above this line is scaffolding to help you find them.
Common questions
Start with work a payer or regulator already defines: insurance verification, prior authorizations, claims and denial follow-up, AR follow-up, and medical records requests. The process rules travel with the task, so an outside assistant can run it in week one without you writing anything down. Prior authorization is usually the single biggest recoverable block of provider time.
Anything requiring licensure or clinical judgment. Clinical triage of symptom calls, treatment planning, case review, and the final approval on a refill all stay with your clinical team. Internal staff management, payroll and performance conversations should also stay in house. A vendor who offers to take these is telling you something about how they operate.
Ask who owns the rules. If a payer, a clearinghouse or HIPAA sets the steps, the job can move today. If you set the steps, it can still move, but someone has to write those steps down first. That is a few hours of your time once during onboarding. Only a license or clinical judgment makes a job impossible to hand off.
HelpSquad engagements start at 20 hours a week on a three-month initial term, then roll three months at a time with 30 days notice. Most practices are better served starting with one lane at 20 to 25 hours and expanding once it is running quietly than by staffing four lanes at once.
Back-office work such as billing, claims, AR, data entry and scribing runs $8 to $10 an hour. Patient-facing work such as front desk, scheduling, intake and calls runs $10 to $13 an hour. Three or more assistants with a team lead, QA and a trainer is priced as a managed team. Every tier includes a dedicated account manager and a HIPAA-compliant virtual desktop with a signed BAA, with no upfront cost, no implementation fee and no charge to replace a bad fit.
Yes, when the vendor is set up as a business associate. HelpSquad signs the BAA at the company level rather than with the individual assistant, and assistants work inside a HIPAA-compliant virtual desktop so patient data never lands on a personal machine and access can be revoked centrally.
They are planning estimates, not measurements. Hours are benchmarked per provider per week against typical load for each practice type, then scaled by your provider count and adjusted upward when you report heavy unanswered call volume. Treat the output as a starting point for a conversation rather than a quote. Your own numbers will always beat a benchmark.
A 30-minute call. No sales pressure. We'll tell you honestly whether we're a fit.