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RCM Vendor Evaluation Calculator

Compare what in-house billing and an outsourced RCM vendor would each net your practice, using your own collection rates, costs, and fee.

RCM Vendor Evaluation — All State RCM
Prepared . Planning estimate only; not a guarantee, quote, or financial advice.

Your numbers

Pre-filled values are examples only. Replace them with your own figures.

Monthly claims submitted

Average billed amount per claim

Current collection rate (in-house)Share of billed charges you collect today.

Proposed collection rate (vendor)Use the rate in the vendor’s written proposal, not a hoped-for figure.

In-house billing cost per monthBilling staff, software, clearinghouse, and related overhead.

Vendor fee (% of collections)Charged on the amount collected, as in most percentage-of-collections contracts.

In-house costs that remain after outsourcing, per monthFor example, a staff member who stays on for front-desk or patient-balance work. Use 0 if none.

Estimated comparison

Outsourced minus in-house, net per year—

Net difference per month—

Break-even vendor collection rate—

Billed charges per month—

Vendor fee per month—

In-house collections / month—

In-house net after billing costs—

Vendor-scenario collections / month—

Vendor-scenario net after fee and remaining costs—

How it works and what it assumes

Billed charges = monthly claims × average billed amount. These are list charges, not cash.
Collections = billed charges × collection rate, calculated separately for the in-house and vendor scenarios.
In-house net = collections − your in-house billing cost.
Vendor-scenario net = collections − (fee % × collections) − any costs that stay in-house.
Difference = vendor-scenario net − in-house net; annual = monthly × 12. A negative figure means the vendor scenario nets less.
Break-even rate = the vendor collection rate at which the difference is zero.
Not included: setup, minimum, or transition fees, contract length, payer mix changes, or seasonality. Claim volume and values are held constant.

Disclaimer: This is a planning estimate based only on the numbers you enter. It is not a quote, a guarantee of results, or financial advice. Do not enter patient information.

Related

Want a written proposal to compare against?

Tell us about your practice and we will walk through scope, reporting, and fees. Please do not include patient information in the form.

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Frequently asked questions

01What does this calculator compare?

It compares monthly net cash from two scenarios: your current in-house billing, and outsourcing at a proposed collection rate and fee. Net means collections minus billing costs, not billed charges.

02Why does the calculator use collections instead of billed charges?

Billed charges are what you list on claims, not what you receive. Payer contracts, adjustments, and denials mean cash collected is lower. Collection rate converts billed charges into estimated cash, and fees and costs are applied to that cash.

03What is the break-even collection rate?

It is the vendor collection rate at which both scenarios net the same amount each month, given your other inputs. If a vendor’s realistic rate is below it, outsourcing nets less on these assumptions.

04Are the pre-filled numbers typical?

No. They are placeholders to show how the tool works. Replace every value with your own reported figures; they are not benchmarks or averages.

05Does this include one-time or hidden costs?

No. It does not include setup fees, minimum fees, transition costs, or other contract terms. Ask any vendor for the full fee schedule in writing and adjust your inputs accordingly.