For multi-location groups, medical chains & large practices

Eleven locations. Eleven different ways of doing the same thing. That's the real problem.

Each office runs its own playbook. One location's AR is clean; another's is buried. Your reports tell you the what — they can't tell you the why. And your payroll keeps growing while your standardization doesn't.

Hired Billing Support becomes your remote operations department — a standardized, accountable layer that runs RCM, AR, prior auth, scheduling, and operations management across every site. One playbook. One scoreboard. One team you don't have to recruit.

— Multi-site command center · Live

Austin
Collections96%
AR days22
Clean rate98%
Dallas
Collections93%
AR days26
Clean rate97%
Houston ⚠
Collections71%
AR days58
Clean rate89%
Phoenix
Collections94%
AR days24
Clean rate97%
Denver
Collections87%
AR days34
Clean rate95%
Tampa
Collections92%
AR days27
Clean rate96%
The growth tax

You've grown. The operational complexity has grown faster.

You added the fourth location and it felt fine. The seventh started to strain. By eleven, every operational meeting is a tour of which office is broken this week.

You have an office manager at every site. They're good. But they all manage slightly differently. Your highest-collecting location is great because Linda is great — not because the system is great. If Linda leaves, the location regresses. You know this because it happened in Phoenix last year.

You have a billing director at HQ. She's drowning. She's overseeing eleven separate workflows that should be one workflow.

Payroll has grown 40% in two years. Collections growth hasn't kept pace.

You don't need more people. You need a different operating model.

01
Eleven locations, eleven workflows.
Standardization decays as you scale. What was once "how we do things" becomes "how each office does things." Reporting gaps widen. Quality varies by site.
02
Performance depends on people, not systems.
Your best office is best because of a person. When that person leaves, the location moves. That's not a business — that's a craft shop.
03
Payroll is outpacing collections.
You added three billers, two MAs, and a coordinator last year. Collections grew 6%. Operational margin shrank. The math is heading the wrong direction.
04
Reporting tells you what, not why.
AR is at 41 days. Houston is at 58. You see it on the dashboard. You don't see why. Or who. Or what to do about it.
05
Standardization is a project nobody finishes.
Every quarter someone writes a new SOP doc. Three offices adopt it. Two don't. Six adopt the parts they like. By next quarter, it's stale.
06
Talent acquisition is consuming leadership time.
Your billing director is interviewing instead of optimizing. Your COO is recruiting instead of strategizing. You're solving last quarter's hiring problem while next quarter's bottleneck builds.
What's actually happening behind the scenes

You don't have an execution problem. You have an operating model problem.

Most multi-location groups grow the same way: replicate the original office, hire a manager, hope it works. It scales until it doesn't — usually somewhere between 5 and 12 locations, where the cost of inconsistency starts to outweigh the cost of the next hire.

At that point, the answer isn't "hire harder." It's not "buy better software." It's: standardize the operational layer across the entire group, and run it from one accountable place.

What the standardized layer looks like
  • One billing operation across all locations, not eleven
  • One AR follow-up team working a single aging report, not eleven
  • One prior-auth queue across all providers, with payer-specialized routing
  • One front-desk overflow team supporting every location during volume spikes
  • One operations lead embedded with your COO, owning KPIs across all sites
  • One real-time dashboard showing performance by site, by provider, by payer
That's the remote operations department. That's what we build for groups.
— Our model

We become your remote operations department.

Hired Billing Support gives multi-location groups a standardized, embedded operations layer that runs the work consistently across every site — at a fraction of the cost of doing it in-house. Same SOPs everywhere. Same KPIs. Same accountability.

You'll have a dedicated operations lead from our side who functions as a department head — reporting into your COO, owning the operational scorecard across all sites, and managing the team that executes underneath them.

Your office managers stop fighting fires and start managing patient experience. Your billing director stops chasing eleven workflows and starts running one. Your COO stops recruiting and starts strategizing.

The chaos doesn't disappear because you wished it away. It disappears because someone is finally running it as one operation.

What we run for enterprise groups

The full operational stack — standardized.

Every capability built to run across multiple sites, multiple EHRs, and multiple specialties from a single accountable layer.

Centralized RCM

One billing operation across every site. Same SOPs, same QA standards, same KPIs. Site-level reporting, group-level dashboard.

Centralized AR Follow-Up

One AR team working a single consolidated aging report. Payer-specialized routing. Cleared systematically, not opportunistically.

Centralized Prior Authorization

Single queue across all providers and specialties. Payer-specialized authorizers. Turnaround tracked at the group level.

Insurance Verification at Scale

Verifications batched and processed for every site's next-day schedule. Real-time visibility into coverage issues before patients arrive.

Front Desk Overflow & Coverage

Phone overflow during volume spikes, after-hours coverage, full virtual front desk for new locations during ramp.

Operations Management Layer

A dedicated ops lead embedded with your leadership, owning standardization, KPIs, vendor management, and continuous improvement.

Group-Level Reporting & Analytics

Consolidated dashboards showing site comparison, provider comparison, payer comparison — with drill-down to root cause.

New Location & M&A Integration

When you open or acquire a site, the operational layer is already standardized and ready. Billing and ops integrated within 30-60 days.

How we work

We become a department of your organization.

— 02

Standardized SOPs.

We work with leadership to define one operational standard, then enforce it consistently. No more "how each office does it."

— 03

One scorecard.

Collections by site, AR by site, clean-claim rate, denial rate, prior-auth turnaround. Real-time. Drill-down.

— 04

We work in your systems.

Whatever each site uses. If you've consolidated, we work in that. Mid-migration? We work in both.

— 05

Scale with your growth.

New location? Operationally ready before the doors open. Acquisition? Integrated within 60 days. Growth doesn't break the operation.

AI + human at enterprise scale

At enterprise scale, AI is the only way the math works.

A 12-location practice generates the operational volume of a hospital. The only way to run it efficiently is to use AI for the repetitive lifting — eligibility checks, claim scrubbing, denial categorization, document classification — and put trained humans on the work that requires judgment.

We've built our enterprise model around that ratio. AI handles the volume. Specialists handle the judgment. Leadership handles the strategy.

That's the only model that doesn't break at scale.

By the numbers

What standardization looks like in numbers.

Drawn from multi-location clients (5–30+ locations) across primary care, dental, behavioral health, urgent care, and multi-specialty groups.

+20%
Group-wide collections lift within the first two quarters.
45%
Lower operational cost versus equivalent in-house build.
28d
Standardized AR days across all sites within 6 months.
97%+
First-pass clean-claim rate consistently across all sites.
-60%
Reduction in site-to-site performance variance.
-70%
Leadership time spent recruiting and managing operations.
Working with HBS has been a game-changer. The team is professional, responsive, and has streamlined our billing operations seamlessly.
HM
Herma Thompson PMHNP-BC
Nurse Practitioner - Psych/Mental Health
The honest comparison

Why not build a centralized billing office in-house?

It's the right question. Many groups try. Here's the trade-off honestly.

Build centralized BO in-house
Embed HBS as remote ops dept
12–24 months to stand up
30–60 days to live
Real estate, infrastructure, fixed cost
Variable cost — scales with you
Hiring 20–40 FTEs
We provide the team
25–30% admin overhead on payroll
None
You bear attrition risk
We absorb it
Capped by your local labor market
Trained healthcare specialist pool
One more business to run
Operations runs itself. You focus on growth.
For groups at 5+ locations, the math almost always favors embedding versus building. Not because building doesn't work — but because the opportunity cost of leadership time spent building operations is higher than the cost of leasing them.
Let's look at the whole operation

One call. Every site on the table. Let's find the leaks.

Give us a 60-minute discovery call. We'll review your operational structure across locations, identify where standardization moves the most dollars, and come back within 10 business days with a phased integration plan. If we're not the right fit, we'll tell you and recommend an alternative.

Mutual NDA · BAA · SOC 2 aligned · Enterprise references available
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