A realistic annual model for a single-biller O&P practice collecting $3,000,000 a year — built from current CMS, BLS, Federal Reserve, Gallup and claim-journey data, not guesswork. Every source is listed at the foot of this page.
$3M / yr · 1 RCM specialist
Billing cost isn’t a salary — it’s a salary plus the hours it consumes, the capital it ties up, and the revenue it quietly loses. Here it’s all on one line each.
Insurance-rule education and compliance alone runs roughly 200 hours a year for an in-house medical biller and 50 hours a year for each O&P clinician — real time pulled from claims work and patient care, priced here at each person’s own fully loaded hourly rate.
Replacing an employee costs 0.5×–2× their annual salary, and U.S. employers lose roughly $1 trillion a year to voluntary turnover, per Gallup’s analysis of national workforce data.6
Absenteeism, turnover and burnout rarely show up as their own line item — until the biller is out and the claims aren’t moving.
* Compass Complete replaces the in-house biller role with our RCM team; there is no separate biller salary on our side.
† Cost of capital on carried terms and Time value of money — aging A/R are two different exposures, not one cost counted twice. The first is on the payables side: components bought on manufacturer and distributor terms come due before the claim pays, so the practice finances the gap. The second is on the receivables side: revenue already earned but not yet collected. Both are discounted at the same rate (3); neither includes the other.
Every figure above is either a published statistic or a stated assumption. Both are itemised in Sources & assumptions at the foot of this page.
That’s how much more this $3M-collections O&P clinic spends every year running billing in-house compared to Compass Complete’s full-service model — and that’s before counting the owner’s own time, stress and attention pulled away from patients and the rest of the practice.
This model uses current published data plus disclosed assumptions for a $3M-collections, single-biller clinic. Every input — collections volume, biller salary, compliance hours, clearinghouse cost — can be swapped for your own.
Every figure in the model above is either a published statistic or a stated assumption. Both are listed here, labelled, so you can check the first and argue with the second. Rates and wage data are as of the dates shown.
U.S. Bureau of Labor Statistics · bls.gov/oes
Base wage for the in-house billing role (SOC 29-2072, Medical Records Specialists; SOC 43-3021, Billing and Posting Clerks).
U.S. Bureau of Labor Statistics · bls.gov/news.release/ecec
Benefits load applied to the base wage. Private-industry benefits ran 30.1% of total compensation ($14.01 of $46.60 per hour worked), which is what turns a salary into a fully loaded cost.
Board of Governors of the Federal Reserve System · 6.75% as of September 3, 2026 · federalreserve.gov/releases/h15
The borrowing rate applied to capital the practice is carrying — on the payables side, components bought on manufacturer and distributor terms (Cost of capital on carried terms), and on the receivables side, revenue earned but not yet collected (Time value of money — aging A/R).
Centers for Medicare & Medicaid Services · cms.gov/medicare/payment/fee-schedules/dmepos
Allowed amounts for the L-coded devices behind the claim values and collections volume the model is built on.
OP Solutions cost model, disclosed input
2.0% of annual collections lost to denials, underpayments and unworked claims running billing in-house ($60,000 on $3M), against 0.5% residual leakage on Compass Complete ($15,000).
Gallup, March 13, 2019 · gallup.com
Replacing an employee costs one-half to two times their annual salary — Gallup calls that a conservative estimate — and U.S. employers lose roughly $1 trillion a year to voluntary turnover.
OP Solutions cost model, disclosed input
$5,800 a year, applying the low end of Gallup’s replacement range (source 6) against the expected annual turnover probability for a single billing seat, plus coverage cost for days the seat is empty.
OP Solutions cost model, disclosed input
200 hours a year for the in-house biller and 50 hours a year for each clinician, priced at each person’s own fully loaded hourly rate (sources 1 and 2).
OP Solutions Compass platform · aggregated, de-identified claim records
Observed days from date of service to payment across client practices, which sets the period the receivable is discounted over in Time value of money — aging A/R.