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Stop losing revenue topreventable billing errors.

Stop losing revenue to preventable billing errors.

Horatio HX delivers HIPAA-compliant, healthcare-trained medical billing specialists — nearshore, in your timezone, integrated with your EHR in weeks. Not offshore. Not software. Dedicated humans who know healthcare billing.

HIPAA compliantSOC 2 Type IIBAA included

Limited Q3 capacity. We prioritize operational integrity over volume. To maintain team quality, we only onboard a select number of new healthcare partners each month.

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Where your revenue is slipping

Most healthcare companies have an execution problem inside billing — not a visibility problem.

  • Preventable claim denials draining revenue

    Up to 40–60% of denials are preventable with the right processes. Most in-house teams don't have the bandwidth to find the root cause.

  • Prior authorization bottlenecks delaying care and cash

    PA is one of the most expensive administrative burdens in healthcare. In-house PA teams are perpetually overwhelmed.

  • Aging A/R that keeps growing — quietly

    Slow claims follow-up means money sitting in A/R for 60, 90, even 120+ days. Every day delayed is cash flow you're not capturing.

  • In-house billing teams that cost too much to maintain

    An RCM specialist costs $55–75K/year. Add benefits, turnover, and management overhead — and you're looking at $85–100K per seat. There's a better way.

The Horatio HX approach

Human-centered medical billing with the precision healthcare demands

  • Healthcare-trained billing specialists who know your vertical — telehealth, diagnostics, GLP-1, behavioral health
  • End-to-end support: charge entry, claims, prior auth, denial management, A/R follow-up, payment posting
  • HIPAA-compliant by design — restricted environments, BAAs, continuous PHI monitoring
  • Nearshore from Dominican Republic, Colombia, Honduras — same timezone, 50–60% lower cost
  • Seamless EHR integration: Athena, eCW, Kareo, DrChrono, NextGen, and more
  • Dedicated teams — no shared agent pools, ever
Measurable outcomes

What many Horatio HX clients typically see

Although results vary by organization, these represent typical outcomes across our healthcare billing clients.

Up to 40%

Reduction in denial-related rework

Typical range: 25–40% depending on vertical

50–60%

Lower RCM labor costs vs. in-house

Compared to fully-loaded US billing team

3–5 wks

From contract to live billing team

Across healthcare verticals and EHR systems

Not software. Not offshore. Not generic.

Every alternative falls into one of two buckets. Horatio HX is deliberately neither.

The two alternatives — and why they fall short

  • Software tools: automate parts of billing, but still require your team to manage the work. No humans. No expertise. No accountability.
  • Offshore BPOs: lower cost, but poor healthcare expertise, timezone friction, weak compliance confidence, and high turnover.
  • Horatio HX: dedicated, healthcare-trained specialists. Nearshore. HIPAA-built. Integrated into your workflows. Accountable for your outcomes.

We're not for everyone — and that's intentional

We work with a limited number of healthcare organizations at any time. Here's an honest look at who gets the most value from Horatio HX.

Strong fit if you are…

  • A growth-stage or mid-market healthcare company scaling billing operations
  • A telehealth, diagnostics, GLP-1, behavioral health, or women's health organization
  • Experiencing high denial rates, slow A/R, or PA bottlenecks you can't fix internally
  • Looking for a dedicated, HIPAA-compliant billing team that integrates into your workflows
  • A Series A, B, or PE-backed healthcare company that won't accept offshore quality trade-offs
  • Ready to launch a billing team within weeks, not months

Probably not a fit if you…

  • Are primarily searching for the lowest-cost outsourcing option available
  • Need part-time, low-volume, or single-task billing support only
  • Are not operating in healthcare or a regulated health-adjacent industry
  • Are not comfortable with nearshore delivery (we don't operate in the US or India)
  • Need a vendor to start immediately with zero onboarding or integration time
How it works

From assessment to live billing team in weeks

A structured, low-friction process that gets your billing team operational without disrupting your existing workflows.

  1. 1

    Free Billing Assessment

    We audit your current workflows, denial patterns, and team structure to find where revenue is leaking.

  2. 2

    Workflow & Compliance Setup

    We design a HIPAA-compliant billing model tailored to your payer mix, systems, and vertical.

  3. 3

    Team Recruitment & Training

    We recruit, hire, and train dedicated billing specialists specific to your workflows and EHR.

  4. 4

    Integration & Go-Live

    Your team is live and integrated into your billing platform in 3–5 weeks. Ongoing QA from day one.

What our clients say

Our clients value discretion and results

Many of the healthcare companies we support consider their operational playbook a competitive advantage — they don't want to publicly associate with outsourcing partners. What we can share: within 90 days, one client's denial rate dropped significantly, their A/R aging improved, and their VP of Revenue Cycle said it was the best operational decision they'd made that year. It just wasn't technically a hire.

On behalf of a Series B digital health client — name withheld by request
The honest comparison

How Horatio HX stacks up

If cheapest matters most, other options exist. If quality, compliance, and measurable outcomes matter, here's the picture.

CapabilityHoratio HXOffshore BPOIn-House TeamBilling Software
Healthcare-trained specialists
Vertical-specific
Generic training
Varies + expensive
No humans
HIPAA compliance + BAA
Built-in + BAA
Claimed, rarely audited
Your responsibility
Partial
US timezone alignment
Nearshore — same hours
Significant overlap issues
Yes
N/A
Dedicated team (no sharing)
Exclusively yours
Shared pools
Yes
N/A
Cost vs. in-house
50–60% lower
40–50% lower
Full cost burden
Needs staff too
Speed to launch
3–5 weeks
6–12 weeks
3–6 months
Weeks (no staff)
Denial management + A/R
Fully managed
Inconsistent
If bandwidth allows
Alerts only
AI-enhanced QA
Built into workflows
Rare
Added cost
Yes
Limited capacity · Q3 onboarding open

Your billing operation should be generating revenue, not leaking it.

Get a free medical billing assessment. We'll review your current RCM setup, identify where denials and delays are costing you, and show you exactly what a Horatio HX billing team would look like for your organization. No obligation. No sales pitch.

  • Free RCM diagnostic — no commitment
  • Reply within 1 business day
  • BAA & HIPAA-compliant by default

Get your free medical billing assessment

Tell us where your revenue cycle stands. We'll show you exactly where you're losing money — and what it would look like to fix it.

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