Pricing
Medical Billing Pricing Based on What We Collect
Our fee is a percentage of the payments we collect for you, quoted in writing for your practice. The quote lists what is included and anything priced separately, so you can compare it fairly with your current costs.
Engagement options
Choose the Scope That Fits Your Practice
Every option is quoted after a short review. Specialty, volume, payer mix and scope change the work involved, so we do not publish fixed price tags.
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Front desk stays in house
Medical Billing
For practices that handle registration and eligibility themselves and want claims, payments and denials managed.
Quoted per practice
Percentage of collections
- Claim scrubbing and submission
- Rejection and denial work, including appeals
- Payment posting from remittances
- Follow-up on unpaid claims
- Monthly reporting and review
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End to end
Front end to final payment
Revenue Cycle Management
For practices that want the whole cycle managed, from eligibility and authorization to patient balances.
Quoted per practice
Percentage of collections
- Everything in Medical Billing, plus:
- Eligibility and benefits checks
- Coding review against documentation
- Prior authorization support
- Patient statements and billing questions
- Root-cause reporting by stage, payer and provider
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Groups, ASCs & projects
Custom Scope
For multi-location groups, ambulatory surgery centers, or a single project such as old A/R or credentialing.
Quoted per scope
Percentage, project or per-provider fee
- Facility and professional claims
- Contract and carve-out payment checks
- Credentialing and enrollment
- Old A/R projects
- Reporting by provider and location
How the rate is set
What Determines Your Rate?
The fee applies to payments actually collected — not to charges.
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1. Specialty
Coding complexity, modifiers, authorizations and documentation review.
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2. Volume
Number of providers, claims and monthly collections.
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3. Payer mix
Medicare, Medicaid, commercial, workers’ compensation and patient balances.
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4. Scope
Which parts of the cycle we handle and which stay with your team.
Comparing options
In-House, Software or a Billing Partner
A plain comparison of how each approach usually works. Your own costs and results are what matter, so use it as a list of questions.
| Question | In-house staff | Billing software only | Billing partner |
|---|---|---|---|
| Who works denials?Correction, appeal and follow-up | Your staff, as time allows | Your staff — software flags them | The billing team, as part of the scope |
| What happens during absences?Vacations, illness, turnover | Work may pause | Work may pause | Covered by the team |
| How is it paid for?Cost structure | Fixed payroll and software | Subscription plus staff time | Percentage of collections |
| Who keeps up with rule changes?Codes, edits, payer policies | Your staff | Software updates edits; staff apply them | The billing team |
| What reporting do you get?Visibility for owners and managers | Depends on staff time | Standard software reports | Monthly report and review |
| Who controls the data?Ownership and access | You | You | You — we work in your systems |
Pricing FAQs
Questions About Cost
How do you charge for medical billing?
Our billing fee is a percentage of the payments we collect for you, so it rises and falls with your actual collections rather than your charges. The rate depends on your specialty, claim volume, payer mix and which services are included. We quote it in writing after a short review of your practice.
What does the fee include?
The written quote lists every service included — typically claim preparation and submission, rejection and denial work, payment posting, follow-up, patient statements and monthly reporting — and anything priced separately, such as credentialing or a project to work old A/R. Nothing outside the quote is charged without your written agreement.
Is there a setup or onboarding fee?
Setup work such as system access, payer setup for electronic remittances and workflow mapping is described in the quote. If any part of it carries a separate charge, the quote says so before you sign. One-off projects, such as a large backlog of old claims, are scoped and priced separately and only if you want them.
Will you work claims from before we start?
Yes, if you want us to. Claims from before the start date are reviewed by filing deadline and value, and we agree in writing how that work is priced — either within the standard fee or as a separate project — before we begin.
How much does it cost to outsource medical billing?
It depends on specialty, volume, payer mix and scope, so any fair comparison starts with your own figures. Add up the full cost of in-house billing — wages, benefits, cover for absences, training, software, clearinghouse and statement costs and management time — and compare it with a quoted fee applied to your actual net collections, checking what each quote leaves out.
Free RCM assessment
See Where Your Revenue Cycle Is Losing Money
We review a sample of your claims, denials and A/R and give you written findings you can keep.