Core billing
Claim preparation, submission, payment posting, and monthly reporting. The steady work most practices want off their desk.
- Daily claim submission
- Posting and reconciliation
- Monthly operating summary
How Fees Work
Pricing built around your actual workflow
There is no honest flat rate for medical billing. Volume, specialty, payer mix, authorization density, and how much of the cycle you keep in-house all change the work. What we can promise is a proposal that names every one of those assumptions.
How We Work
Three ways practices usually start
Scope is agreed in writing before any work begins. Mix and match to fit how your practice runs.
Denial & A/R support
For practices with a backlog. Denials classified and worked, aging balances split into queues, and follow-up documented.
- Denial reason coding
- Aging balance queues
- Appeal tracking
Custom workflow
When the practice keeps part of the cycle in-house. We take a defined slice and report on it clearly.
- Credentialing tracking
- Reporting only
- Backlog projects
Before You Sign
What your proposal should specify
A billing agreement that is vague about scope is expensive later. These are the items we expect to see in any proposal, ours or a competitor's.
- Services included and explicitly excluded
- Fee basis: percentage of collections or flat fee
- Which payers and claim types are in scope
- Reporting cadence and the measures used
- Onboarding steps and required system access
- Data safeguards and confidentiality terms
- Termination notice and transition support
- How scope changes are priced mid-engagement
Cost Drivers
What changes the number
Claim volume
More claims mean more work, but less per claim.
Payer mix
Medicaid and managed-care plans need more follow-up per dollar.
Authorization density
Procedures and drugs add tracking work before the claim.
Systems
One integrated system is cheaper than three that do not talk.
Documentation quality
Clean notes reduce rework and records requests.
Scope split
Keeping the front office in-house lowers the fee.
FAQ
Pricing questions practices actually ask
If yours is not here, ask it on a call. The answer is usually short.
Do you charge a percentage of collections or a flat fee?
Both exist, and the right one depends on the work. Percentage-based fees suit full revenue-cycle management because they scale with volume. Flat fees suit narrow scopes like credentialing tracking or a one-time A/R project. We will tell you which we think fits and why.
What makes a practice expensive to bill?
Volume matters less than complexity. A high-claim-volume practice with clean workflows is easier than a low-volume practice with four systems, heavy prior authorization, and a large self-pay balance. Payer mix, authorization density, and documentation quality drive cost more than the number of providers.
Are there setup or onboarding charges?
Sometimes, when the backlog or system setup is substantial. It is always stated separately in the proposal so you can see it before signing.
What is not included?
Typically: malpractice or compliance consulting, software licenses, clearinghouse fees, postage for patient statements, and legal review of payer contracts. Anything outside scope is named in the proposal.
How quickly can we see results?
Payment posting and clean claim flow improve in the first month. Denial rate and A/R aging are lagging measures, so expect two to three months before the trend is meaningful.
Free Billing Audit
Want a clearer picture of your billing?
Request a free audit. We will look at your recent claims and tell you what we would fix first — no obligation, and no patient information needed to get started.