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.
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
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
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
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.
Pricing questions practices actually ask
If yours is not here, ask it on a call — the answer is usually short.
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.