Most medical billing companies charge a percentage of what they collect for you, commonly in the 4–10% range. Where you land in that range depends on your specialty, claim volume, average reimbursement and how much of the revenue cycle the company handles.
The three common pricing models
| Model | Typical range | Best for |
|---|---|---|
| Percentage of collections | 4–10% of net collections, often with a monthly minimum | Most practices. The billing company only earns when you get paid. |
| Per claim | A fixed fee per claim submitted | High-volume, low-complexity practices with low denial rates |
| Flat monthly fee | Fixed monthly price for a defined scope | Practices with very stable volume that want predictable costs |
What should be included in the price
- Claim scrubbing and electronic submission
- Rejection and denial work, including appeals
- Payment posting and reconciliation
- Insurance A/R follow-up on every unpaid claim
- Monthly reporting on collections, denials and days in A/R
Services often priced separately: credentialing, old A/R recovery, patient statements and collections, eligibility verification, and coding audits.
Hidden costs to ask about
- How "collections" is defined. Does the percentage apply to patient payments you collect at the front desk?
- Setup and termination fees. Long contracts with exit fees reduce your leverage.
- Clearinghouse and statement fees passed through to you.
- Minimum monthly fees that matter if your volume is seasonal.
Outsourced vs in-house: a quick comparison
An in-house biller costs salary plus benefits and payroll taxes (often 20–30% on top), software, training, and the cost of coverage when they are out or leave. For many small practices, outsourcing at 5–8% of collections costs about the same or less, with more coverage and expertise. Run your own numbers with our billing cost calculator.
Questions to ask before signing
- Who exactly will work my account, and what are their credentials?
- Do I keep my EHR, and do payments go directly into my bank account?
- What are your service levels for claim submission and denial follow-up?
- What will I see in reporting, and how often?
- How much notice do I need to give to leave, and how is my data returned?