If you are thinking about outsourcing your billing, the first question is simple: what will it cost? The honest answer is that most medical billing companies charge a percentage of what they collect for you, usually somewhere between 4% and 10% of collections. Most small practices are quoted 5% to 8%. But the percentage alone does not tell you what you will really pay. Here is how pricing works and how to compare quotes fairly.
The three common pricing models
Percentage of collections. The most common model. The billing company keeps a share of the money it actually brings in. This lines up their incentive with yours: they only earn more when you collect more.
Flat fee per claim. You pay a set amount for each claim submitted. It can look cheap, but it rewards volume rather than results, and denied claims that need rework may cost extra.
Monthly flat fee. A fixed monthly price regardless of volume. Predictable, but you may overpay in slow months, and the vendor has less reason to chase every unpaid balance.
What changes the price
- Specialty. Specialties with complex coding, frequent prior authorizations or high denial rates usually cost more to bill.
- Claim volume. Larger practices often get a lower percentage.
- Payer mix. Heavy Medicaid or workers' compensation work takes more follow-up.
- Old A/R. Cleaning up months of unpaid claims is extra work, and some companies charge separately for it.
- Services included. Eligibility checks, credentialing, patient statements and reporting are sometimes included and sometimes billed as add-ons.
The fees that are easy to miss
Two quotes at the same percentage can end up very different. Ask every vendor about:
- Net collections or gross charges? The same percentage costs far more when it is applied to gross charges.
- Setup or onboarding fees. Some companies charge these up front.
- Minimum monthly fees. Common, and fair, but know the number.
- Contract length and exit terms. A long contract with a cancellation fee protects the vendor, not you.
- Software fees. Reporting portals and dashboards are often a separate purchase.
Outsourcing versus an in-house biller
An in-house biller costs a salary, benefits, payroll taxes, software, training and cover for vacations and sick days. When one person leaves, your cash flow can stall for weeks. An outsourced team spreads that work across trained specialists, so claims keep moving. For many small and mid-sized practices, a percentage fee ends up costing less than a full-time hire while collecting more.
What InCareMD charges
Our billing and revenue cycle management is 5% of collections with a $750 monthly minimum, on what we actually collect. There are no setup fees and no long contracts. Eligibility checks, claim submission, denial management and A/R follow-up are included, and you watch every claim and payment on your own MDClaim360 dashboard at no extra cost. You can see typical market rates side by side on our compare page.
A quick way to compare quotes
Take each quote and estimate a normal month: your expected collections times the percentage, plus any minimums, software and add-on fees. Then ask each vendor how they will report denials and how quickly they follow up on unpaid claims. The cheapest quote is rarely the one that collects the most.