Straightforward plans. Clear fees.

How medical billing fees usually work

When practices shop medical billing companies, the first fork is flat monthly fee versus a share of collections. Either model can be fair or expensive depending on claim volume, specialty mix, and how much work you still want to keep in-house. We list three plans so you can run the math before a sales call — not after.

Starter is a flat $899/month for solo clinicians and small offices submitting up to about 250 claims a month. Growth is 4.5% of collections for practices roughly up to five providers who need denial management, credentialing help, and a named account manager. Enterprise is a custom quote for multi-site groups, hospitals, and MSOs that need roll-up reporting, specialty coding teams, and contract-level analytics. No setup fees. No per-claim add-ons. Agreements that do not bind you beyond 90 days.

Flat monthly fee versus percentage of collections

A flat monthly fee favors predictability. If you are a solo primary-care or behavioral-health practice with steady volume, $899/month often costs less than a percentage once collections rise. You know the expense in January and in July. The trade-off: Starter covers core submission, eligibility, posting, and 60-day A/R follow-up — not full denial appeals or new-provider credentialing. If denials or payer enrollment already consume your week, Growth usually fits better even when the percentage line looks higher at first glance.

Percentage pricing ties our fee to collections posted: we earn when you collect. At 4.5% of collections, Growth includes the work that typically lifts net revenue — denial management and appeals, patient statements, credentialing for new providers, and a weekly KPI view. Practices with higher-RVU procedures, specialty imaging, or frequent commercial-payer friction often recover more than the fee gap in the first quarter because clean claims and worked denials compound faster than a lower flat fee that stops at posting.

What each plan covers — and what it does not

Every plan includes claim scrubbing and submission, eligibility and benefits checks, and ERA/EOB posting. That is the baseline. Growth and Enterprise add denial workflows, patient billing, and credentialing support because those are the three places practices lose money after the claim leaves the clearinghouse. Enterprise adds multi-location rollups, specialty-matched coding teams, payer-contract variance reporting, an implementation team, SLA language, and quarterly leadership reviews — the layer multi-site operators need when one dashboard has to represent several clinics.

Clearinghouse connectivity is not a separate line item, and we do not bill for every status call. If a feature sits on a plan, it is inside the monthly or percentage fee. Out-of-scope work — one-off consulting, legacy A/R clean-up older than the plan’s follow-up window, or custom software builds — is quoted separately with written scope. Invoice surprises are how billing vendors lose practices; we would rather omit a line from the marketing page than bury it in a contract.

Who each plan fits

Starter fits solo practitioners and two-provider offices that want reliable submission and posting without an account manager on every call. Growth fits expanding groups — often family medicine, urgent care, dermatology, cardiology, or therapy practices — that need denial recovery and credentialing when a new clinician joins. Enterprise fits organizations that already have an operations lead and need us as an extension of that team across sites, with reporting finance and clinical leadership can both use.

If you are leaving another billing company, we start with a free revenue review. That review shows denial rates, A/R aging, and underpayment patterns so you can see whether Starter, Growth, or Enterprise is the right entry point. Most clients begin on Growth; some move to Starter after the front end stabilizes, and some move to Enterprise when a second location opens.

Agreements, exits, and how pricing stays fair

We do not sell multi-year locks. Standard agreements renew on short cycles and can be ended with notice inside a 90-day framework. That keeps us earning the relationship every quarter. Published pricing stays in place unless your volume or footprint clearly moves you into another tier — and we tell you before we suggest a change. If Growth’s percentage is no longer the fair model because collections and claim mix changed, we put the math on one page and you decide.

Practices nationwide work with us remotely from our Houston base. Hours are Monday–Friday, 8am–8pm ET. Support response targets are listed on each plan: 24 hours on Starter email, four hours on Growth phone and email. Enterprise SLAs are written into the statement of work. If you want a number before you talk to sales, use the tiers above; if your mix is unusual — high Medicaid, heavy DME, or hospital outpatient — request an Enterprise conversation and we will price from your last 90 days of remits, not a generic average.