Pricing
Medical billing companies charge in one of three ways: a percentage of collections, a flat monthly fee per dedicated biller, or a fee per claim. Which one suits you depends on volume, payer mix and how much of the cycle you hand over. Below: how each model works, what moves a quote and what a quote covers. A written quote follows a short review.
Last reviewed by the Remitwright billing team. Editorial policy
The models
Every billing company in this market uses one of these, or a mix. None is right for everyone, and each one shapes what the company is motivated to do.
You pay a share of what the company collects each month.
Your volume varies month to month and you want the biller paid only when you are.
Small balances may not be worth the company's time. Check whether patient payments count. Some states restrict percentage arrangements for some provider types; ask your counsel.
A fixed fee for a named biller or team, whatever the month's collections.
You want one accountable person and a predictable cost, and your volume is steady.
The fee is the same in a slow month. Scope has to be written down so that "everything" means the same thing to both sides.
A fixed amount for each claim submitted.
High volumes of simple, similar claims, with follow-up kept in-house.
The incentive is to submit, not to collect. Find out whether corrected claims, secondaries and appeals count as new claims.
Side by side
Hourly and dedicated-FTE arrangements are variants of the flat fee; they are listed on their own because they reward different things. No figures: the number belongs in a quote that knows your practice. Medical billing pricing models compared weighs each one on incentives, predictability and contract terms.
| Model | How it is calculated | What it rewards | Watch for | Fits when |
|---|---|---|---|---|
| Percentage of collections | A share of the money the company collects, counted when the payment posts. | Collecting rather than submitting: the company is paid when you are. | Whether patient payments and front-desk copays count; whether small balances get worked; state rules on percentage arrangements for some provider types. | Volume that varies month to month, and an owner who wants the biller's pay tied to cash in. |
| Per claim | A fixed amount for each claim submitted, sometimes with a separate rate for corrected claims and appeals. | Getting claims out quickly. Follow-up is rewarded only if the contract says so. | Whether corrected claims, secondaries and appeals count as new claims, and who works the denials. | High volumes of simple, similar claims with follow-up kept in-house. |
| Hourly or dedicated FTE | A rate for the hours a named biller works, or a fixed amount for a full-time biller assigned to you. | Time spent, so productivity has to be visible in the weekly report. | Whether hours are logged and reported; what happens in a quiet month; who covers leave. | A practice that wants one accountable person and reads the report closely. |
| Flat monthly | One fixed fee for a defined scope, whatever the month's collections or claim count. | Predictability on both sides; the company earns by working efficiently within the scope. | Scope creep in either direction. "Everything" has to be written down, and the fee should move when the scope does. | Steady volume and a defined scope, where a predictable cost matters more than a variable one. |
How Remitwright prices
Our model is set out in writing in every quote: which of the three it is, what it includes, what it excludes, and how the fee moves if your volume changes. We do not publish a rate card, because the right number depends on your specialty, volume, payer mix and scope, and a number that ignores those changes later.
Every written quote states
What drives a quote
Tell us about them in the review and the quote will reflect them.
Coding depth, authorization load and payer quirks differ: ABA and DME take more work per claim than a two-code office visit.
More claims means more hours, but the hours per claim fall as the biller learns your payers.
Medicaid managed care and workers' compensation take more follow-up per dollar than Medicare and large commercial plans.
A clean start costs less than a backlog. Old A/R is quoted as its own project after a recoverability assessment.
Some systems automate posting and scrubbing; some need a person to do by hand what others do overnight.
One stage (denials, say) costs less than the whole cycle. New credentialing and enrollment projects and audits are priced separately.
Each adds enrollment work, reconciliation and reporting lines.
Statements, calls and payment plans are their own workload and are quoted as such.
Scope
Terms
What every quote says, in the order it says it. The quote is the document both sides sign, so it is where your contract terms are set.
How access to your systems works
The billing cost calculator shows its formula and uses only the ranges you enter. Nothing is assumed and nothing is sent anywhere.
Questions
Still deciding?
If your question is not here, add it as a note in the review and a billing specialist replies in writing.
Get a billing reviewOr write to sales@remitwright.com
Medical billing companies charge in one of three ways: a percentage of what they collect, a flat monthly fee per dedicated biller, or a fixed fee per claim. The figure depends on specialty, claim volume, payer mix, existing A/R and how much of the cycle you hand over, which is why a public rate card rarely survives contact with a real practice. We give a written quote after a short review of your billing.
Under a percentage model the fee should apply to collections: money that has posted. A percentage of charges would pay the company for claims that were never paid, and you should walk away from that. Whatever model a quote uses, it names the base the fee applies to and the payments that are excluded, such as copays taken at the desk.
It depends on the model. Under a percentage model the fee falls with collections. Under a flat fee it does not, which is the trade-off for predictability. The quote explains how the fee moves with your volume so there are no surprises in a slow month.
Whatever the model, the quote lists exactly which payments the fee applies to. Copays collected at your front desk before we touch a claim are a common exclusion; the quote will say.
Not always. Add up what an in-house biller costs you: salary, benefits, software seats, training, cover for leave, and the revenue that leaks when one person is also the receptionist. Compare that with a quote for the same scope. If your in-house biller keeps days in A/R low and works every denial, keep them. Outsourcing earns its place when billing depends on one person or when denials are logged but not worked. Outsourced medical billing, explained covers when it is and is not the right move, and how to hire a medical biller sets out what the employee side of the ledger holds.
Start with public data. The Bureau of Labor Statistics puts the May 2025 median wage for medical records specialists at $51,140 a year, and its June 2026 employer-cost release puts benefits at about 30 percent of private-industry compensation, so a loaded in-house cost sits well above the salary line before software seats, recruiting and the cost of an empty chair. A billing company's quote replaces those lines with one fee, as a percentage of collections, a flat fee or a per-claim rate. Compare the two as cost to collect, which the cost guide walks through with the sources.
From the quoted fee for the billing work, and from nothing else. We take no revenue share from software vendors or clearinghouses, no referral fees, and no commission for recommending one system over another. The quote is the whole of what you pay us.
Because the number depends on eight things we cannot know from here: your specialty, claim volume, payer mix, existing A/R, software, scope, providers and locations, and whether you want patient billing. A rate card that ignores them is a number that changes after you sign. Tell us those eight things in the review and the quote comes back in writing.
The written quote states whether any setup work is charged and what it covers. Nothing is charged that is not in the quote.
Yes. Fill in the three-step form, and a billing specialist reviews what you have told us and replies in writing, by email.
It is written into your quote, with the contract length and what happens to claims in flight on the day you leave. Before you switch from anyone, read the notice period in your current contract too: the parallel run in the switching plan is planned around it.
Old A/R is quoted as its own project after a recoverability assessment, never folded into the monthly fee without you seeing it. You can have the old company run it out, hand it to us as a project, or keep it in-house. Whichever you choose, it sits on its own line in the weekly report, so old money and new money are never mixed.
Next step
Tell us what you bill for and roughly how much. A billing specialist reviews it and replies with a quote that says what it includes and what it does not.
You answer three questions
A billing specialist reads them
A written reply by email
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While you wait: see the sample weekly report or read how switching works. You can also download the sample weekly report (PDF).
