Medical billing services send proposals when a practice is looking to outsource billing, switch vendors, or fix a backlog of unpaid claims. Practices compare percentage rates, but also what is included, such as denial work, patient statements, and reporting. A clear proposal explains what the percentage covers so it can be compared fairly.
When to use estimates: Use estimates to provide project quotes and get client approval before starting work. Once approved, convert your estimate to an invoice with one click to collect payment.
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Pricing depends on claim volume and specialty complexity, and a change in provider count later should trigger a defined fee adjustment.
List claim submission, payment posting, denial follow-up, patient statements, and eligibility checks so nothing is assumed to be free.
Credentialing, coding review, AR cleanup, and appeals often cost extra, and stating that upfront avoids surprise add-ons.
State whether the percentage applies to net collections, whether patient payments count, and what the monthly minimum is.
Working in the practice's existing software or in yours affects setup time and who pays for licenses and per-claim fees.
Existing aged claims should be reviewed in the quote, with a stated approach for working or writing them off.
A 30 to 90 day notice period and any tail fee on pending claims protect your revenue after a client leaves.
| Service | Priced | Typical range |
|---|---|---|
| Full-service billing (claims, posting, denials, statements) | percent of net collections | 4%-9% |
| Flat monthly billing fee, small practice | per provider per month | $350-900 |
| Claim submission only | per claim | $3-8 |
| Accounts receivable cleanup (aged claims over 90 days) | per hour | $40-85 |
| Payer credentialing and enrollment | flat fee per payer | $150-400 |
| Practice setup and clearinghouse enrollment | flat fee | $250-1,000 |
| Denial appeals and reprocessing | per appeal or per hour | $25-75 per appeal |
| Patient statement mailing and phone follow-up | per statement or per month | $1-3 per statement |
Typical US ranges. Rates vary by region, experience, and job size.
Request the last three to six months of charges, payments, and an AR aging summary. Your percentage should reflect actual volume and payer mix, not the practice's estimate.
A rate like 7% on the first $30,000 collected per month and 5% above that rewards growth and is easy to explain. Practices often prefer it to a single flat percentage that feels expensive as they grow.
Enrollment, EDI and ERA setup, and fee schedule loading take real time before you earn anything. A one-time setup fee keeps the monthly rate competitive.
Old AR is often a different job from ongoing billing. Offer an hourly rate with a cap, or a contingency percentage on recovered claims, so the practice sees it as separate from the monthly fee.
Give a range only. Final pricing should wait until you review claim volume, specialty, payer mix, and denial rates, since these drive your workload.
Thirty days is common. Collections patterns and your own capacity change, and a valid-through date gives you a clear point to revisit the rate.
Some billers charge a flat fee of $300 to $1,000 for a billing audit and credit it toward setup if the practice signs. A free quote is more common for standard practices, but a paid audit makes sense for complex or troubled accounts.
If you quote a flat monthly fee, include a provision to adjust it if claim volume or provider count changes by a set amount, such as 20%. Percentage-based fees adjust on their own.
Use the Medical Billing Service invoice template to bill the client, or convert this estimate once it's approved.
Medical Billing Service invoice template