The three ways billing companies charge
Almost every medical billing company prices its services using one of three models. Understanding them is the key to comparing quotes fairly.
- Percentage of collections. You pay a percentage of what the billing company actually collects for you — commonly in the 4%–9% range depending on volume, specialty and scope. Because the company only earns when you get paid, incentives are aligned.
- Per-claim fee. A flat fee per claim submitted (often a few dollars). Predictable, but it pays the biller whether or not the claim is collected, so follow-up can suffer.
- Per-FTE / dedicated staff. You fund a dedicated full-time resource (or team) for a fixed monthly rate. Best for high, steady volume where you want dedicated capacity.
What a fair price should include
The headline percentage only matters relative to what's bundled in. Before comparing numbers, confirm whether these are included or billed as extras:
- Insurance eligibility and benefits verification
- Medical coding and coding review
- Denial management and appeals
- Patient statements and patient-balance follow-up
- Provider credentialing and payer enrollment
- Transparent monthly reporting
A low percentage that excludes verification, coding and credentialing can easily cost more than a slightly higher rate that includes everything.
Hidden costs to watch for
Ask every prospective biller about setup or onboarding fees, statement and postage charges, clearinghouse fees, minimum monthly commitments, and long-term contracts with cancellation penalties. These quietly inflate the true cost.
So what's a fair number?
For most independent practices, a percentage-of-collections arrangement that includes verification, coding, denial work, statements and credentialing is the most cost-effective and the easiest to reason about — you always know the biller is motivated to collect every dollar.
How Synergy prices
Synergy typically works on a percentage of what we collect, with insurance verification, coding, credentialing, patient statements and reporting included at no extra charge. There's no long-term contract, a 30-day free trial, and a 90-day money-back guarantee on full revenue cycle management. See our full pricing comparison.
Frequently asked questions
Is a percentage-of-collections model better than per-claim?
For most practices, yes. Because the billing company only earns when you actually get paid, a percentage model keeps them motivated to work every claim and follow up on denials, rather than simply submitting and moving on.
Does outsourcing actually save money versus in-house billing?
Often, yes — once you account for salaries, benefits, software, clearinghouse fees, training and turnover, an outsourced percentage frequently costs less than a full in-house team while improving collection rates.