About Pricing

Hi Gina. I really appreciate your efforts giving us such valuable information through your website. And am not sure whether I should ask you this question or not.

I was referred to this website to one of my friends and he wanted to know about pricing of medical billing related works like:

1- Eligibility Verification
2- Charge Entry
3- Payment Postings
4- AR Follow up, etc.

So do you charge one price just like what we collect we charge a percentage of that amount? Or should we have 2 different pricing models? If it's different pricing then what should we charge provider?

Please get back to me. I really appreciate you.

Thank You So much.


There's a couple ways to charge in situations where you are not providing full services:

* Percentage
* Hourly
* Per item

It kind of depends on the particular service provided. For certain tasks like eligibility verification, charge entry, and payment posting it's hard to charge a percentage just for that task. I would think charging on a per item or hourly rate would be preferred.

AR follow up is also difficult because it's very time consuming and sometimes difficult to determine what amount to base it on unless you are posting payments also. I've seen AR percentages fairly high because of this. Depending on the age of the account it gets harder to collect the older the accounts are. We've provided AR services on an hourly basis before and that worked out pretty well.

As far as determining what to charge I would recommend figuring out how much it cost you to provide that particular service and allow yourself enough margin to fairly compensate you for your time. We talked to an accountant one time who suggested charging approximately 3 times your cost to allow enough to cover your overhead and allow a fair pay for your time and effort.

It also depends on the provider specialty you are billing for. Some specialties are more demanding than others. That's why I don't give a specific percentage. I've seen it range from 5% to 10% depending on the specialty, size, and scope of services

Just don't get locked into a long term contract where you can't make any money. We've been in those situations before and it's very frustrating.

Hope this answers your questions. I encourage visitors to share and comment on their suggestions or experiences below.

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Oct 14, 2016
Collecting on AR
by: Michelle

I own a small billing company and would like to know how you guys do regarding collecting money on AR.

Do you collect on older claims that has been paid but never posted by previous biller. Any help would be very appreciated.


Thanks for your comment Michelle.

Speaking for myself, If it's just a few claims I wouldn't charge to post older claims those that have been paid as a result of the previous biller. It does benefit us as the billing service to have accurate AR. If it was a significant number of claims, I would propose to the provider a reasonable fee and explain that this work was not anticipated.

Many times when a provider changes billing services, there are these types of issues that have to be dealt with. The good news is that they become fewer as time goes on.

Hope this helps.

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