What is the percentage fee for home based medical billing service?

by Tina Margiano
(Mission Viejo, CA)

I am currently working at a physician office for 2 years and just got another offer to do the claims at home from another small practice.
What is the percentage fee for home-based medical billing service? I live at Southern California by the way.
I thank you and really appreciate your feedback.

Tina,

I depends on the services provided, the specialty, the size of the practice, and the local competition. I typically see anywhere from 6% to above 10%.

The lower percentage would be for just filing claims and not sending out patient statements, claim follow-up, patient reminders, etc. The higher percentage would be for full services for a specialty that’s more demanding – or if they have a lot of Medicare or Medicaid claims that don’t pay much.

For an average Family practice I would expect between 7% to 8% in our area.

Another factor would be what expenses you may have. If you are using the physicians software, server/computer and their clearinghouse I would expect the percentage to be a little lower.

Before I quote a potential client I try to estimate what my cost would be to serve them. I’ve been advised that service providers should charge at least 3 times their expenses to make a decent profit and pay their expenses and overhead.

Here’s a web page where I discuss in a little more detail.

Thanks and good luck!
Gina

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