Most outsourced medical billing for independent practices is priced as a percentage of the collections the billing company recovers for you — not a flat fee — so the cost scales with your actual reimbursement. The right rate depends on your specialty, claim volume, and payer mix; at FYNQ it typically lands in the 4–8% range, with the exact rate quoted after a free Billing Health Check. Here's how the common pricing models work, what moves the number, and how to compare outsourced billing against keeping it in-house.
The most common model. You pay a set percentage of the money the billing company actually collects for you, so the cost scales with your reimbursement rather than a fixed bill. The percentage depends on your specialty, claim volume, and payer complexity.
A fixed amount each month regardless of collections. Predictable, but it can cost more than percentage billing for lower-volume practices and less for very high-volume ones — and it doesn't tie the biller's incentive to your results.
A fixed charge for each claim submitted. Simple to forecast by volume, but it pays the same whether or not a claim is followed up, appealed, or ultimately collected.
A blend — for example a smaller percentage plus a base fee, or separate pricing for add-ons like credentialing and prior authorization. Useful when your needs span more than core claim submission.
No two practices pay the same rate, because the work behind each claim differs. These are the factors that move the number up or down.
Specialties with dense CPT sets, frequent modifiers, or heavy prior-authorization requirements take more work per claim than simpler office-visit billing.
Higher monthly volume can lower the effective rate, while very small practices may see a slightly higher percentage to cover fixed account-management cost.
A book of business weighted toward complex commercial payers and Medicaid plans usually requires more follow-up than one dominated by a few cooperative payers.
Core claim submission costs less than a full revenue cycle engagement that adds eligibility verification, prior authorization, credentialing, denial management, and A/R recovery.
Working a backlog of old, unpaid claims is often priced separately from ongoing billing because it is a one-time, labor-intensive recovery effort.
Comparing billing costs fairly means looking past the headline fee. In-house billing carries salaries and benefits, billing software, clearinghouse fees, ongoing coder training, and the cost of covering work when staff are out — plus the revenue quietly lost when claims sit unsubmitted or denials go unworked during a staffing gap. Outsourced billing converts most of that into a single variable cost tied to collections.
The honest comparison is total cost of billing versus net collections under each approach — not fee against fee. A free Billing Health Check establishes your current net so you can compare like for like before deciding anything.
Outsourced medical billing is most commonly priced as a percentage of the collections the billing company recovers for you, rather than a flat fee — which keeps the cost aligned with your actual reimbursement. The percentage varies with your specialty, claim volume, and payer complexity, and some companies instead charge flat monthly or per-claim fees. FYNQ Medical Billing prices as a percentage of collections, typically in the 4–8% range, with the exact rate quoted after a free Billing Health Check that first establishes your current collection baseline.
It depends on your practice. In-house billing carries salary, benefits, billing software, clearinghouse fees, ongoing coder training, and the cost of coverage when staff are out — plus the revenue lost when claims sit unsubmitted or denials go unworked during staffing gaps. Outsourced billing converts most of that into a single variable cost tied to collections. The honest comparison isn't just the headline fee; it's the total cost of billing versus the net collections each approach produces. The free Billing Health Check helps you see your current net so you can compare like for like.
This varies by billing company and by the scope of work. Some engagements include onboarding in the standard rate; others price credentialing, payer enrollment, or aged-A/R cleanup separately because those are distinct, labor-intensive projects. The clearest way to avoid surprises is to ask for an itemized quote that separates ongoing billing from any one-time setup work. FYNQ outlines scope and any one-time work as part of the quote that follows the Billing Health Check.
Percentage-of-collections pricing aligns the billing company's incentive with the practice's: the biller earns more only when you actually get paid, which rewards diligent claim follow-up, appeals, and A/R recovery rather than just claim submission. Flat and per-claim models pay the same whether or not the money is ultimately collected. That alignment is the main reason percentage-of-collections is the most widely used model in independent-practice billing.
Look past the headline percentage. Compare what each quote actually includes: does the rate cover denial management, appeals, and A/R follow-up, or only claim submission? Are eligibility verification, prior authorization, and credentialing included or billed separately? What reporting will you receive, and how often? A slightly higher rate that includes aggressive denial work and transparent reporting often nets more than a lower rate that stops at submission. Ask each company to quote on the same defined scope so you're comparing equivalent services.
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