ClaimPillar Medical Billing, Coding & Revenue Cycle Management
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Priced by specialty and practice size

Medical billing pricing: from 5.0% of insurance payments

Your rate is set by your specialty and clinician count, with 0% of patient payments and $0 setup. Every pricing term is below.

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5 business days from your aging export and BAA. Yours to keep.

Full-Service Billing

Claims, payment posting, denials and insurance A/R follow-up for one percentage, set by your specialty and clinician count; inherited claims 90+ days past the date of service follow A/R Recovery terms. $0 setup.

Find your rate

5.0%–8.5%

of insurance payments; 0% of patient payments

Complete RCM

9.0% of insurance payments

Everything in Full-Service Billing, plus aged A/R, credentialing, prior authorizations and a named senior lead.

What it adds
  • Aged A/R at no added percentage
  • Credentialing for every clinician
  • Prior authorizations handled
  • A named senior billing lead

Rate card

Your rate, by specialty and practice size

Clinicians are counted on the 1st of each month from the rendering NPIs we billed the month before (for ABA, BCBAs and BCaBAs, not RBTs). Your rate moves with your size band the next month, in either direction.

Full-Service Billing: your rate as a percentage of insurance payments
Specialty1 clinician2–5 clinicians6–15 clinicians
Mental & behavioral healthTherapists, counselors, psychologists and psychiatric practices8.0%7.5%7.0%
ABA therapy8.5%8.0%7.5%
PT, OT, speech & chiropractic7.5%7.0%6.5%
Primary care, pediatrics & urgent care6.5%6.0%5.5%
Specialist physician groupsCardiology, orthopedics, gastroenterology, dermatology, urology, OB-GYN, oncology and other office-based specialists6.0%5.5%5.0%

Your fee is a percentage of insurance payments posted on claims we submitted or worked, net of payer recoupments and refunds. We take 0% of patient payments, copays and anything your front desk collects.

Not in the fee base: patient payments, copays, capitation, incentive or grant payments, and payments on claims we never submitted or worked.

Multi-specialty practices: each clinician's claims are billed at that clinician's segment rate; the size band counts every clinician.

16+ clinicians, or anesthesia, radiology, DME, lab and home health: written quote within 1 business day, same fee base, cap and terms.

Of 31 billing-company pages we checked on October 7, 2026, 14 published their own numeric rate: seven from 2.49%, three from 2.99% and four ranges within 4–8% of collections or revenue. See the sample and what each rate is charged on.

Monthly fee on $30,000 of insurance payments, 2–5 clinicians: Mental & behavioral health $2,250.00; ABA therapy $2,400.00; PT, OT, speech & chiropractic $2,100.00; Primary care, pediatrics & urgent care $1,800.00; Specialist physician groups $1,650.00; Fee cap that month (9.0%) $2,700.00.
Worked example for the insurance payments shown; 0% of patient payments. Percentage fees and mailed statements are capped at 9.0% of that month's insurance payments; the $400 minimum still applies from invoice 4. Source: the rate card and worked example on this page.

Minimum and cap

What a month costs

Example: 3 therapists with $30,000 of insurance payments in a month pay 7.5%, or $2,250. That month's cap would be $2,700.

The same practice in a slow month: $4,000 of insurance payments at 7.5% is $300. Invoices 1–3 charge $300; from invoice 4 the $400 minimum applies, even though that month's 9.0% cap is $360.

Setup fee
$0
Monthly minimum
Invoices 1–3: only percentage fees on that month's insurance payments, plus any statements or add-ons you order; the $400 minimum starts with invoice 4.
Fee cap
Percentage fees and mailed statements are capped at 9.0% of that month's insurance payments; the $400 minimum still applies from invoice 4.
Mailed patient statements
$0.95 each
Invoicing
Invoiced on the 10th for the prior month's insurance payments, due within 15 days by ACH. Every payment goes straight to your practice's own bank account. We never receive, deposit or endorse your payments; we invoice you once a month.

Contract

Contract, rate lock and leaving

What you pay after the rate lock ends, and what happens on the way out, written down before you sign.

Contract

Month to month. Leave with 30 days' written notice. No termination fee.

Rate lock for 12 months

Your rate-card rate can't rise for 12 months from your start date; size-band changes still apply; later changes need 60 days' written notice.

Clean-Exit Terms

Leave with 30 days' notice and no termination fee. Want a run-out? We keep working the claims we submitted for 90 days at your plan rate. Decline it and we charge nothing on payments that post after you leave.

Notice by email; optional run-out covers claims we submitted before your exit date, at your plan rate; handover file within 10 business days of exit.

Handover file: Every open claim with its status and next action, the denial log, payer correspondence and credentialing files, in CSV and PDF.

What’s included

Everything in Full-Service Billing, and what is not

Your part: Sign the service agreement and BAA, give us logins to your practice-management system and clearinghouse, join one 45-minute kickoff call, sign off encounters so charges are complete, and answer our documentation questions within 5 business days.

IncludedWhat you getLimit or comparison
Full-Service BillingSolves: claims sitting and denials unworkedClaim creation and scrubbing, submission, payment posting, denial work and appeals, insurance A/R follow-up, eligibility checks for new patients and changed coverage, authorization expiry tracking, coding checks against your documentation, patient balances calculated and statements sent in your practice's name, and a KPI report with written definitions by the 10th of each month.In-house: about $4,042 a month for a billing and posting clerk at the median wage, before benefits (BLS)
Deadline SweepSolves: near-deadline claims dying during the switchEvery inherited claim within 30 days of a filing, corrected-claim or appeal deadline is worked within 5 business days of access.Terms: Starts at access; covers up to 250 claims (more gets a day-1 deadline schedule); worked means submitted, corrected, appealed or returned with the fix.Up to 250 claims; above that, a written deadline-order schedule on day 1.
On-Our-Watch GuaranteeSolves: paying a biller and still losing claimsIf a claim misses a filing, corrected-claim or appeal deadline while it is on our watch, we pay you what it would have paid.Terms: Claims we get complete 10+ business days before the deadline; contracted rate less any copay you collected, paid automatically within 30 days of final denial; capped $10,000/month; your holds excluded.Covered up to $10,000 a month
Clock-or-Credit GuaranteeSolves: a billing team that goes quietFrom go-live, every new claim goes out within 1 business day of complete charge data, and every denial is worked within 2 business days of posting — or $25 comes off your invoice for each late one.Terms: Mon–Fri ET business days by your system's timestamps; worked: resubmitted, appealed or returned with the fix; auto-credited; capped at monthly fee; clearinghouse outages excluded.$25 per late item, up to that month’s fee
0% of patient paymentsSolves: a percentage taken on copaysYour fee is a percentage of insurance payments posted on claims we submitted or worked, net of payer recoupments and refunds. We take 0% of patient payments, copays and anything your front desk collects.Your math: your patient payments × the rate a total-collections biller charges
Fee capSolves: fees stacking upPercentage fees and mailed statements are capped at 9.0% of that month's insurance payments; the $400 minimum still applies from invoice 4.Your math: percentage fees and statements at most 9.0% of that month's insurance payments; from your 4th monthly invoice, never below $400
Clean-Exit TermsSolves: getting stuck againLeave with 30 days' notice and no termination fee. Want a run-out? We keep working the claims we submitted for 90 days at your plan rate. Decline it and we charge nothing on payments that post after you leave.Terms: Notice by email; optional run-out covers claims we submitted before your exit date, at your plan rate; handover file within 10 business days of exit.Handover file within 10 business days of exit
Not includedYour EHR or practice-management subscription and clearinghouse fees (paid to those vendors), any application fee a payer or state charges, mailed patient statements at $0.95 each, and collection-agency, attorney or court costs.

Premium tier

What Complete RCM adds

9.0%of insurance payments

One rate for every specialty and size up to 15 clinicians. Same $0 setup, $400 minimum from invoice 4, guarantees and Clean-Exit Terms.

On-Our-Watch Guarantee: Claims we get complete 10+ business days before the deadline; contracted rate less any copay you collected, paid automatically within 30 days of final denial; capped $10,000/month; your holds excluded.

Clock-or-Credit Guarantee: Mon–Fri ET business days by your system's timestamps; worked: resubmitted, appealed or returned with the fix; auto-credited; capped at monthly fee; clearinghouse outages excluded.

Everything in Full-Service Billing, plus:

  • inherited and aged A/R worked at no added percentage
  • credentialing and re-credentialing for every clinician and payer you choose
  • eligibility verified for every scheduled visit 2 business days ahead
  • prior authorizations requested, tracked and submitted for renewal from your clinical documentation
  • a monthly underpayment check
  • a named senior billing lead with a weekly 30-minute call
  • once a year, fee-increase requests to your top 3 commercial payers (the payer decides)

Standalone services

Buy one service without full billing

Each has its own price and terms; none needs a Full-Service Billing contract.

A/R Recovery

15%

For inherited claims 90+ days past the date of service: 15% of the insurance payments that post after we work them, and $0 on claims that never pay.

Terms: Fee only on insurance payments posting after our logged action; patient payments 0%; full-service clients stay under the 9.0% fee cap.A/R recovery service

Credentialing & Payer Enrollment

$149 per payer

Billed only after the payer confirms your effective date; $0 if denied or panel closed; filed within 5 business days of your complete packet. Status updates every 14 days.

Per-payer credentialing

60-Day Underpayment Check

$495

The same deliverable as the bonus below, sold on its own to practices that keep billing in-house. Needs your fee schedules.

Bonuses

Included with Full-Service Billing

Four extras that come with the plan; beneath each, what it costs on its own or the work it takes.

  • Deadline Claims at Your Plan Rate

    Inherited claims within 30 days of a deadline when you start are worked at your plan rate, not the 15% A/R Recovery rate.

    A/R Recovery sold separately at 15% of the insurance payments that post after we work the claims

  • New-Clinician Enrollment

    Clinicians who join while you're a client get enrollment filed with up to 5 payers each (the payer decides), with no per-payer fee.

    Sold separately at $149 per payer ($745 for 5 payers)

  • 60-Day Underpayment Check

    In month 3 we compare every payment from your first 60 days against your contracted rates and appeal each underpaid line. Needs your fee schedules.

    Sold separately at $495

  • Front-Desk Fix Sheet

    Each month, your top 3 denial causes with the exact front-desk or documentation fix for each, for future visits, plus a 20-minute call with your front desk every quarter.

    About 2 analyst hours of work a month

In-house or outsourced

Compared with hiring a biller

A billing and posting clerk's median wage is $48,500 a year (BLS, May 2025): about $4,042 a month before benefits, software and the clearinghouse, or about $5,774 at the private-industry benefit share (BLS, June 2026).

Sources: BLS, financial clerks pay · BLS, employer costs for employee compensation

A billing clerk is paid whether claims pay or not. Your first three invoices are only a share of insurance payments that already reached your account, plus any statements or add-ons you order.

In-house vs outsourced billing, compared Compare two quotes with the medical billing cost calculator

Guarantees

We guarantee our own work: deadlines and turnaround

No billing company can force a payer to pay a claim, so neither guarantee promises a payer decision. Both apply to Full-Service Billing and Complete RCM.

Deadline guarantee

On-Our-Watch Guarantee

If a claim misses a filing, corrected-claim or appeal deadline while it is on our watch, we pay you what it would have paid.

Terms in one line

Claims we get complete 10+ business days before the deadline; contracted rate less any copay you collected, paid automatically within 30 days of final denial; capped $10,000/month; your holds excluded.

If we miss
What it would have paid: your contracted rate for those codes with that payer, less any copay you collected; with no contract on file, that payer's average allowed amount for the code over your prior 12 months; failing that, the CY2026 Medicare Physician Fee Schedule national non-facility amount.
Cap
$10,000 a month

Speed guarantee

Clock-or-Credit Guarantee

From go-live, every new claim goes out within 1 business day of complete charge data, and every denial is worked within 2 business days of posting — or $25 comes off your invoice for each late one.

Terms in one line

Mon–Fri ET business days by your system's timestamps; worked: resubmitted, appealed or returned with the fix; auto-credited; capped at monthly fee; clearinghouse outages excluded.

If we miss
$25 off your invoice for each late item
How to claim
Automatic: credited on that month’s invoice

We publish client results only with written permission. Until we have them, judge us by the guarantees and the free Deadline Map.

Common questions

How much does a medical billing service cost?
ClaimPillar's Full-Service Billing costs 5.0% to 8.5% of insurance payments, set by your specialty and clinician count, with 0% of patient payments, $0 setup and a $400 minimum from your 4th monthly invoice. Complete RCM is 9.0%. Many quotes charge on total collections instead; the cost guide's worked example converts one to our fee base.
How much do ABA billing companies take?
We charge ABA practices 8.5% of insurance payments for 1 clinician, 8.0% for 2–5 clinicians and 7.5% for 6–15 clinicians, with 0% of patient payments. Clinicians are counted on the 1st of each month from the rendering NPIs we billed the month before (for ABA, BCBAs and BCaBAs, not RBTs). Your rate moves with your size band the next month, in either direction. When you compare quotes, check whether the percentage also applies to patient payments. Our ABA therapy billing page covers the authorization and unit rules we work.
How much do chiropractic billing services charge?
Chiropractic is in our PT, OT, speech & chiropractic row of the rate card: 7.5% of insurance payments for 1 clinician, 7.0% for 2–5 clinicians and 6.5% for 6–15 clinicians, with 0% of patient payments. See chiropractic billing for the manipulation and active-treatment rules behind many denials.
Is there a setup fee, minimum or long contract?
$0 setup. Invoices 1–3: only percentage fees on that month's insurance payments, plus any statements or add-ons you order; the $400 minimum starts with invoice 4. Month to month. Leave with 30 days' written notice. No termination fee. Your rate-card rate can't rise for 12 months from your start date; size-band changes still apply; later changes need 60 days' written notice. To put these beside another company's contract, use the nine-term contract checklist.
Do you take a percentage of patient payments or copays?
No. We take 0% of patient payments, copays and anything your front desk collects. Not in the fee base: patient payments, copays, capitation, incentive or grant payments, and payments on claims we never submitted or worked.
What does an in-house biller cost by comparison?
About $4,042 a month for a billing and posting clerk at the median wage, or about $5,774 with benefits, before software and the clearinghouse (U.S. Bureau of Labor Statistics: wages May 2025, benefits June 2026). The in-house vs outsourced billing guide compares responsibilities as well as cost.

Sources and review

Page revised October 8, 2026 · Review contact: Hyder Shah (inquiries@claimpillar.com). Wage and benefit figures are national BLS estimates; your local costs will differ. Every price on this page is ours.

The Free A/R Deadline Map

See which claims to work first, before you choose.

The 5 business days start when we have your claim-level aging export and a signed BAA. The map is yours to keep whether or not you hire us, and if your A/R doesn't need outside help, the map says so.

Get my free A/R Deadline Map

5 business days from your aging export and BAA. Yours to keep.