Medical Billing Services for Small Practices From 5.5%

Who our medical billing services for small practices are built for

Our small-practice billing is for independently owned practices with 1 clinician or 2–5 clinicians. Your size band is recounted each month from the clinicians we billed, and a group that grows to six clinicians moves to the group rates on the rate card.

Hand your billing to us at one of these points:

• The only biller quit or went on leave, and claims stopped going out.
• The owner is entering charges and calling payers after clinic hours.
• The current billing company stopped answering, and claims are aging past 90 days.
• A new practice or a new clinician needs payer enrollment before the first visit.

Therapists, counselors and psychologists in private practice pay the Mental & behavioral health rates, and our behavioral health billing team works their claims. Family medicine and pediatric offices pay the Primary care, pediatrics & urgent care rates through our primary care billing service. Groups of six or more get the same work through our full medical billing service. Cash-only practices are not a fit: our fee is a share of insurance payments, so a practice that bills no insurance has nothing for us to work.

What we take over and what your practice keeps

With one to five clinicians, one absent biller can stop every claim, so we take the whole claim cycle rather than one queue. Your logins, your bank account and your clinical decisions stay with you.

What stays with your front desk?

Your front desk keeps scheduling, check-in, copay collection and patient conversations about balances. We check eligibility for new patients and changed coverage and send coverage problems back to your front desk. Our Complete RCM plan, at 9.0%, also verifies eligibility for every scheduled visit two business days ahead.

Where small practices lose revenue, and what we do about it

Small practices lose money where one person holds the whole process.

• One biller, no backup. When the only biller is out, claims and denials wait. A team, not one person, holds your queue: new claims go out within 1 business day of complete charge data and denials are worked within 2 business days of posting.
• A new clinician sees patients before enrollment. For physicians and non-physician practitioners, Medicare billing privileges start no earlier than the later of the filing date of an approved application and the first date of service at the new location (42 CFR 424.520(d)). We file from your complete provider packet and track each payer until it confirms the effective date. Billed only after the payer confirms your effective date; $0 if denied or panel closed; filed within 5 business days of your complete packet.
• Every question waits in the owner's inbox. We send one decision list with the question, what we checked and the next step, and send it to the backup contact you name when the owner is away.
• Old claims age after a staff change. Claims left by a departing biller or billing company drift toward filing deadlines. The One-Week Deadline Sweep for Specialty Practices: Every inherited claim within 30 days of a filing, corrected-claim or appeal deadline is worked within 5 business days of access. 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.
• One collection number hides the adjustments. Medicare's remittance advice reports the reason and value of each adjustment, and our report keeps each one visible.

Read the workflow as text

1. Agreement and BAA — You sign the scope and BAA and give us your system logins. Owner: Practice owner.
2. Opening inventory — We separate inherited claims from new work and sort them by deadline. Owner: Our billing team.
3. Daily claim cycle — Claims out, payments posted and denials worked inside your own systems. Owner: Our billing team.
4. Decision list — Questions only your practice can answer, each with context and next step. Owner: Owner or backup.
5. Monthly report — Submissions, payments, adjustments and open items, with written definitions. Owner: Our billing team.

What our billing costs a practice with 1–5 clinicians

Your specialty segment and size band set your rate, shown in the table, and setup is $0. 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. Percentage fees and mailed statements are capped at 9.0% of that month's insurance payments; the $400 minimum still applies from invoice 4.

Does the monthly minimum matter for a solo practice?

Only in a month when your percentage fees come to less than $400. 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. Example arithmetic: at 8.5% that is a month with less than $4,706 of insurance payments; at 6.0%, less than $6,667.

Payer application fees and your software subscriptions stay with you; the full rate card lists every exclusion and add-on.

To see your open claims before you decide, request The Free A/R Deadline Map, a deadline-sorted list of your unpaid claims over 90 days, from your aging export and a signed BAA, or ask for a small-practice quote with your provider count, specialty and software.

Our fee or a part-time biller: where each costs less

A billing clerk is paid whether claims pay or not; our fee moves with your insurance payments. Each figure is the monthly insurance payments at which our fee equals that cost, using the May 2025 median wage for billing and posting clerks, $48,500 a year (BLS Occupational Outlook Handbook), and the June 2026 wage share of employer cost: 80.0 percent for part-time and 70.0 percent for all private-industry workers (BLS Employer Costs for Employee Compensation).

Below the line, our fee costs less; above it, the wage costs less on paper, before cover for leave, sick days or a resignation. This is example arithmetic, not a quote; the in-house vs outsourced billing cost model adds software, turnover and the hybrid option.

How we start with a small practice

1. Agreement and BAA. You sign the service agreement and a business associate agreement before we see patient data; HHS lists claims processing or administration, data analysis, billing, and practice management among business associate activities.
2. Access and kickoff. You give us logins to the systems you already use and join one kickoff call. We work inside your existing practice-management system and clearinghouse; tell us which ones and we confirm in writing within 1 business day.
3. Opening inventory. We separate new work from inherited claims and sort the inherited ones by deadline, so old A/R never mixes with new claims in fees or reports.
4. Go-live. Go-live, when your first claims go out, comes within 5 business days of access; any unbilled backlog follows within 10 business days of access. Clock starts with your signed agreement, signed BAA and working system logins; it extends day for day while we wait on access.
5. First review. We review the first report and decision list with you before anything else changes.

Replacing a billing company? Read our guide to switching billing companies before you give notice.

Opening a new practice or adding a clinician?

Payer enrollment, not our go-live, sets the first date you can bill, so send us the provider packet before the first patient visit. Our payer enrollment service files and tracks each application, and credentialing with commercial plans runs alongside it. Our new-practice billing setup checklist lists the order and published lead times.

What we report every month, and the guarantees behind it

Your report arrives by the 10th of each month with written definitions for every measure. It shows the claims we submitted, the payments and adjustments we posted, the balances still open and the decisions waiting on your practice.

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. 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. No billing company can force a payer to approve a claim; what we guarantee is that a claim on our watch does not miss its deadline, or we pay it on the terms above.

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

Common questions

What does medical billing cost a small practice with you?

A practice with 1–5 clinicians pays 5.5% to 8.5% of insurance payments, set by specialty segment and size band, 0% of patient payments and $0 setup. Not in the fee base: patient payments, copays, capitation, incentive or grant payments, and payments on claims we never submitted or worked. The rate card lists every band and add-on.

Can we cancel, and what happens to our claims if we leave?

Yes, with no termination fee. 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.

Do you bill for therapists and counselors in private practice?

Yes. Private practice billing and small-practice billing are the same service here. Therapists, counselors and psychologists pay 8.0% solo or 7.5% with 2–5 clinicians, and our mental health billing team works their claims.

Can a solo practice outsource only part of its billing?

Yes, for claims over 90 days through A/R Recovery, and for payer enrollment through Credentialing & Payer Enrollment; both are priced on their own on the rate card. Claims, posting and denials come as one plan, so the team that sends a claim also works its denial.

Do we have to change our EHR or billing software?

No. We work inside your existing practice-management system and clearinghouse; tell us which ones and we confirm in writing within 1 business day. Our software compatibility page lists the access we need in your system.

Will you take over our old A/R when we switch billing companies?

Yes, as a separate inventory so old and new work stay distinct in fees and reports. Claims over 90 days go to A/R Recovery: 15% of the insurance payments that post after we work them, $0 on claims that never pay. Fee only on insurance payments posting after our logged action; patient payments 0%; full-service clients stay under the 9.0% fee cap.

Do you handle credentialing for a new practice or a new clinician?

Yes. Credentialing & Payer Enrollment costs $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. While you are a client, 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.

What do you need from our practice to start?

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. Send your provider count, specialty and software through the contact form, never patient records or logins.