Medical Billing Pricing
Summary
- Rate: 2.99%–6% of collections
- Minimum: $1,000 per month. Each month you pay whichever is higher.
- Your percentage: set after the free audit, based on specialty, volume, payer mix and scope
- Credentialing and old A/R cleanup: quoted separately after the audit
- BAA: signed with every client before we access PHI
MB Claims charges 2.99% to 6% of the collections on the claims we manage, or $1,000 per month, whichever is higher. We set your exact percentage after a free audit of your A/R and denials, and write it into your agreement before we start.
Email hello@mbclaims.comHow is the monthly fee calculated?
Each month, your fee is the higher of these two amounts:
- Your agreed percentage × the collections on the claims we managed that month
- $1,000
At lower monthly collections, the $1,000 minimum is the larger number. Above a certain level, the percentage takes over. Where it switches depends on your rate:
| Your rate | The percentage fee passes $1,000 once monthly collections exceed about |
|---|---|
| 2.99% | $33,445 |
| 4% | $25,000 |
| 6% | $16,667 |
Worked examples
These examples only show how the formula works. They aren't quotes, and they don't predict your collections. We picked the rates to show the math. They don't say what a practice of that size would pay.
| Monthly collections | Example rate | Percentage fee | You pay that month |
|---|---|---|---|
| $15,000 | 6% | $900 | $1,000 (minimum applies) |
| $20,000 | 4% | $800 | $1,000 (minimum applies) |
| $25,000 | 4% | $1,000 | $1,000 (the two are equal) |
| $60,000 | 4% | $2,400 | $2,400 |
| $100,000 | 2.99% | $2,990 | $2,990 |
What decides where you fall between 2.99% and 6%?
We set your percentage after reviewing your reports in the free audit. These are the factors that move it:
- Specialty and coding complexity. Behavioral health authorizations, cardiology diagnostics, DME documentation and timed therapy units take more work per claim than routine office visits.
- Monthly claim volume. Steady, higher volume spreads the fixed work of running your account across more dollars, which tends to support a lower percentage.
- Payer mix. Medicaid managed-care plans, authorization-heavy commercial plans and secondary or coordination-of-benefits claims need more follow-up.
- Denial levels. A practice with frequent denials needs more appeal and correction work than one with mostly clean first submissions.
- Scope. Coding review, eligibility checks, patient statements and reporting depth all change the workload.
- Systems and access. Working inside one EHR/PM system is simpler than moving between several systems or portals.
What's included in the percentage?
Your agreement lists the exact scope. In a standard medical billing engagement, the percentage covers the day-to-day billing workflow:
- Charge entry or charge review
- Coding review against your documentation by our AAPC-credentialed coding support team, when coding is in scope
- Claim scrubbing and electronic claim submission
- Payment posting from ERAs and EOBs, with underpayments flagged
- Denial follow-up, corrected claims and appeals on the claims we submit
- Insurance A/R follow-up
- Monthly reporting on collections, denial categories, days in A/R and aging by payer
We work inside the systems you already use, including Epic, eClinicalWorks, NextGen, AdvancedMD and PracticeSuite. We also work inside other existing EHR and PM systems. You don't have to switch software.
What's quoted separately?
These depend heavily on your situation, so we price them after the free audit, in writing, before any work starts:
- Credentialing and provider enrollment (Medicare, Medicaid, commercial payers, CAQH)
- Cleanup of old A/R, meaning claims a previous biller or your in-house team submitted before we started
- Virtual assistant and front-desk support
We don't publish a setup fee. If onboarding needs extra work, such as a large backlog, we quote it in your written proposal so you see it before you agree to anything.
How does this compare with other billing companies?
Physician community and industry guides commonly cite 4%–10% of collections for outsourced medical billing. Private practices in one large physician community most often report paying 5%–7% (Physician Side Gigs). Monthly minimums are also common, especially for smaller and newer practices.
A lower headline percentage doesn't always mean a lower bill. When you compare quotes, compare four things side by side: the percentage, the minimum, what's included, and what's billed separately. Our guide to how much medical billing companies charge walks through how to compare them.
How do you get your rate?
- Request the free audit. Use the form below or email hello@mbclaims.com.
- Send summary reports. Send your A/R aging by payer, a denial summary and monthly collections. We don't need patient details at this stage.
- Get your written review and rate. Within 5 business days of receiving your reports, we send back our findings, your proposed percentage, and quotes for anything billed separately.
- Sign and start. You review the agreement and we sign a BAA. Then you set up user access for our team in your systems.
Common questions
Frequently asked questions
Is the $1,000 minimum charged every month?
Yes. Each month, you pay whichever is higher: your percentage of that month's collections, or $1,000.
What counts as "collections"?
Collections are the payments received on the claims we manage during the month. Your agreement defines this precisely, including how patient payments and refunds are treated.
Do you charge a setup fee?
We don't publish one. If your onboarding needs extra work, such as cleaning up a backlog of old claims, we quote it in writing after the free audit, before you sign.
How much does credentialing cost?
Credentialing and provider enrollment are quoted after the free audit. The price depends on how many providers and payers are involved.
What are the contract terms?
The term and notice period are set out in your written proposal. You see them before you commit.
Do you guarantee a collection rate?
No. Collections depend on documentation, payer rules, eligibility and enrollment. Every month we report denial categories, days in A/R and aging by payer, so you can judge the work.
Do you sign a BAA?
Yes. We sign a Business Associate Agreement with every client before we access any PHI. How we handle PHI →