Questions billers actually ask

Cloud billing software generally lands between $100 and $500 per provider per month once you count what the quote leaves out: clearinghouse access at $25 to $500 a month, data migration that can run $500 to $10,000, training, and metered storage. Vendors with published entry prices include RXNT at $126 and EZClaim at $199; most others require a sales call.

Ours is flat and printed: $79, $149, or $249 a month with all of the above included. The complete vendor-by-vendor breakdown is in the 2026 pricing survey.

Outsourced services charge 4 to 10 percent of monthly collections, most commonly 5 to 8 percent. Per-claim models run $3 to $10 per claim. Specialties with complex claims (anesthesia, behavioral health) and low-volume practices pay the high end. Full benchmarks, including what to charge if you are the billing company, are in this guide.

It is a multiplication problem. A service fee scales with collections forever; a software subscription does not. At $50,000 monthly collections, 6 percent is $36,000 a year against roughly $1,800 for software. Outsourcing genuinely wins for very small volumes with zero staff time. Run your own numbers; the calculator concedes the cases where the outsourcers are right.

No. Month to month on every plan, cancel anytime, no termination fee, and canceling one thing never reprices another. Annual billing is just a prepaid discount, refunded for unused full months if you leave.

Yes. Patient demographics, payer lists, fee schedules, and code libraries import from CSV exports and 837 files. Migration help is free on every plan, and telling us what you are leaving on the contact form gets you a straight answer about exactly what carries over.

Most practices submit claims the same week they sign up. The honest caveat every vendor should give you: payer-side enrollments for ERAs and certain electronic connections take two to four weeks because payers control that clock, not the software. We start those enrollments on day one so they finish while you work.

Yes, that is the point of the Billing Company plan: unlimited client workspaces, per-client rules and fee schedules, white-label reports, and staff roles, at one flat price with no per-client file fees.

Yes to both. The platform runs in any modern browser on Mac, Windows, or iPad. The iOS app covers the away-from-desk work: push alerts on denials, live claim status, and payment notifications.

Yes. Encryption in transit and at rest, role-based access controls, complete audit trails, and a Business Associate Agreement included with every plan rather than sold as an add-on. The mobile app keeps PHI off the device at rest and requires Face ID or passcode re-entry.

The intermediary between you and the payers. It validates each claim against payer formatting rules (the front-end edits), converts it to the right electronic format, routes it, and returns acknowledgments and rejections. Standalone clearinghouse access is a $25 to $500 monthly line item at many vendors; here it is part of the subscription.

A rejection fails before adjudication: the clearinghouse or payer front end caught a data problem and the claim never entered the payer's system. Fix it and resubmit; no appeal exists or is needed, but the timely filing clock keeps running. A denial comes after adjudication: the payer processed the claim and refused it, so the path is a corrected claim or a formal appeal within the appeal window. The full breakdown with the ten most common rejection reasons is here.

Almost entirely at the front end: eligibility verified before the visit, demographics confirmed at check-in, claims scrubbed for code pairing and modifier problems before submission, and filing deadlines tracked per payer. The HFMA benchmark is about a 5 percent denial rate; every point above it is measurable money, which the calculator will put a number on.

The share of claims accepted and paid on first submission with no human touch after. Healthy is 95 percent or better. Below that, the fix is nearly always front-end scrubbing rather than faster rework.

Clean electronic claims typically pay in 14 to 30 days. State prompt-pay laws cap how long payers can sit on clean claims. Every rejection or denial restarts the clock, which is why first-pass acceptance is the metric to obsess over.

Medicare gives 12 months from the date of service. Ohio Medicaid gives 365 days. Most commercial payers give 90 to 180 days, and your contract can shorten that. The maintained payer-by-payer table, with clock-start rules and what to do when you miss one, lives on the timely filing cheat sheet.

The repetitive layers are automating fast: eligibility checks, format scrubbing, payment posting. The judgment layers are not: appeal strategy, complex coding calls, payer phone battles, and telling a provider their documentation will not survive an audit. The realistic outcome is one biller comfortably running more volume, which is a growth story for billers and billing companies, not an obituary. We build for exactly that biller.