Medical Billing Services for Small Practices
A published price you can check against your own collections: 6% of collections, $1,000 monthly minimum, month-to-month, no setup fee.
Medical billing services for small practices take claims, denials and A/R follow-up off a front desk that was never meant to do them, for a fee paid from what is collected. ClaimCarePro publishes that fee: 6% of collections, a $1,000 monthly minimum, month-to-month, no setup fee. This page shows what it would cost at your practice’s size, including when the minimum makes us the wrong choice.
A small practice does not need a bigger billing system. It needs claims going out daily, denials worked by reason code, and someone watching each payer’s filing limit. If you have old claims you have given up on, start with a free A/R audit.
Last updated October 16, 2026. Reviewed by Jacob Greenberg, ClaimCarePro. Payer deadlines are checked against the regulator’s text, linked below.
What a small practice gets
- A price you can calculate today: 6% of collections, $1,000 monthly minimum, no setup fee, month-to-month.
- Claims out daily: eligibility, coding review, submission, posting, denials and follow-up handled.
- No single point of failure: a bench of experienced part-time billers covers the account.
- Old claims worked at 10% contingency: nothing collected, nothing owed.
- Credentialing at $250 per payer: new providers enrolled by the same team that bills.
What billing looks like inside a small practice
Written by people who ran practices, not only billed for them.
In most small practices, billing is nobody’s full-time job, and that is the whole problem. The front desk checks patients in, answers the phone, collects copays and bills when the waiting room empties. Claims go out in batches. Denials get opened when the pile gets big. The owner finds out about a problem when a deposit is short.
We know that pattern from the inside. The people who started ClaimCarePro ran two medical practices while doing the billing for them, spent about three months training one practice’s staff on its EHR, and installed EHRs in two more. The story is on our about page. What it taught us: the fix for a small practice is not more software. It is someone whose job is the claims, every day, with a deadline list in front of them.
The two ways small practices lose money they earned
Claims that never go out. One practice came to us with a full year of Medicare visits that had never been billed; we recovered about $200,000 of a year's unbilled Medicare claims for the practice. Medicare allows one calendar year from the date of service, so the backlog was aging toward the limit every week. We pulled every unbilled visit, sorted by date of service and billed the oldest first.
Providers the payer cannot pay. A claim for a provider whose enrollment is incomplete or lapsed is denied however clean it is. When enrollments stall, the cause we see most is, in Jacob Greenberg’s words, “bad data from the providers”: an old address, a lapsed document, or NPI and tax ID details that do not match across the application, CAQH and the state license. Our credentialing service checks those before anything is filed.
What medical billing costs a small practice, at your size
Every fee is published. The table below is the same price applied to four practice sizes, minimum included.
ClaimCarePro charges 6% of collections with a $1,000 monthly minimum, month-to-month, with no setup fee. The fee is a share of what is actually paid, not of what is billed. The minimum matters most to the smallest practices, so here it is in plain numbers: at about $16,667 a month in collections, 6% equals $1,000. Below that line you pay the minimum, which is a higher effective rate.
| Monthly collections | Monthly fee | Effective rate | Note |
|---|---|---|---|
| $8,000 | $1,000 (minimum applies) | 12.5% | Below the break-even line. Consider aged A/R recovery first. |
| $16,667 | $1,000 | 6% | Break-even: the minimum and 6% are the same. |
| $25,000 | $1,500 | 6% | A typical one- to two-provider office. |
| $50,000 | $3,000 | 6% | The fee grows only because collections grew. |
| Service | Price | Terms |
|---|---|---|
| Full-service billing | 6% of collections | $1,000 per month minimum, month-to-month, no setup fee |
| Aged and denied A/R recovery | 10% contingency | Nothing collected, nothing owed |
| Credentialing, per payer application | $250 per provider | Re-credentialing is also $250 |
| CAQH setup | $250 | Built or repaired, attested, payers authorized |
| New-practice credentialing bundle | $1,750 per provider | Additional providers $1,400 each |
| Credentialing maintenance | $99 per provider per year | Re-attestation and expiring documents tracked |
The same prices are on our pricing page. To compare them with a salaried biller line by line, use our in-house vs outsourced cost comparison, and for the full scope of the service see outsourced medical billing services.
A small-practice biller vs an outsourced team
The comparison most small practices are actually making: a front-desk person who also bills, against a team whose only job is the claims.
| In-house, part of someone’s job | ClaimCarePro | |
|---|---|---|
| Who bills | The front desk, the office manager or the owner, between other jobs | Billers whose only job is your claims, scaled onto the account as needed |
| When claims go out | When someone has time, often in batches | Daily, with automated checks before submission |
| Denials | Opened when the pile gets big | Worked by reason code, repeat causes reported back |
| Coverage when someone is out | Billing stops | Other billers on the bench pick it up |
| Cost | Wages and software whether claims pay or not | 6% of collections, $1,000 per month minimum |
| Knowing the deadlines | Learned the hard way, one denial at a time | Filing limits tracked payer by payer |
What you get in week 1 and month 1
Targets we aim to hit when a small practice starts, in the order we do them. System access and payer enrollment set the pace.
Week 1
- A business associate agreement signed before any patient data moves.
- Individual logins to your EHR or practice-management system, clearinghouse and payer portals.
- An inventory of unbilled visits and open A/R, sorted by filing deadline.
- An enrollment check: every provider, every payer, effective dates on file.
Month 1
- New claims going out daily, rejections fixed and resent.
- Electronic remittances set up so payments post line by line.
- The first denials worked, with the repeat causes sent back to the front desk as fixes.
- Your first monthly report: charges, payments, adjustments, denials and A/R aging by payer.
On established accounts our first-pass clean claim rate runs ~95%. A new account starts lower, because the first month is spent fixing the eligibility, enrollment and data problems a practice brings with it.
The payer rules small practices miss most
Not because they are obscure, but because nobody in a small office owns them. Each row links the source.
| Payer | Rule | Source |
|---|---|---|
| Original Medicare | Claim filed no later than 1 calendar year after the date of service | 42 CFR 424.44 |
| Medicare, new provider | Services can be billed up to 30 days before the enrollment effective date, under the rule’s conditions | 42 CFR 424.521 |
| CAQH ProView | Re-attest every 120 days (180 in Illinois), or commercial payers may stop reading the profile | CAQH ProView quick reference |
| Florida-regulated commercial plans | Submit within 6 months of the date of service, or of receiving the insurer’s correct name and address | Fla. Stat. 627.6131(3)(b) |
| Florida PIP (auto no-fault) | Bill within 35 days of service, or up to 75 days when the insurer had notice of treatment within 21 days | Fla. Stat. 627.736 |
Two of these rows hit new small practices hardest. Medicare’s 30-day retro billing window means a provider who starts seeing Medicare patients long before enrollment is approved may not be able to bill all of those visits. And a lapsed CAQH attestation can stall commercial credentialing without anyone at the practice being told. The common denial causes behind the rest are in our guide to why medical claims get denied.
The small practices we bill for most
More than half of the practices we bill for are chiropractic, physical therapy and injury clinics.
That mix shapes what we are good at. Chiropractic and physical therapy practices live on visit counts, modifiers and plan limits. Injury clinics bill auto insurers as well as health plans: we bill PIP for chiro and injury clinics in Tampa Bay, and remittances from Progressive, Allstate and USAA post daily. Start with chiropractic billing, physical therapy billing or personal injury and PIP billing.
We also bill for solo and two-provider offices in other specialties, including mental health practices. Florida practices can read our Florida medical billing services page for state-specific rules.
Questions a small practice should ask any billing company
Including us. Get the answers in writing.
- What will I pay at my collections? Not the percentage alone: the minimum, setup fee and term too.
- Is the fee on collections or on billed charges? Billed charges pay the company even when you are not paid.
- Who works my account when someone is out? A one-biller company has the same weakness as a one-biller practice.
- Which accounts does your performance number cover? A clean-claim rate without a qualifier is marketing.
- Do I keep my logins? Clearinghouse, payer portals and bank deposits should stay in your name.
- Will you sign a BAA before onboarding? The only right answer is yes.
Medical billing for small practices: questions owners ask
Short answers to what small-practice owners search before choosing a billing company.
How much do medical billing services cost for a small practice?
Is outsourcing medical billing worth it for a small practice?
Can a solo practice afford a medical billing company?
What should a small practice look for in a billing company?
Will a small practice get attention from a billing company?
How long does it take to switch a small practice to outsourced billing?
Do I need a billing company if I only have one or two providers?
Can a billing company help a new small practice get credentialed?
What happens to old unpaid claims when a small practice outsources?
Do small practices keep control of their money when they outsource?
How a small practice starts
- 1
Send your collections and A/R
A recent month of collections and an aged A/R report. We tell you the fee and what is near a filing limit.
- 2
Sign the BAA and grant access
Individual logins to your systems. Nothing moves before the BAA is signed.
- 3
We bill daily from then on
Claims, posting, denials and follow-up, with a monthly report you can check against your deposits.
See Your Fee at Your Size
Send us a month of collections and your aged A/R. We will show you the fee, what is still collectable and what is close to a filing limit. Call (727) 580-8186.