Services, Benchmarks & Custom Quotes
Below is an overview of the services we offer and how we structure pricing. Every practice is different, so we use standard industry benchmarks as a starting point and confirm your exact investment on a complimentary call.
All figures on this page are standard benchmarks or estimates. Final pricing is based on a complimentary discovery call and the specific needs of your practice.
Credentialing, billing, and practice support services.
Provider Enrollment
Get physicians, groups, and facilities enrolled and in-network with the payers you need.
Medical Credentialing
Applications, CAQH upkeep, and payer follow-up managed end-to-end so nothing falls through the cracks.
Insurance Credentialing
Panel enrollment with commercial payers so your practice can bill sooner and get paid faster.
Medicare Enrollment (PECOS)
PECOS applications, revalidations, and reassignments handled for you from start to finish.
CAQH Credentialing
CAQH ProView setup, attestation, and ongoing upkeep — without the stalls or missed deadlines.
Payer Contracting
Insurance contract review and negotiation support for stronger reimbursement terms.
Credentialing Maintenance
Re-credentialing and expirable tracking so your enrollments stay current and compliant.
Revenue Cycle Management
Full billing support: claim submission, payment posting, denials, appeals, A/R follow-up, and reporting.
Four things that shape your investment.
Tell us these four things and we can turn around a clear, itemized quote.
Number of providers.
One physician versus a full roster changes the scope significantly.
Number and type of payers.
Medicare, Medicaid, and each commercial plan is a separate application with its own process.
Enrollment vs. maintenance.
A one-time enrollment is priced differently from ongoing upkeep like re-attestation, revalidation, and expirable tracking.
Complexity.
New practices, facility credentialing, and payer contracting take more work than a straightforward panel add.
How much does medical billing & credentialing cost?
There is no single price — cost scales with the number of providers, the number of payers, and whether you need one-time enrollment or ongoing maintenance. Every BrightBill engagement is quoted individually.
As a rough industry benchmark, credentialing services commonly run about $200–$500 to set up a provider with a payer, and roughly $50–$200 per provider per month for ongoing maintenance; full outsourced RCM engagements are often quoted around 3–7% of monthly collections. These are market figures to set expectations, not our prices — your quote depends on your provider count, payer mix, and scope.
What we need to quote you
- Number of providers and practice type
- Monthly collections and payer mix
- Services you want in-house vs. outsourced
- Current pain points and timeline
Three simple ways to pay
Because every organization has different volumes, specialties, and operational demands, we offer several structures that ensure fairness, stability, and scalability.
Flat Monthly Fee
A fixed monthly fee for the contracted scope of services. Optional add-on services (credentialing, audits, cleanup projects, etc.) are quoted separately. Ideal for practices with predictable volume and consistent workflows.
Base + Percentage (Most Common)
A guaranteed monthly base fee plus a percentage of monthly collections. The base covers the fixed work we do every month: A/R follow-up, denial management, appeals, patient statements, payment posting, reporting, and compliance oversight. The percentage aligns the fee with your actual revenue.
Percentage Only
A percentage of monthly collections with no base fee. Available only when collections volume is consistently high enough to support the workload of full revenue cycle management.
Which Pricing Model Fits Your Practice?
Every practice is different. This chart shows how the three structures compare so you can see why we usually recommend one over the others.
| Model | Best For | How It Works | Pros for Practice | When to Avoid |
|---|---|---|---|---|
| Hybrid (Base + Percentage) | Most practices, especially those needing full RCM | Base covers fixed workload; percentage covers variable workload; both apply monthly. | Predictable support; cost scales with growth; full RCM coverage. | Avoid only if the practice wants ultra-simple billing and has extremely stable volume. |
| Percentage Only | High-volume, commercial-heavy, stable practices | Fee is based entirely on collections. | No upfront cost; easy to understand. | Avoid for low-volume, messy, or Medicaid-heavy practices. |
| Flat Monthly | New, low-volume, or Medicaid-heavy practices | One fixed fee regardless of collections. | Predictable budgeting. | Avoid for high-volume practices where workload scales significantly. |
Billing, Denials & Revenue Cycle Management
Our full RCM service handles the day-to-day work of getting you paid. Pricing is based on practice size, collections volume, and the model you choose.
- Onboarding, payer setup, and workflow design
- Claim creation, scrubbing, and submission
- Denials, appeals, and A/R follow-up
- Payment posting and reconciliation
- Monthly reporting and a regular call with our team
- HIPAA-compliant workflows and access controls
Standard benchmark: Full RCM is often structured as a flat monthly fee, a base plus percentage of collections, or percentage only. Capitated / managed care revenue is typically billed at a lower percentage than fee-for-service collections. We confirm the exact structure and rate for your practice on the call.
Advice, Audits & Oversight — Without the Day-to-Day Billing
For practices that keep billing in-house but want expert eyes on performance: billing audits, KPI reviews, denial root-cause work, SOPs, and staff coaching. Consulting is priced individually based on the size of your practice and exactly what you want included — a one-time audit, a monthly review, or ongoing advisory support. We will scope it together on a complimentary call and send you a written quote.
Credentialing and Payer Enrollment Services
Credentialing vs. Contracting
Credentialing / per-payer enrollment is for practices that already hold an active contract with a payer and need a provider linked to it. The relationship with the payer already exists — we handle the enrollment, CAQH cleanup, application, follow-ups, and effective-date confirmation.
New payer contracting & enrollment is a completely different scope. Here there is no existing contract. We build the relationship from scratch, review and negotiate the contract, analyze the fee schedule, set up every billing connection, and confirm the provider is truly active and ready to bill. For a solo provider this may be less or bundled depending on needs; for group practices it can be higher based on provider roster and complexity.
| Service | Scope |
|---|---|
| Per Payer Enrollment / Per Provider | For existing contracts. One more enrollment or revalidation for the same provider. |
| Ongoing Maintenance | We track expirations, attestations, and directory accuracy so nothing lapses. |
| New Payer Contracting & Enrollment* | Building a brand-new payer relationship from scratch: contract review, negotiation support, fee-schedule analysis, and full billing setup. |
| Complex Engagements | Group and multi-provider enrollments, bulk or multi-state enrollments, facility enrollments, new payer contracting and rate negotiation, new lines of business, name or ownership changes, and rush timelines. |
* Group practices may be higher depending on practice type and size, because each provider must be added to the contract. Solo providers may be less or bundled depending on needs. We confirm the exact fee after reviewing your roster and payer requirements.
Anything more complicated starts with a complimentary 30-minute discovery call. You get a written quote, scope, and timeline within 2 business days.
Remote Practice Support
Part-Time Coverage
Up to 20 hours a week of remote front-desk support.
Full Business Hours
Standard weekday coverage for your practice.
Overflow / As Needed
Flexible hours based on your volume — ask for details.
Includes scheduling, intake coordination, insurance verification support, patient communication, and reminder calls. Pricing depends on hours and scope — ask for a custom quote.
Patient Billing Phone Support
Optional add-on for practices that want patient billing calls handled by trained representatives. We scope the monthly fee based on expected call volume. Higher volumes are quoted separately.
Standard Terms
- Collections means all payments received (insurance and patient), minus refunds.
- Minimum service term is 3–6 months for new clients.
- An onboarding fee applies unless we waive it in writing.
- Anything outside the agreed scope is quoted separately.
- Every range here is a benchmark — we confirm your exact price on the call.
Pricing FAQ
How do I know which pricing model is right for my practice?
It depends on your collections volume, payer mix, and how predictable your monthly revenue is. Flat fee works well for steady, predictable practices. Base + Percentage is the most common because it protects you in slow months while staying fair in busy months. Percentage Only is available when your volume is consistently high enough to support the workload.
What is included in the monthly fee?
Full RCM includes claim creation and scrubbing, submission, payment posting, denial and appeal management, A/R follow-up, monthly reporting, and a regular check-in with our team. Credentialing, consulting, cleanup projects, and add-ons like patient billing phone support are priced separately based on scope.
Are there any hidden fees?
No. We quote your monthly fee, onboarding fee, and any add-ons in writing before work begins. Anything outside the agreed scope is discussed and approved first.
Why is there an onboarding fee?
Onboarding covers the work required to safely transition your billing — payer setup, workflow mapping, system access, historical A/R review, and staff training. It is a one-time cost, and we occasionally waive it for qualifying engagements.
How does the Base + Percentage model work?
This is our most popular option because it balances stability and fairness. Each month you pay a guaranteed base fee that covers the fixed work we do no matter how many claims go out: A/R follow-up, denial management, appeals, patient statements, payment posting, reporting, and compliance oversight. On top of that, you pay the agreed percentage of your FFS and capitated collections. The base is always charged, the percentage is added on top, and base fees do not roll over or credit forward.
Can I change pricing models later?
Yes. After the initial term, we can review your volume and adjust the structure if your practice has changed. Any change is documented in a written amendment.
What if my practice is new and has no collections history?
New practices usually start on a flat monthly fee while volume stabilizes. Once we have a few months of collection data, we can revisit a percentage-based model.
How is credentialing priced?
Credentialing and enrollment are quoted individually based on provider count, payer mix, and whether the payer contract already exists. Per-payer enrollment for existing contracts, ongoing maintenance, new payer contracting, and complex engagements all have different scopes. We review your needs on a complimentary discovery call and send a written quote.
Do you charge extra for patient billing calls?
Patient billing phone support is an optional add-on. We scope the monthly fee based on expected call volume and include a generous allowance. Higher volumes are quoted separately.
How do I get an exact quote?
Book a complimentary call. We will review your volume, specialty, payer mix, and current pain points, then send a written proposal with your exact monthly fee, onboarding cost, and any add-ons within 2 business days.
Disclaimer: Every figure on this page is a benchmark or estimate. Your final price is determined after a complimentary discovery call where we review your practice size, payer mix, specialty, and exact scope of work.
Ready to Get Started?
- Book a complimentary 30-minute call.
- We review your volume, payer mix, and gaps, then send a tailored proposal within 2 business days.
- Sign the agreement and we begin implementation.