Medical Billing Services for Small Practices

By MedicalBillingSelect · Sources checked October 5, 2026

A medical billing service sends your claims, chases unpaid ones, works denials, and posts payments. The services compared here generally price billing as a percentage of collections. Their published percentage components run from 2.9% to 8%, before minimums and other fees.

For a small practice, the monthly minimum can matter more than the headline percentage.

Here is why. Recoup publishes 3% with a $1,000 monthly minimum. Under those terms, $12,000 a month in eligible insurance payments means a $1,000 base fee. That is 8.3% of those payments, not 3%. Recoup serves outpatient mental-health groups and clinics first; a solo practice needs to confirm fit.

Below, you can compare eight services, see what the published fee components come to at your size, and check two written quotes side by side. The provider links on this page are unpaid.

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Compare billing services for a small practice

These eight are listed A to Z. This is not a ranking. We read what each company publishes about its own offer. We did not test their work.

"Not published" means we could not find it in the company's public pages. It does not mean zero. Ask for it in writing.

Ready to ask for a quote? These go straight to each company's own site.

Request AdvancedMD RCM pricing

See athenaOne

See Carepatron managed billing

Explore CureMD billing services

View eClinicalWorks pricing

View MedPrecision pricing

Request a Medwave quote

View Recoup pricing

Before you write to any of them, take the quote request further down. It gets you answers you can line up.

What a billing service costs at your size

The percentage is only part of the bill. Three things change it:

1. The monthly minimum. If your percentage comes to less than the minimum, you pay the minimum.
2. What the percentage applies to. Some companies charge on all money collected. Others charge only on insurance payments.
3. Extra fees. A base fee per clinician, software, patient statements, setup.

Here is what the published terms above come to at four practice sizes. All amounts are U.S. dollars. These are fee components and a conditional minimum floor, not full invoices. We assume all collections are eligible insurance receipts and the percentage arrangement is available for the practice. Carepatron uses monthly non-supervisee pricing. MedPrecision shows both possible published tiers for more than one provider; confirm your tier.

Read this before you pick the smallest number:

• Unknown charges stay unknown. AdvancedMD and MedPrecision Solo have an unpublished minimum. eClinicalWorks does not publish one. Carepatron's number leaves out the separate platform plan and any applicable transaction or third-party costs; its software table does not establish whether claim/check charges are added to managed billing. The eClinicalWorks number leaves out patient-statement and eClinicalMessenger charges. MedPrecision's number leaves out applicable third-party costs and separately quoted work. If you retain your current claim-transmission system with Recoup, its charges stay with you.
• The CureMD number is a conditional floor from its public V1018 addendum. It applies only if that addendum governs and your order form does not set a different minimum. CureMD does not publish its rate. This is not a current quote.
• athenahealth and Medwave publish no rate, so they have no number here.
• Bold marks where Recoup's minimum exceeds its percentage component. Divide $1,000 by 3% and the crossover is about $33,333 in monthly eligible insurance payments; Recoup rounds this to about $33,000 on its page.
• These are not the same service. Some are sold with the company's own software. Recoup focuses on outpatient mental health. A lower fee can also mean less work is included.

Now try your own numbers. The first part shows the published components at your size. The second part compares two quotes you have in hand, including percentage, fixed, and per-claim fees. The calculator keeps your inputs in your browser. Enter practice totals, not patient information.

See published fees at your size

Type what your practice collects in a normal month. Everything stays in your browser.

Monthly collections ($)

Providers who bill (1 to 10)

Share that comes from insurance (%)

Show published fees

Compare with an in-house biller

Hourly wage ($)

Hours per week

Payroll taxes and benefits (%). Optional.

Update in-house cost

$24.59 is the U.S. median hourly wage for medical records specialists (Bureau of Labor Statistics, May 2025). This is a broader occupation, not a local billing-staff quote. Change it to what you would pay.

Compare two quotes

Leave a box blank if you don't know the number yet. Blank means unknown. Type 0 only when the company confirmed there is no charge.

Compare the same month and included work. Enter only extra fees outside the base fee and minimum. For independent clinician/location minimums or other unsupported fee structures, obtain the provider's monthly total and use a fixed-price quote.

Total monthly practice receipts ($). Optional.

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The one formula to remember

Minimum ÷ rate = the eligible collections where the percentage component reaches the minimum.

A $1,000 minimum at 3% means about $33,333 a month in the receipts the fee applies to. Below that, the minimum alone exceeds 3%. Fixed extras still add to the bill above that point. If each provider has a separate minimum, calculate each provider separately; a practice total can hide the cost of a quieter clinician.

Here is what a minimum does to a 6% quote. These are example numbers, not a company's prices.

Why the lowest percentage can cost more

Say Quote A is 4% with a $1,500 minimum. Quote B is 6% with no minimum. Same work, no other fees. This is the example loaded in the tool above.

The "cheaper" 4% quote costs more until you collect $25,000 a month.

A note on "4% to 10%"

You may see 4% to 10% quoted as a market range. Recoup's pricing page describes it as a commonly quoted range, not an audited small-practice benchmark. We did not establish an audited dataset behind it. Use the written terms for your practice to set a budget.

Which kind of help fits your practice?

Start with what just happened.

Then check how your collections affect the decision. These are shopping priorities, not company eligibility rules.

Keeping your EHR

Medwave says you can use your own software. Recoup says it works inside the EHR you already run and builds the connection at its own cost. MedPrecision states that EHR integration is included.

That is a start, not proof for your system. Ask each company to show how a charge moves from your exact EHR to a paid claim. Ask who types what, and who pays the claim fees your EHR already charges.

AdvancedMD, athenaOne, Carepatron, CureMD, and eClinicalWorks offer billing alongside their own software. Confirm which EHR or practice-management licenses the proposed service requires and whether you would have to change systems.

Opening a practice

Confirm the enrollment, network status, and effective dates you need with each payer before billing. Credentialing checks professional qualifications; it is not the same as network contracting or electronic claims enrollment. Aetna, for example, requires both credentialing and contracting to join its network.

Two published facts show why timing matters:

• Carepatron's help article estimates 60 to 180 days for payer credentialing. Its billing terms start fees when you accept them, even if onboarding or credentialing is unfinished.
• CureMD's public RCM addendum sets a fallback First Charge Entry Date 60 days after the agreement's Effective Date. That is a software charge-entry definition, not a promise that fees wait 60 days. Ask when the minimum, software, and other fees actually start.

So ask every company two things. When do your fees start? And is credentialing included, extra, or mine to do?

Therapy and counseling practices

For an ABA-specific comparison, see ABA billing services.

Some billing offers are built for mental health only. Some of those are built for groups, not solo clinicians. Recoup says "group practices and clinics first" and tells practices under about $33,000 a month in insurance payments to talk before signing. If you are solo, run the minimum math first.

What a billing service does, and what stays with you

A billing service sends and chases claims. It does not see the patient or write the note. In many cases it does not pick the codes either.

These public documents show why the task split matters:

• AdvancedMD's terms: it does not assign diagnosis and procedure codes.
• CureMD's terms: it does not assign codes, and you resolve credit balances and refunds.
• Carepatron's billing terms: code selection, prior authorizations, and patient intake stay with you; pre-start service dates need a separate written agreement. Its help article also excludes workers' compensation claims; confirm that scope.
• athenaOne's service description: the Base service leaves patient billing inquiries with your team and returns claims that need corrected information or missing documentation. Ask what any added service changes.

Ask each company to mark this list: theirs, yours, shared, or not included.

One more thing. Outsourcing does not remove your responsibility for the information you supply. Confirm the correct billing and rendering NPIs—National Provider Identifiers—and plan for someone on your side to read the monthly report.

Should you outsource, hire a biller, or stay in-house?

Compare the monthly bill for each at your size.

The U.S. median wage for medical records specialists was $24.59 an hour in May 2025, says the Bureau of Labor Statistics. This occupation includes medical coding and records work; it is not a dedicated survey of small-practice billers. Use local hiring quotes when you have them.

At that wage, using 52 weeks divided by 12 months, before payroll taxes, benefits, and software:

• Full time (40 hours a week): about $4,262 a month
• Half time (20 hours a week): about $2,131 a month
• 10 hours a week: about $1,066 a month

Here is where wages alone match a percentage fee:

Below those levels, the percentage component costs less than those wages; above them, wages alone can be lower. This assumes the same collections base, no minimum, and no other service fees. Add employer costs, software, supervision, and any work your practice still has to do before deciding.

Cost is not the whole story. Plan for backup when an in-house biller is sick or leaves. A billing service means you still need someone to feed it clean information and read its reports.

If your biller is good and staying, you may only need better tools.

See what to check when you keep billing in-house

Nine things to get in writing before you sign

1. How the fee works. Percentage, flat price, per claim, or a mix.
2. What the percentage applies to. All money collected, or insurance payments only? Do copays taken at your front desk count?
3. The monthly minimum. The dollar amount. Is it per practice or per provider? CureMD's public default is per provider.
4. Every other fee. Setup, software, statements, eligibility checks, training.
5. Your software. Can you keep it?
6. The work included. Use the list above.
7. Old balances. Who works them, and at what fee.
8. How you leave. Notice period, automatic renewal, and what you owe after you give notice.
9. The business associate agreement, or BAA. For a HIPAA-covered practice, a billing company handling protected health information is generally a business associate. Put the BAA in place before sharing that information. HHS publishes sample terms. Have your attorney or compliance adviser read the real one.

Read number 8 against the actual contract. Published terms show how much it varies:

• Recoup: month to month, 30 days' notice, no term to buy out.
• MedPrecision: its pricing page describes 12 months initially, then month to month with 60 days' notice. Its terms put the signed Service Agreement first, use 60 days' notice where it is silent, and retain fees on later collections attributable to claims it worked. Confirm the actual term, notice, and exit charges.
• Carepatron: 30 days' written notice, then a 90-day claims runout and up to six more months of collection fees. The base clinician fee stops at termination. Annual seats are a separate prepaid commitment, generally nonrefundable if you leave for convenience. The percentage tail does not apply to its restricted-state per-claim arrangement.
• CureMD: its RCM addendum illustrates a charge-submission cutoff with January 31 notice and April 30 as the cutoff; processing fees may continue. Its separate public general agreement contains a 60-month default initial term and early-exit charges. Confirm which documents your order incorporates; the cutoff is not the full cancellation policy.
• AdvancedMD: its marketing page says "flexible agreements." Its public terms run the default first term through the 12th full calendar month after the effective date, unless the order form sets another term. Ask for the notice, renewal, and early-exit provisions that apply to your order.

If you practice in New York or bill Medicaid

Do not assume a percentage arrangement is permitted everywhere. New York Education Law §6530(19) restricts professional fee sharing in medical practice, subject to specified exceptions.

For New York Medicaid, 18 NYCRR §360-7.5(c) says a billing agent's compensation must relate reasonably to the service cost, be independent of amounts billed and collected, and not depend on actual payment collection. New York is not a substitute for checking your own state and payer rules.

CureMD's addendum allows the parties to agree to visit-based pricing when law prevents the percentage formula; the monthly minimum still applies. Carepatron's pricing page lists $7 per submitted claim in restricted states, plus the applicable clinician fees. The existence of an alternative does not establish that your proposed contract complies.

This is general information, not legal advice. Have a health care attorney check the structure for your state, profession, and payer mix, including any Medicaid billing, before signing.

Send this to the companies on your shortlist

Send the same message to two or three companies. They answer the same ten questions, so you can line the answers up. Then put the numbers into the quote comparison.

Use it by email to ask for basic terms before booking a call.

Start with practice-level totals and do not attach patient records. If a company needs records for a later analysis, arrange the BAA and secure transfer first.

Quote request Subject: Written billing quote for our small practice Hello, We are comparing billing services and would like a written quote. About our practice - Specialty and care setting: [ ] - State(s): [ ] - Number and type of clinicians, including any supervised clinicians: [ ] - EHR / practice software we use now: [ ] - We want to: [keep our software / look at new software] - Who does our billing today: [ ] - Insurance payments we receive in a normal month: about $[ ] - Patient payments we receive in a normal month: about $[ ] - Claims we send in a normal month: about [ ] - The work we most need help with: [ ] - When we want to start: [ ] Please answer in writing: 1. Your fee. Is it a percentage, a flat price, per claim, or a mix? What money does a percentage apply to: all eligible collections, or insurance payments only? Explain front-desk payments, self-pay, refunds, and any excluded service dates. For per-claim pricing, define the billable unit and whether resubmissions cost extra. 2. Your monthly minimum. Is it per practice, per clinician, or per location? If it applies separately to each clinician, please show the calculation for each clinician rather than only a combined practice total. 3. Every other charge: clinician or seat fees, setup, software, clearinghouse, statements, eligibility checks, training, and anything else. Please mark what is not included, when each fee starts, and any annual-prepayment commitment. 4. Can we keep our current software? If yes, how does your team work in it? 5. Who does each job: choosing codes, entering charges, fixing rejected claims, working denials and appeals, prior authorizations, posting payments, patient statements, and patient phone calls? 6. Credentialing and payer enrollment. Is it included, extra, or ours to do? How are included applications counted across providers, payers, and states? 7. Unpaid claims from before you start. Will you work them, and at what fee? 8. Contract length, notice to cancel, and any automatic renewal. 9. What we owe if we leave, how long you keep working claims after notice, and how and when we get our data out. 10. A copy of your service agreement, order form and incorporated terms, and your business associate agreement (BAA). Please show what we would pay each month at $[lower amount] and at $[normal amount] in collections, and list one-time charges separately. Please confirm that the proposed fee structure is available for our state, profession, and payer mix. We have not included any patient records. If you need records later, please tell us first how to put the BAA and secure transfer in place. Thank you, [Name, role, practice, email]

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Back to the service comparison

Switching billing companies

A useful timeline depends on your systems, payer connections, and open claims. Get the order right, and get dates in writing.

1. Read your current contract first. Find the notice period, the last day of service, and any fees that continue after notice.
2. Sort the work in progress. Claims sent, claims not yet sent, open denials, patient balances, old insurance balances. Give each pile one owner.
3. Set a cutoff date. The old company handles visits up to that date. The new one handles visits after it. This is how you avoid claims sent twice and claims nobody owns.
4. Check the connections. Assign responsibility for electronic claims, remittance notices, access permissions, and any payer authorizations that must change. Verify that payments continue reaching the correct practice bank account.
5. Get your data. Ask for the format and the date. Carepatron's terms, for example, promise open-claims accounting and an accessible electronic export, such as CSV, Excel, or PDF, within 30 days after termination.
6. Check the first month. Match the first report against your bank deposits.

Questions small practices ask

Will a billing company take a solo practice?

Some will. MedPrecision publishes a solo rate. Carepatron charges base clinician fees without a separate collections minimum. Others make it hard with a high minimum. Medwave says on its own site that solo providers often struggle to find a billing company, and that it takes new practices. Ask the minimum question first.

Does the billing company need to be local?

No. Claims are sent electronically. What matters is who does the work, what hours they answer, and whether they know your specialty and your payers. Ask a local company the same questions you would ask a remote one.

How long does it take to get started?

Ask for a dated plan after the company has seen your software and payer list. If you are a new practice, credentialing can be a major delay. Carepatron's help article estimates 60 to 180 days; that is the company's estimate, not a deadline every payer follows.

Can MedicalBillingSelect get quotes for me?

No. We don't collect your details or pass them to anyone. You pick the companies and contact them yourself. How this site works.

How we chose these services and checked the facts

We picked eight offers a small practice is likely to weigh. They cover billing sold with a company's own software, billing in the software you already have, and one mental-health-only service. A company did not need to pay us or have a referral program to be listed. This is not a full list of the market, and leaving a company out is not a judgment of it.

Provider prices and contract terms above come from the company's own website or public contract documents, read on October 5, 2026. Sources are linked in the comparison and relevant sections. Company claims remain attributed to the company. We did not use any of these services, and no company confirmed a quote to us.

The dollar figures in the tables are our math on those published terms. When a fee was not published, we marked it as unknown and did not turn it into zero. Carepatron's pricing and billing terms differ from its help article; we used the pricing page and terms for its fees and flagged scope details that still need confirmation. We did not fill gaps with averages.

Terms change. If you see one that is out of date, tell us and send the source. Read how we compare.

Your next step

Pick the two or three services that can do the work you need in the software you want. Send each the same quote request. Then compare the monthly bill at your collections.

Compare billing services

Get the quote request

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