Which Medical Billing Pricing Model Is Best for Therapists?
By Dax Earl • October 23, 2026
The best billing pricing model is the one that fits your practice’s workload, makes someone responsible for unpaid claims, and is permitted for your practice. A low invoice is useful only if you understand the work it buys. For ongoing insurance billing, Bomi prefers a percentage of net collections where permitted because both teams benefit when the practice actually gets paid.
Sections
What are the four main ways billing companies charge?
Percentage pricing charges a share of defined collections or charges. Those are different bases: a collections fee follows money received, while a charges-based fee can be due before payment. Flat monthly pricing buys an agreed scope for a recurring amount. Per-claim pricing charges for a defined claim event. Hourly pricing charges for recorded working time.
None of these labels guarantees eligibility checks, payment posting, denial appeals, credentialing, patient balance work, or old-claim cleanup. Start by asking each vendor to mark those services included, excluded, or separately priced.
How do the costs compare for the same practice?
Consider a hypothetical month with $20,000 in eligible net collections, 160 original claims, and 12 hours of biller work. At an illustrative 4%, the collections fee is $800. At an illustrative $750 flat monthly fee, it is $750. At an illustrative $6 per original claim, it is $960. At an illustrative $60 an hour, it is $720. These are arithmetic examples, not market averages or competing quotes.
Keep service scope equal before comparing those totals. Add EHR subscriptions, applicable transaction charges, onboarding costs, minimums, and work the practice still has to do. Do not count a low software submission fee as the price of an end-to-end billing team.
Which model fits a new, growing, or established practice?
A new practice may value a fee that moves with collected revenue because a fixed bill can feel large before insurance payments arrive. A mature practice with stable volume and strong internal billing oversight may prefer a fixed budget. A practice buying a defined cleanup project may find hourly work with a budget and deliverables easier to evaluate.
Per-claim pricing can make costs track submission volume and can support arrangements where a collections percentage is prohibited. The trade-off is paying for the agreed submission event even when the claim is unpaid. A growing group should ask whether flat fees have volume or clinician limits before assuming the invoice stays fixed.
Why does Bomi favor a percentage of collections?
We want your practice and our billing team working toward the same outcome: accurate claims that turn into appropriate payment. Collections-based compensation gives us a financial reason to keep working after submission. It also makes the billing fee move with the revenue in the agreed fee base.
Incentives still need a clear scope and visible reporting. Ask who follows a denial, how refunds affect the fee, and what happens at termination. When percentage compensation is prohibited, Bomi uses its applicable per-claim arrangement and keeps the responsibility for follow-through in the service scope.
What should I ask before choosing a biller?
Ask for one sample invoice using your own recent numbers, a list of exclusions, the definition of the fee base or claim unit, the follow-up responsibility, and the exit terms. Review a slow month as well as an ordinary month. Then compare what your practice keeps after billing costs and what your staff still has to handle.
Related questions
Why Bomi uses percentage billing
Flat monthly versus percentage billing
Per-claim versus percentage billing
Hourly versus ongoing outsourced billing
See Bomi’s current pricing or talk through your practice’s billing needs.
Frequently Asked Questions
Is the cheapest billing model always best?
No. Compare the included services, the practice’s remaining work, and actual collections after fees. A cheaper invoice may buy a narrower service.
Does percentage billing mean a percentage of billed charges?
Not necessarily. A contract can use charges or collections. Bomi’s standard percentage arrangement uses defined net collections, subject to its agreement and applicable state restrictions.
Want Bomi to handle insurance billing?
Bomi helps therapy practices with benefit checks, claims, denials, balances, CAQH, attestations, and revenue management.
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About Bomi
Founded by George Ruan, Dax Earl, and Andrey Goder, Bomi helps independent therapists and group practices with insurance billing, credentialing, and payer follow-up. Bomi grew out of Dax’s experience helping his mother with her therapy practice, with a clear purpose: reduce the administrative burden of insurance while keeping practice owners in control.
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