Pricing
One Rate, Everything Included, Published in the Open.
Percentage of collections. No module upcharges, no setup fees, no lock-in.
- 3–8%
- of collections
- $0
- setup fees
- 11
- SLA targets, in writing
Published rates · no module upcharges · exit anytime if we miss.
Rate Calculator
Estimate your monthly fee — no email required
Move the slider and pick your practice type. The estimate updates from our published rates, not a sales conversation.
Rate Calculator
No email gate. Answers straight from our published rates.
Estimated monthly fee
$9,000
Effective rate: 6.00%
$150,000 × 6.00% = $9,000/mo
An estimate from published rates. Your quote is confirmed after a free revenue audit.
Looking to model revenue leakage instead? See the ROI Calculator in Resources — it answers a different question.
Pricing Models
Revenue Cycle Pricing Options: Find the Best Fit
Every healthcare practice is different, so there's no one-size-fits-all pricing model. Medical billing companies typically offer four common pricing approaches, each with its own advantages.
Percentage of collections
3–8%
of net collections
Vendor earns only when the practice collects. Aligns incentives around actual revenue — not claim volume or hours logged.
Trade-off: variable monthly cost that moves with your collections.
Per claim
~$4–12
per claim submitted
A fixed fee for every claim that goes out the door. Predictable per-unit cost at high volume.
Trade-off: the vendor is paid whether the claim gets paid or not — a quiet incentive to submit, not to collect.
Per FTE
~$12–18
loaded, per hour
Staff augmentation model — you rent dedicated headcount rather than an outcome.
Trade-off: you're paying for time on the clock, not results on the scorecard.
Hybrid base + %
Base + %
monthly + reduced rate
A fixed base fee plus a smaller percentage. Blends budget predictability with shared upside.
Trade-off: floor cost even in slow months; useful when volume is steady.
We generally recommend percentage of collections because it aligns our success with yours — we earn more only when you actually collect more. However, we'll work with you to choose the pricing structure that best matches your practice's goals, size, and workflow. Industry ranges above are market context, not NuGenera quotes.
Rate Factors
What drives where your practice lands
Specialty complexity
Behavioral health, oncology, orthopedics, and other high-acuity specialties involve heavier authorization, documentation, and coding workloads.
Pushes rate up.
Monthly claim volume
Larger practices generate operating leverage. We pass through economies of scale rather than pocketing them.
Pushes rate down.
Payer mix complexity
Heavy Medicaid, workers' comp, or a long tail of small commercial payers takes more work per dollar collected than a clean commercial-heavy mix.
Pushes rate up.
Condition of existing AR
A healthy AR book is straightforward to operate. Historical AR cleanup on aged claims is scoped and quoted separately so ongoing rate stays honest.
Doesn't affect ongoing rate — priced separately.
Scope
Full-cycle engagements are more efficient per dollar than picking off a single module. AR + denials only carries a lower rate but a narrower outcome.
Full cycle is the lowest effective rate.
All-Inclusive
Everything Included. One Transparent Rate.
All core RCM services and operating essentials are covered under one simple percentage—no hidden fees, no line-item surprises.
Included Services in every engagement
- Eligibility & Benefits Verification — Confirm coverage and benefits before services are rendered.
- Prior Authorization Support — Obtain and track payer authorizations.
- Medical Coding & Documentation Review — ICD-10/CPT validation and coding quality checks.
- Charge Entry & Claim Submission — Accurate claim preparation and electronic filing.
- Clearinghouse & EDI Management — Clearinghouse fees, enrollments, and connectivity included.
- Payment Posting & Reconciliation — ERA auto-posting, EOB posting, and payment balancing.
- Accounts Receivable Follow-Up — Proactive payer follow-up to accelerate collections.
- Denial Management & Appeals — Analyze, correct, appeal, and prevent denials.
- Underpayment Recovery — Identify and recover missed reimbursement opportunities.
- Patient Billing & Support — Statements, payment assistance, and billing inquiries.
- Credentialing & Payer Enrollment — Provider enrollment, revalidation, and CAQH maintenance.
- Performance Reporting & KPI Dashboards — Actionable financial and operational insights.
- Dedicated Account Manager — A named point of contact backed by an experienced RCM team.
Benchmarks
How NuGenera compares
- NuGenera Target:Transparent SLA commitments you can hold us accountable to.
- Industry Average:Independent MGMA & HFMA benchmark comparisons.
- In-House Estimate:Typical internal costs, including people, technology, and overhead.
% of collections
- NuGenera Target
- 3–8%
- Industry avg.
- 4–10%(MGMA)
- In-house est.
- N/A (fixed payroll)
Setup fees
- NuGenera Target
- $0
- Industry avg.
- $1K–$5K typical(MGMA)
- In-house est.
- Software onboarding + training
Clean-claim rate
- NuGenera Target
- 99%+
- Industry avg.
- ~95%(HFMA)
- In-house est.
- Varies by staffing
Days in AR
- NuGenera Target
- <25
- Industry avg.
- 30–40(MGMA)
- In-house est.
- Varies by staffing
Onboarding time
- NuGenera Target
- 1–2 weeks parallel run
- Industry avg.
- 30–90 days(HFMA)
- In-house est.
- Hiring cycle
Module upcharges
- NuGenera Target
- None
- Industry avg.
- Common (coding, credentialing add-ons)
- In-house est.
- N/A
Contract exit
- NuGenera Target
- 30-day exit if targets missed
- Industry avg.
- 12–36 month lock-in typical
- In-house est.
- Employment at will
Sources: MGMA DataDive and HFMA MAP Keys benchmark reporting. NuGenera figures are contractual targets, not achieved results.
Founding Client Program
Preferred pricing for early partners
A straight value exchange: preferred pricing in exchange for publishable 90-day performance baselines. No borrowed logos, no invented testimonials — real numbers, measured and shared.
- Preferred pricing for early partners
- Publishable before/after baselines within 90 days
- A straight value exchange — no fabricated proof
Placeholder
First case studies
Coming Q3 2026
We won't publish results until a founding client reaches a verified 90-day baseline.
FAQ
Pricing questions, answered directly
Get your rate — from a free revenue audit
Tell us about your practice. We'll review your specialty, volume, and current AR condition and come back with a fixed percentage, not a range.
(855) 455-2873No commitment required · Results in 48 hours.
Get your free revenue audit
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