Prices
Our pricing is designed to scale with your practice
Claims management fees are based on your monthly claim volume, with lower rates as volume increases. Everything under Optional Fees is only charged when you ask for it.
Claims Management
Percentage of amounts paid on each claim submitted. Your rate drops automatically as your volume grows.
Starting rate
12%
up to 99 claims
per month
11%
100–299 claims
per month
10%
300–899 claims
per month
9%
900–2,699 claims
per month
8%
2,700+ claims
per month
- Total claims volume is the aggregate number of claims submitted through us each month under your own EIN(s). If you own more than one company we manage claims submission for, total claims volume includes claims from all of your entities.
- If you network with LH, we do not use LH claims volume when calculating your claims volume.
- Rates are based on your average monthly claims volume over a three-month period. Our clinical manager will communicate any rate adjustment to you in a timely manner, and all rate adjustments take effect on the first day of the following month.
Account Management
| Item | Amount | Occurrence / Frequency |
|---|---|---|
| Onboarding | $100 | per provider to add into internal software and systems |
| Claim Reconsiderations | $0 | phone calls with payer reps or in-portal requests, at our discretion |
| Out-of-Network Submission Fee | $15 | per out-of-network claim submitted (plus the applicable claims management rate) |
| Denied Claims (In-Network Only) | $15 | per in-network denied claim (only when all codes on a claim are unpaid) |
| Late Payment | 1.5% / mo | applied to unpaid balances beginning 48 hours after invoice delivery |
| Failed Payment Processing | $25 | per billing cycle if you fail to maintain a valid payment method on file, or payment is not successfully processed |
| Legal Issues | $375 | per hour, when requested by you or required to participate in a legal proceeding |
Only when you ask for it
Optional services are performed on your request or authorization. We never independently initiate work that generates a fee.
Optional Credentialing Tasks
| Task | Amount | Occurrence / Frequency |
|---|---|---|
| In-Network Payer Contract Application | $200 | Split into two payments: 1. $125 for each in-network application 2. $75 when the contract is received, whether it is executed or not |
| Adding a Provider to a Group In-Network Contract | $110 | per provider |
| Address, Name, or EIN Change | $75 | per payer or platform |
| Out-of-Network Payer Registration | $120 | per insurance company |
| Electronic Funds Transfer (EFT) / Direct Deposit Set Up | $75 | per insurance company |
Optional Practice Management Tasks
| Task | Amount | Occurrence / Frequency |
|---|---|---|
| Electronic Health Record (EHR) Integration | $10 | per month, per provider, to link your EHR’s backend to our systems |
| Financial Strategy Dashboard | $15 | per month, per company |
| Explanation of Benefits (EOB) Storage | $25 | per month, per company, for up to 100 EOBs |
Optional Denials Tasks
| Task | Amount | Occurrence / Frequency |
|---|---|---|
| First and Second Level Appeals, Audits and Special Assignments | $65 | per hour, for forms, letters, chart management, and related administrative coordination as needed |
| Sending Medical Records | $25 | per patient (mother or baby) |
Pricing terms. Rates reflect the current annual pricing schedule. Any updates to pricing for the following year will be communicated at least 60 days in advance of implementation.