MedSole RCM
Outsourced medical billing services

Outsource medical billing services for an affordable 2.99%, with no hidden fees

Practices outsource medical billing services to MedSole RCM to get claims paid on time without adding staff. Our AAPC-certified coders and billers handle eligibility, coding, claim submission, payment posting, and denial appeals inside the EHR you already use.

You pay a flat 2.99% of monthly collections, so you only pay when a claim pays. There's no setup fee, software fee, clearinghouse fee, or monthly minimum, and the agreement runs month to month.

Get my free medical billing audit → See our transparent pricing ↓

We've served more than 4,000 providers in all 50 states, billing 900+ payers

✓Fast reimbursement: claims out in 24 hours
✓Transparent pricing: one flat 2.99%
✓Maximum collections: 97%+ net collection rate
MedSole RCM billing specialist reviewing claims in a practice management system
10-digit number required
Revenue cycle basics

What is outsourced medical billing, and who is it for?

With outsourced medical billing services, a practice hires a third-party company to run the billing side of its revenue cycle management (RCM). That covers eligibility checks, coding, claim submission, payment posting, denial appeals, and AR follow-up. The claims still go out under the practice's own NPI and payer contracts, and the company is usually paid a percentage of collections.

A medical practice billing service doesn't replace your front desk. Your providers still document and sign their notes, and your staff still registers patients and collects copays. Everything after the visit moves to the billing team, along with the hours your office manager spends on hold with payers.

When medical billing outsourcing makes sense

Practices tend to look at outside medical billing services when one of these sounds familiar:

  • You're a solo or small practice without a full-time biller
  • You're opening a new practice and need billing ready before the first claim
  • Your biller is leaving, or AR over 90 days keeps growing
  • You're adding providers faster than you can hire billing staff
  • Your specialty has payer rules a general biller misses, like time-based therapy codes or telehealth modifiers
Physician shaking hands with a medical billing specialist over a desk with a laptop, collection reports, and cash

Private practices and groups that outsource medical billing services keep their payer accounts and portals in their own name. If you ever switch companies, nothing has to be handed back.

Recognize your practice in that list? Talk it through with a biller before you decide to outsource medical billing.

From eligibility to payment

What's included when you outsource medical billing services

Our medical billing outsourcing services cover eligibility checks, coding, claim submission, payment posting, denial management, and AR follow-up for every claim. Because these are end-to-end medical billing services at one rate, 2.99% of collections, you don't pay extra for denials, appeals, AR follow-up, or reporting.

In Experian Health's 2025 survey, providers named missing or inaccurate claim data as the top cause of denials. That's why medical billing and coding outsourcing puts two checks on every claim before it goes out.

Step 1: Patient demographics entry

We enter and check each patient's demographics and insurance details within 12 to 24 hours of receiving complete records, so names and member IDs match the payer's file.

Explore patient demographics entry services

Step 2: Insurance eligibility and benefits verification

We verify coverage and patient cost share 24 to 48 hours before each visit, with results back to your front desk within 24 hours.

Explore benefit verification services

Step 3: Prior authorization

We submit each request and track it against the payer's decision deadline, now 72 hours for urgent and 7 days for standard requests with Medicare Advantage and Medicaid plans.

Explore prior authorization services

Step 4: Medical coding and claim submission

Charges are entered within 12 to 24 hours, coded by AAPC-certified coders for CPT, ICD-10-CM, HCPCS, and modifiers, scrubbed against NCCI edits, and sent within 24 hours of the visit.

Explore claim submission services

Step 5: Payment posting and reconciliation

We post ERA and EOB payments the day they arrive and reconcile each one against the claim, so underpayments get flagged the same day.

Explore payment posting services

Step 6: Denial management and appeals

Every denial gets a root cause within 24 hours and an appeal within 48 hours, and we correct the process behind repeat denials.

Explore denial management services

Step 7: AR follow-up and recovery

We work unpaid claims by age at 30, 60, 90, and 120+ days, and follow up with payers well before timely filing limits run out.

Explore accounts receivable follow-up

Step 8: Reporting and analytics

Your account manager walks you through a weekly AR update and a monthly dashboard covering clean claim rate, denial rate, net collection rate, and days in AR.

Explore medical billing reports

8 steps, one flat rate 2.99%

Reporting and the account manager are part of our outsourced billing services, so neither adds to the 2.99%.

Not sure which part of your medical billing services is leaking money?

The free billing audit checks your denial rate, AR aging, clean claim rate, and payer mix, then shows you.

Credentialing with billing

Medical billing and credentialing services under one team

Medicare and Medicaid won't pay a provider who isn't enrolled, and commercial plans usually deny the claim or pay it at out-of-network rates. That's why our credentialing and billing services run on one timeline. Billing is 2.99% of collections, and credentialing is a separate $99 per payer application.

Practices usually add credentialing when they open, bring on a new provider, join new plans, or move to a new state. Approval takes about 30 to 90 days, depending on the payer. You'll find the timeline for each payer on our provider enrollment and credentialing services page.

One credentialing specialist files your applications within 48 hours of complete documents and calls every payer on your file weekly. After approval, the team sets up EFT and ERA with the payer, so payments deposit to your account and post electronically. Our billing team starts sending claims to that payer once it confirms your effective date.

The team also tracks revalidation and recredentialing dates, since a lapse can stop payments from that payer.

This team has helped me to run my private medical practice very smoothly. I truly appreciate Jack and his help with the credentialing, Andrew and his help with billing and Alex with all the miscellaneous questions we have had.
Svetlana McGrath, Nurse Practitioner, Pediatrics (Google, June 2026)

Need to get credentialed before you can bill?

Tell us which payers you want to join. A credentialing specialist will lay out each application and its usual approval time, at $99 per payer.

Transparent pricing

How much does it cost to outsource medical billing?

Most billing companies charge a percentage of what your practice collects. MGMA's rule of thumb puts billing and RCM costs, in-house or outsourced, at about 5% of collections. MedSole RCM charges a flat 2.99% of monthly collections, with no setup fee, software fee, or monthly minimum.

When you outsource medical billing services to MedSole RCM, the 2.99% is the whole billing fee, and it's calculated on the payments we collect each month. The fee rises when your collections rise, and a slow month costs you less. Your agreement runs month to month, so there's no long-term contract to buy out.

What the 2.99% covers, and what it doesn't

Your 2.99% includes:

  • Eligibility checks and prior authorizations
  • Coding review and claim submission
  • Payment posting and denial appeals
  • AR follow-up on every unpaid claim
  • Old AR cleanup after the switch, with no separate fee
  • Monthly reporting and one account manager
  • Billing inside your current EHR, with no software to buy
Physicians and nurses reviewing practice revenue charts on a large wall screen

2.99% is all you pay for medical billing

There's no setup fee, software fee, clearinghouse fee, or monthly minimum on top. Credentialing and any single service you buy on its own are priced separately.

Service Fee
Medical billing
Full-service medical billing 2.99% of monthly collections
Setup, software, and clearinghouse fees No fee
Monthly minimum No fee
Separate services, priced on their own
Hospital billing 2.5% of collections
Credentialing $99 per payer application
Denial management or AR follow-up alone 4.49% of what's recovered
Benefit verification alone $4 per verification
Cost comparison

In-house vs outsourced medical billing: what each really costs

MedSole RCM bills at 2.99% of what your practice collects. One in-house hire costs $51,140 a year in base pay alone, the BLS median for medical records specialists. Below about $1.7 million in yearly collections, it costs less to outsource medical billing services to MedSole than to pay that one salary.

The cost of outsourcing medical billing also moves with your collections. A salary is owed in a slow month too.

In-house medical billing

  • $51,140 median base pay a year, before benefits and payroll taxes
  • Billing software and clearinghouse fees, usually paid by the practice
  • Training time whenever payers or codes change
  • Claims that can sit when your biller is out or quits
  • A fixed cost, owed whether claims pay or not

Outsourcing to MedSole RCM

  • 2.99% of monthly collections, with no setup or software fee
  • No clearinghouse fee, since we bill inside your current EHR
  • AAPC-certified coders who keep up with payer and code changes
  • A team that covers the work when someone's out
  • A cost that rises and falls with your collections

At $40,000 a month in collections, MedSole's fee comes to $14,352 a year. That's $36,788 less than one hire's base pay, before benefits.

BLS has no separate category for billers. Medical records specialists, which includes medical coders, is the closest match. Pay varies by state.

When in-house billing still makes sense

A large group with its own billing department and low turnover may not save much by outsourcing medical billing. Medical billing outsourcing also works in parts. Keep your billers and send us only denials and AR follow-up. Or add a billing virtual assistant, from $14 an hour, who works under your team.

Want the same comparison for your practice? Tell us what you collect a month, and a billing specialist will put your in-house and outsourced costs side by side.

Pros and cons

Benefits of outsourcing medical billing, and how to avoid the risks

The benefits of outsourcing medical billing come down to four things. Claims get paid faster, fewer get written off, the cost tracks what you collect, and your staff gets hours back for patients. The risks are real too, and a good contract covers each one.

What practices gain

Outsourcing medical billing services to MedSole RCM changes six things for your practice. Our RCM page covers the wider benefits of outsourcing revenue cycle management.

  • Claims go out within 24 hours of the visit, and payments post the day they arrive.
  • Unpaid claims get worked before timely filing runs out, which is one year from the date of service for Medicare and often less for commercial plans.
  • A full team works your claims, so one person's vacation or resignation doesn't stop billing.
  • Your fee is 2.99% of what's collected, which ties the cost to results.
  • Payer and code changes, like 2026's prior authorization deadlines and new ICD-10 codes, are our job to track.
  • You and your office manager stop chasing payers and get those hours back.

The risks, and what to require in writing

Before you outsource medical billing services, put six protections in the contract. Most lists of the pros and cons of outsourcing medical billing skip this part.

Risk What to require in writing How MedSole RCM handles it
Hidden fees One rate, with every possible fee listed Flat 2.99%, with no setup, software, clearinghouse, or minimum fee
No visibility Your own access to reports and AR by age Weekly AR updates and a monthly dashboard
Slow replies A named contact and a set reply time One account manager, with replies within 24 hours
Only easy claims get worked Denial and aged AR reporting Every denial worked within 48 hours, and every unpaid claim followed up by age
Lock-in or data held back Month-to-month terms, and your data stays yours Month-to-month terms; payer accounts and portals stay in your name
HIPAA exposure A signed Business Associate Agreement before any access BAA signed before we touch any patient data

If a billing company won't put these in writing, keep looking.

Why practices switch

Why choose MedSole RCM for outsourced medical billing: one affordable rate, a full billing team

When you outsource medical billing services to MedSole RCM, you get a full billing team for one affordable fee, with no long-term contract to lock you in. That team handles what providers ask us for most.

Client results

Results practices see with MedSole RCM

MedSole RCM's client reports track clean claim rate, denial rate, net collection rate, and AR aging. Use the same numbers to judge anyone you outsource medical billing services to. Ask any company offering outsourced medical billing services for the same figures.

The numbers we report

Clean claim rate
99%
Denial rate
Under 4%
Net collection rate
97%+
Days in AR
Under 28

Averages across MedSole RCM clients. Results vary by specialty and payer mix.

Fast reimbursement

  • Coverage verified 24 to 48 hours before the visit
  • Claim filed within 24 hours of the visit
  • Payment posted the day it arrives

Maximum collections

  • Follow-up by age, starting at 30 days
  • Underpayments flagged the same day
  • Old AR worked after the switch

What providers say about their billing

Twila Jones Mojica

Mental Health Counselor

"Andrew communicates in real time and the turnaround for payments moves rather quickly. I highly recommend Medsole RCM for those in private practice."

Trustpilot reviewJuly 2025

Cleavon Matthews

Counselor

"Excellent services. Jack and the team made the credentialing experience pretty seamless. I also contracted with them to do monthly billing and my revenue definitely increased."

Google reviewJune 2026

Isabella Saffioti

Occupational Therapist

"I was previously using a different billing company who was making several mistakes with my billing, I was not getting paid and it was a complete mess. ... Andrew has been helping me with all of my billing and he even was able to get me a higher reimbursement rate with two insurance companies."

Trustpilot reviewDecember 2025

Andrea Piazza

Licensed Mental Health Counselor

"Medsole is an excellent and irreplaceable business partner. We keep coming back to them for more and more services because we trust their work that much. I would highly recommend them to anyone looking for a credentialing, billing or VMA vendor."

Google reviewJuly 2026

Meg-Anne Coyne

Social Worker, Clinical

"I had an excellent experience with MedSole-RCM Credentialing and billing. Their team was pleasant, efficient, and got me enrolled with Medicare incredibly quickly. Pricing was competitive, and Noah was a delight to work with, knowledgeable, responsive, and attentive. I highly recommend MedSole-RCM to any provider seeking reliable credentialing and billing support."

Google reviewMay 2026

Yzetta Martinez

Licensed Mental Health Counselor

"Their team responded quickly and thoroughly when it came to checking credentialing and addressing any discrepancies reported by patients regarding their insurance coverage. It's clear that they take their role seriously and are committed to making sure everything runs smoothly on the back end."

Trustpilot reviewJuly 2025

Read MedSole RCM billing reviews
Any practice size

Outsourced billing for solo, small, group, and hospital practices

MedSole RCM provides physician billing services for practices of every size, from a solo provider to a multi-site group, and runs hospital billing as its own service. The process is the same whenever you outsource medical billing services. What each practice needs most is different.

Solo and small practices

Solo and small practices get affordable medical billing services without hiring a full-time biller. The fee is 2.99% of what you collect, and one account manager learns your payers.

Private practice billing

New practices

New practices can have credentialing and billing set up before the first patient visit, so early claims aren't held up by enrollment. Still forming the entity? LLC or PLLC formation is $349 with us, plus state filing fees.

LLC and PLLC formation

Group and multi-site practices

Group and multi-site practices keep one account manager across every location. Our outsourced billing services credential new providers as you hire them, and reports break out denials by payer and reason.

Group practice billing

Clinics

Clinics usually see denials start at the front desk, with a missed eligibility check. We check coverage before every visit through our outsourced medical billing services for small clinics, and our billing outsourcing services work any denial that slips through.

Hospitals

For hospitals, MedSole RCM runs a separate service. When you outsource hospital billing to us, the rate is 2.5% of collections and covers facility and professional billing, plus DRG and APC coding.

Hospital billing services
Specialties we bill for

Specialty medical billing services, by billers trained in your field

Each specialty has its own CPT codes, modifiers, payer rules, and documentation standards. MedSole RCM's billers know the denial triggers that hit your specialty and which payers reject which modifiers.

See all 75+ billing specialties

Get specialty billing help

Leave your details and a billing specialist will walk you through the billing rules for your specialty.

Your information is secure and will never be shared.

Thank you! Your request has been received. A MedSole RCM billing specialist will contact you shortly.

Buyer's checklist

How to choose among medical billing outsourcing companies: 7 questions and 5 red flags

There's no single best billing company for every practice that wants to outsource medical billing services. Among outsourced medical billing companies, the right fit answers seven questions in writing. Compare third-party medical billing companies on what the fee covers, the numbers they report, who answers your calls, and how easy it is to leave.

Questions to ask before you sign

Before you outsource billing services to anyone, get these answers in writing:

  1. Is your fee a percentage of collections or of charges, and what's billed separately?
  2. Have you billed for practices in my specialty, and can I speak with one?
  3. Who codes my claims, and how often is that coding audited?
  4. Will you bill inside my current EHR, or do I need new software?
  5. Do insurance payments deposit straight into my practice's account?
  6. What happens to my AR over 90 days when you take over?
  7. Where does your billing team work, and who can see my patients' data?

Red flags in a billing contract

Read the contract before you sign. In medical billing outsourcing, any of these is a reason to keep looking:

  • A fee based on charges billed
  • Add-on fees the contract doesn't list
  • A multi-year term with early-termination penalties
  • Insurance payments routed to the billing company's account
  • Promised revenue increases or guaranteed results

Question 3 matters more than it looks. The OIG's compliance guidance for third-party medical billing companies says percentage billing arrangements may increase the risk of upcoding. A medical billing outsourcing company should show you who checks its coding. At MedSole RCM, AAPC-certified coders review every claim before it goes out.

Onboarding process

How to outsource medical billing and switch billing companies without a revenue gap

When you outsource medical billing services to MedSole RCM, the first claims go out within 7 to 10 business days, and the full switch takes 30 days. Your current biller keeps working until we're live, so claims don't fall into a gap.

Step 1 · Week 1

Free billing audit and revenue analysis

We pull your denial rate, AR aging, clean claim rate, net collection rate, and payer mix from your system. You get a written report showing where revenue is leaking. There's no cost and no commitment.

Step 2 · Weeks 2 to 3

Onboarding and EHR integration

We set up inside the EHR and practice management system you already use, and check each provider's credentialing status. First claims go out within 7 to 10 business days, depending on how quickly EHR access comes through.

Step 3 · Weeks 3 to 4

Parallel billing transition

Your current process keeps running while our team shadows it, then takes over. There's no blackout period where claims stop going out, and filing deadlines stay covered. We also start working your aged AR, with no separate cleanup fee.

Step 4 · Day 30 onward

Full revenue cycle management

By day 30, the switch is complete. Your billing team handles every step from eligibility to AR follow-up, and one account manager is your single contact for anything billing.

Step 5 · Every month

Performance review

Each month, your account manager walks you through collection rate, denial trends, AR aging, and clean claim rate. When a payer changes its rules, the team updates your claims workflow to match.

What to have ready

Most of this comes from your current biller or EHR. Your account manager confirms the exact list on the first call. You'll need the NPI and tax ID for each provider and the group, your payer list and current fee schedules, login access to your EHR or practice management system, ERA and EFT enrollment details for your clearinghouse, your latest AR aging report, credentialing status for each provider with each payer, and open denials and their appeal deadlines.

When you're ready, week one starts with the free audit.

Works with your EHR

EHR and practice management systems we bill in

We bill inside your current EHR and practice management system, so your front desk keeps its logins and nothing gets migrated.

Don't see your system? We bill in 50+ EHR and practice management platforms.

Nationwide coverage

Affordable medical billing in all 50 states, across 900+ payers and state Medicaid programs

Practices in all 50 states outsource medical billing services to MedSole RCM, which bills more than 900 payers from its base in Mesa, Arizona. Medicare's core rules are national. Medicaid rules change at every state line, because each state sets its own filing limits and managed care rules. Our billers work each state's Medicaid program and its plans by those rules.

Map of the United States with each state labeled, showing MedSole RCM's nationwide medical billing coverage
Common questions

Outsourced medical billing FAQs: pricing, HIPAA, payments, and switching

Everything you need to know about our outsourced medical billing services, pricing, onboarding, and how we protect your revenue cycle.

Still have questions?

Can't find the answer you're looking for? Our billing specialists are ready to walk you through every detail of your revenue cycle.

Q1 Does the 2.99% include credentialing?

No. Billing is a flat 2.99% of monthly collections, and credentialing is a separate $99 per payer application. One provider with one payer counts as one application. Credentialing is a one-time project for each payer, while billing runs every month, so each is priced on its own. That keeps the cost to outsource medical billing with MedSole at 2.99%. Behavioral health practices often start both at once through our mental health billing and credentialing services.

Q2 Are there hidden fees or a monthly minimum?

No. MedSole RCM charges a flat 2.99% of monthly collections, with no setup fee, software fee, clearinghouse fee, or monthly minimum. Working your old AR after the switch carries no cleanup fee, and patient statements have no separate printing or mailing charge. The only services priced outside the rate are credentialing, at $99 per payer application, and single services bought on their own, like standalone denial management.

Q3 Is prior authorization included in the 2.99%?

Yes. Prior authorization is part of full-service billing at no separate charge. The team submits each request and follows it to a decision before the visit, so fewer claims get denied for a missing authorization. Practices that only need help with authorizations can buy that service on its own, priced by request volume and specialty. Either way, the requests run inside your current EHR and payer portals.

Q4 How fast do insurance payments come in?

It depends on the payer, but the claim itself goes out within 24 hours of the visit. Medicare holds clean electronic claims for at least 13 days and pays them within 30 days of receipt. Commercial payers follow state prompt-pay laws, which vary by state. We post each payment the day it arrives, and our clients average under 28 days in AR.

Q5 How does MedSole RCM maximize collections?

We work every unpaid claim until it's paid or resolved. That means follow-up by age at 30, 60, 90, and 120+ days, well before timely filing limits run out. We check each payment against the claim when it posts, so an underpayment gets flagged the same day. After the switch, we also work your old AR with no cleanup fee. Our clients average a 97%+ net collection rate, and results vary by specialty and payer mix.

Q6 Can a small or solo practice outsource medical billing services?

Yes. Small and solo practices can outsource their billing with no monthly minimum, so a slow month costs less. The fee is 2.99% of what's collected, which means a solo practice collecting $20,000 a month pays $598. Your agreement runs month to month, and one account manager learns your payers, so your claims don't depend on a single part-time biller being in the office.

Q7 Is outsourced medical billing HIPAA compliant?

It is when the billing company signs a Business Associate Agreement and protects patient data as the HIPAA Security Rule requires. HHS lists billing as a business associate function. Our outsourced medical billing services start with a signed BAA before we access any data. Patient data is protected with 256-bit AES encryption in transit and at rest, and our systems get quarterly vulnerability assessments and annual audits. Every team member is screened against the OIG exclusion list.

Q8 Do I have to switch EHRs or buy new software?

No. We bill inside the EHR and practice management system you already use, across 50+ platforms, including athenahealth, eClinicalWorks, AdvancedMD, and SimplePractice. There's no data migration and no software fee. A medical billing service should fit your workflow, so your staff keeps scheduling and charting the way it does today. Dental practices on Dentrix, Eaglesoft, Open Dental, or Curve Dental are covered too.

Q9 When will I see the first payments after switching?

When you outsource medical billing to MedSole RCM, the first claims go out within 7 to 10 business days. Payment timing then depends on the payer. Medicare holds clean electronic claims for at least 13 days and pays them within 30 days of receipt. Commercial payers follow state prompt-pay laws, which vary by state. Your current biller keeps working during the switch, so payments on older claims keep coming in.

Q10 Which KPIs should a medical billing company report?

A medical billing company should report your clean claim rate, denial rate, net collection rate, and days in AR every month. Clean claim rate is the share of claims accepted on the first submission. Denial rate is the share of claims payers deny. Net collection rate is the collectible revenue that reaches your account after contractual adjustments. Days in AR is how long revenue waits, on average, to be paid. MedSole RCM's client averages are 99%, under 4%, 97%+, and under 28 days.

Q11 Is AI replacing medical billers?

No. Software now handles repetitive checks, such as eligibility and claim scrubbing, but appeals and payer calls still need trained billers. The 2025 CAQH Index found that electronic transactions helped US healthcare avoid $258 billion in administrative costs in 2024. That's the work automation does well. Outsourcing medical billing gives you both sides: MedSole RCM combines AI tools with AAPC-certified billers, who work the denials software can't fix.

Q12 Do you bill for DME suppliers and laboratories?

Yes. Suppliers that outsource DME billing services get HCPCS coding and medical necessity paperwork checked before each claim goes out, including monthly rentals and the written orders payers ask for. Labs that outsource laboratory medical billing get panel codes checked against payer frequency limits. Both are among the 75+ specialties we bill, with the same AAPC-certified coding review as every other claim.

Q13 Can I cancel, and who keeps my data?

Yes. MedSole RCM works month to month, and your payer accounts and portals stay in your practice's name the whole time. Nothing has to be handed back when you leave. Because we bill inside your own EHR, your claims history and reports stay in your systems too. If you outsource medical billing services to us and later move on, your next team starts with everything in place.

Q14 What are the best medical billing outsourcing companies in the USA?

The best one for your practice is the company that puts its fee, reported numbers, reply times, and exit terms in writing, with references in your specialty. Many online rankings are published by billing companies themselves, so read them with care. Use our seven questions to ask before you sign, and compare the answers side by side. For a starting point, get a free billing audit of your current numbers.

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Free billing audit

See where your claims stand before you outsource medical billing services

The free audit shows your denial rate and AR aging, whether or not you choose MedSole RCM. If the numbers make the case, we take over your medical billing services for a flat 2.99% of collections, month to month.

  • Flat 2.99% of monthly collections
  • No setup fee or long-term contract
  • 99% clean claim rate
  • Works inside your current EHR

Fill out the form, and a MedSole specialist will reply within 24 hours.

Or call (602) 563-5281 or email info@medsolercm.com