physiciancure.com Pricing

Physiciancure.com makes a specific claim regarding its pricing model, stating “Affordable pricing starting at just 2.95% of monthly collections.” This indicates a common pricing structure for medical billing services, where the cost is a percentage of the revenue collected on behalf of the practice.

This model is often attractive to healthcare providers as it aligns the billing company’s success with the practice’s financial performance: the more revenue collected, the more the billing company earns.

However, “starting at” implies potential variations and additional costs that may not be immediately obvious.

Understanding the Percentage-Based Pricing Model

The “2.95% of monthly collections” model is a prevalent method in the medical billing industry. Here’s how it typically works and what it implies:

• Alignment of Interests: This model incentivizes the billing company to maximize collections for the practice, as their income directly depends on it. If they don’t collect, they don’t get paid for that portion.
• Variable Cost: The cost to the practice fluctuates with their monthly revenue. In high-collection months, the cost is higher, but in lower months, it’s lower, making it flexible for practices with fluctuating patient volumes.
• “Collections” Defined: It’s crucial to understand what “collections” refers to. It usually means all money received from payers (insurance companies) and patients for services rendered. It should include successful claim payments, patient co-pays, deductibles, and self-pay amounts.
• “Starting At”: The phrase “starting at 2.95%” is a key qualifier. This suggests that some practices or specialties might pay a higher percentage. Factors influencing a higher rate could include:
  • Specialty Complexity: Certain medical specialties (e.g., complex surgeries, oncology) have more intricate coding and billing requirements, which might warrant a higher percentage.
  • Claim Volume & Value: Very low volume practices might have a higher minimum percentage, or very high volume practices might get a slight discount.
  • Additional Services: If a practice requires extensive denial management, credentialing for multiple new payers, or advanced reporting beyond standard services, the percentage might increase or additional fees could apply.
  • Age of Receivables: Dealing with a high volume of aged receivables (old unpaid claims) can be more labor-intensive and might justify a higher rate.

Potential Hidden Costs or Exclusions

While 2.95% is presented as an affordable starting point, potential clients should inquire about:

• Setup Fees: Are there any one-time setup fees for integrating with their EHR or initial credentialing?
• Clearinghouse Fees: Are electronic claim submission fees (clearinghouse fees) included in the percentage, or are they a separate pass-through cost?
• Software Fees: If Physiciancure.com uses proprietary software that the practice needs to access, are there additional software licensing or user fees?
• Statement Fees: Are patient statement printing and mailing costs included, or are they billed separately per statement?
• Reporting Customization: Is basic reporting included, but custom reports incur additional charges?
• Advanced Analytics: Are deeper analytics or business intelligence tools part of the standard offering or an add-on?
• Termination Fees: Are there any fees associated with early contract termination?
• Minimum Monthly Fees: Some percentage-based models might have a minimum monthly fee, regardless of collections, to cover overhead.

Comparison to Industry Averages

Pricing for medical billing services typically ranges from 4% to 10% of collections, with averages often falling between 5% and 8%. A “starting at 2.95%” is indeed on the lower end of this spectrum, potentially making Physiciancure.com very competitive on price. However, practices should be cautious:

• “You Get What You Pay For”: Extremely low rates can sometimes indicate limited service scope, less experienced staff, or a business model that relies on high volume with less personalized attention.
• Full Service vs. Basic: Ensure that the 2.95% covers all the comprehensive services promised (e.g., eligibility verification, denial management, appeals) and not just basic claim submission.
• Net Collections Impact: A slightly higher percentage charged by a more efficient billing company could still result in higher net collections for the practice if they recover more denied claims or reduce days in A/R more effectively. For example, a company charging 5% but recovering an additional 5-10% of revenue that would otherwise be lost due to denials could be more cost-effective than a company charging 2.95% but missing out on these recoveries.

Factors Influencing Your Practice’s Rate

When contacting Physiciancure.com for a quote, be prepared to provide details about:

• Your Specialty: Some specialties (e.g., mental health, physical therapy, surgery) have different billing complexities.
• Average Monthly Collections: This is a primary driver of the percentage fee.
• Volume of Claims: How many claims do you submit per month?
• Current Denial Rate: Understanding your existing challenges helps them assess the effort required.
• Existing EHR System: Compatibility and integration efforts can influence pricing.
• Specific Service Needs: Do you need credentialing, old A/R cleanup, or other specialized services?

In conclusion, Physiciancure.com’s pricing model is appealingly low at its starting point. What to Expect from physiciancure.com

However, prospective clients must conduct thorough inquiries to understand the full scope of services included at that rate, potential additional costs, and to ensure that the “affordability” doesn’t come at the expense of comprehensive service quality or hidden fees.