Not all outsourced billing is priced the same way, and the pricing model shapes how the work gets done. But the bigger difference between billing companies usually isn't the pricing label — it's the scope. A company that only submits claims and one that owns the whole revenue cycle can charge in exactly the same way and deliver completely different results. Here is what each common model rewards, what to watch for, and how to compare quotes fairly.
Per-claim billing.
You pay a fixed amount for each claim submitted. It is transparent and easy to forecast from your claim count. The catch is what it rewards: the fee is earned when a claim goes out, not when it gets paid. A per-claim biller has little reason to spend an hour on a stubborn denial or a 90-day-old claim, and resubmissions can bill again. Per-claim pricing is also most often paired with a narrow scope — submission, and not much after it.
Percentage of collections.
You pay a share of what the billing company actually collects for you. It is the most common model in dental billing because it ties the company's income to yours: a claim that never gets paid earns them nothing, so denials, appeals, and aging AR matter to them as much as to you. It also scales naturally — a newer practice pays less, a busier one pays more for more work.
What to watch for is in the definitions. Ask whether the percentage applies only to insurance payments or also to patient payments you would have collected anyway. Ask whether the rate steps down as your collections grow, whether there is a minimum, and whether verification, pre-authorizations, clearinghouse fees, or setup are billed on top. Two quotes at the same headline percentage can differ by thousands a year once those are added in.
Flat monthly fee.
You pay one fixed amount each month, scoped to your volume at onboarding. It is the easiest model to budget. The trade is that the scope has to be defined carefully up front, and the fee has to be revisited as your volume changes — so "flat" usually means flat until the next re-scope. And because the fee doesn't move with results, the incentive to chase the difficult claims has to come from the company's own discipline rather than from the pricing.
What you're really buying.
Per-claim pricing usually buys claim submission. Full-service RCM buys ownership of the number — verification, coding, submission, posting, denials, appeals, and AR follow-up, run as one operation with someone accountable for the result. Any of the three pricing models can be attached to either scope. For most practices, full-service is what they actually wanted when they said they needed "billing help," so start there and judge the pricing second.
How to compare quotes on equal terms.
Turn every quote into one number: the total monthly cost at your current insurance collections, including every add-on, divided by those collections. That effective rate lets you compare a per-claim quote, a percentage quote, and a flat fee side by side — and compare any of them with the true cost of an in-house hire. Then ask the same scope questions of each: who works denials, how often AR is touched, and what reporting you keep.
How ZenHub prices it.
We publish our rates. Billing is a flat $900 a month for practices collecting under $30,000 in insurance, 3% of insurance collections from $30,000 to $100,000, and 2.75% on every dollar above $100,000 — counted like a tax bracket, so crossing a line never makes your bill jump. Patient payments don't count, pre-authorizations and standard insurance verifications are included, there is no setup fee, and every plan covers the full revenue cycle. You can see your own number in seconds with the billing cost calculator, and see what a full cycle includes in our guide to outsourced dental billing.