How Much Do Medical Billing and Credentialing Services Cost in the USA?

Choosing a medical billing or credentialing partner is an important financial decision for healthcare practices. Whether you operate a therapy practice, mental health clinic, behavioral health organization, psychology practice, psychiatry practice or another healthcare organization, understanding how billing and credentialing fees work can help you choose a solution that fits your practice.

The cost of outsourced medical billing services in the USA can vary depending on the provider, services included, collection structure, and practice requirements. Instead of looking only at the percentage or flat fee, healthcare providers should consider what is included, how fees are calculated, and how the service supports the overall healthcare revenue management cycle.

What Does Medical Billing Cost in the USA?

Medical billing companies commonly use different pricing models, including percentage-based billing, flat monthly fees, or customized arrangements. The right option depends on your practice size, insurance volume, collections, and administrative requirements.

Creare Solutions uses a percentage-of-net-collections model for its billing support. The current pricing is 4% of net collections, with invoices generated at the end of each month based on revenue actually received. Pending or unpaid claims are not included until payment is collected. 

This model aligns the billing service with your practice's actual collections: when your practice does not receive payment, Creare Solutions does not charge the 4% percentage fee on that unpaid amount.

What Is Included in the 4% Billing Fee?

For healthcare and therapy practices, medical billing involves much more than simply submitting claims. Effective billing support can cover multiple stages of the revenue cycle.

Creare Solutions' billing service includes:

• Verification of Benefits before sessions

• Patient billing after sessions

• Full claims submission

• EOB entry

• Denial tracking and resolution

• Stale-claim monitoring

• Credential management

• CAQH and attestations

• Roster updates

• Balance and credit management

• Payment plan management

• Reporting 

By bringing these activities together, practices can reduce the administrative burden associated with insurance billing and spend more time focusing on patients and practice growth.

How Does Medical Billing Support Your Revenue Cycle?

A strong healthcare revenue management cycle helps ensure that services are properly billed, claims are followed up, payments are collected, and outstanding issues are addressed.

For example, a typical process may include:

Patient Eligibility → Benefits Verification → Service → Claim Submission → EOB → Payment → Denial Follow-Up → Revenue Reporting

When one part of this process is delayed, it can affect cash flow. Professional medical billing support can help practices maintain consistency throughout the process.

For healthcare clinics, the benefit is not simply outsourcing administrative work. The goal is to create a more organized billing process that supports timely reimbursement and better visibility into practice revenue.

How Much Does Medical Credentialing Cost?

Credentialing is another important expense healthcare providers need to consider. Before providers can bill many insurance companies, they may need to complete payer enrollment and credentialing requirements.

Creare Solutions currently lists medical credentialing services at $50 per insurance company/therapist. The service includes CAQH setup and maintenance, payer applications, credentialing packets, attestations, effective-date tracking, roster updates, and ongoing credential management. 

Credentialing costs can vary based on the number of payers, provider type, location, and complexity of the application process. For practices working with multiple insurance companies, having a dedicated credentialing process can help reduce administrative delays.

What are the Benefits of Outsourcing Medical Billing?

For many healthcare practices, outsourcing billing can provide benefits beyond saving administrative time.

1. Reduced Administrative Work

Healthcare providers and office teams can spend significant time checking benefits, submitting claims, following up on unpaid claims, and managing billing questions. Outsourcing these responsibilities allows your team to focus on patient care and practice operations.

2. Better Claims Management

A dedicated billing team can monitor claims, identify denials, follow up on outstanding payments, and help address billing issues before they become long-term problems.

3. More Consistent Revenue Management

An organized billing workflow can help practices maintain a more consistent process from verification through payment collection.

4. Support for Practice Growth

When billing administration is handled efficiently, providers can focus more attention on adding patients, expanding services, hiring staff, and growing their practice.

5. No Need to Change Your EHR

Creare Solutions states that practices do not need to migrate to a new EHR. Its billing support works with existing systems including SimplePractice, TherapyNotes, and Sessions Health. 

Why a Percentage-Based Billing Model Can Make Sense

A percentage-based model can be attractive to healthcare practices because the billing fee is connected to actual collections.

With Creare Solutions, the billing service is 4% of net collections. The fee is calculated based on money actually collected during the billing cycle rather than pending or unpaid claims. For example, if a practice collects $10,000 during a month, a 4% billing fee would be $400.

This makes it easier for practices to understand the relationship between collections and billing costs.

Is Medical Billing Worth the Cost for a Healthcare Practice?

The answer depends on your practice's needs, internal staffing, insurance volume, and administrative workload.

A healthcare practice may benefit from outsourced billing when its team is spending too much time on claims, eligibility verification, denials, patient balances, or payer-related administration.

The real value should be evaluated based on the complete service—not simply the percentage charged.

When comparing a Medical Billing Company USA, healthcare providers should consider:

• What services are included?

• Is pricing based on collections or charges?

• Are unpaid claims excluded?

• Are there long-term contracts?

• Is credentialing included or separate?

• Does the company work with your existing EHR?

• Are there additional third-party fees?

• Is reporting included?

• How are denials and aging claims handled?

What Additional Fees Should Practices Know About?

Medical billing companies may not cover every third-party cost. Creare Solutions states that pass-through expenses can include EHR fees, payment processor fees, bank fees, government fees, payer fees, and other third-party costs when applicable.

Understanding these costs before signing an agreement helps healthcare providers compare pricing more accurately and avoid unexpected expenses.

Creare Solutions Pricing at a Glance

Service	Pricing
Medical Billing	4% of net collections
Credentialing	$50 per insurance company / therapist
Billing Contract	Month-to-month
Billing Fee Timing	After collections are received
Unpaid Claims	Not included until paid
EHR Migration	Not required
Supported EHRs	SimplePractice, TherapyNotes, Sessions Health

These details reflect the pricing information currently published by Creare Solutions. 

Choose a Billing Partner Based on Value, Not Just Price

The lowest medical billing fee is not always the most cost-effective option. Healthcare providers should evaluate the complete service, including claims management, benefits verification, denial follow-up, credentialing support, reporting, technology compatibility, and ongoing customer support.

For therapy practices and healthcare clinics, the right billing partner can help simplify the administrative side of the healthcare revenue management cycle while allowing providers to focus on patient care.

Creare Solutions offers month-to-month billing support based on net collections, along with separate credentialing services, so practices can choose support based on their operational needs.

Final CTA

Ready to simplify your billing and credentialing?Connect with Creare Solutions to discuss your practice, current billing workflow, credentialing needs, and the pricing option that fits your healthcare organization.

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Frequently Asked Questions

How much does medical billing cost in the USA?

Medical billing pricing varies by company and pricing model. Creare Solutions currently charges 4% of net collections for its billing support, with billing calculated on revenue actually collected. 

How much does medical credentialing cost?

Creare Solutions lists credentialing at $50 per insurance company/therapist. Services include CAQH, payer applications, credentialing packets, attestations, effective-date tracking, roster updates, and credential management.

Does Creare Solutions require a long-term contract?

No. The pricing page states that Creare Solutions operates on a month-to-month basis without long-term contracts. 

Does Creare Solutions charge for unpaid claims?

The 4% billing fee is based on net collections actually received. Pending claims are not included until payment is received. 

Do I need to change my EHR?

No. Creare Solutions states that it works with existing EHR systems, including SimplePractice, TherapyNotes, and Sessions Health, without requiring an EHR migration. 

Is medical billing outsourcing beneficial for healthcare clinics?

It can be beneficial for practices that want to reduce administrative workload, improve claims follow-up, manage denials, and maintain a more organized revenue cycle while their team focuses on patient care.

What should I consider when choosing a medical billing company?

Look beyond the percentage rate. Compare the services included, pricing structure, contract terms, claims management, denial follow-up, credentialing support, EHR compatibility, reporting, and any additional third-party costs.