By Brandon Seigel, Chief Problem Solver · September 23, 2026 · 6 min read
Start with the people
Billing is people work. Ask who will touch your account, whether they're employees, and how long they tend to stay. Turnover means relearning your payers and your practice over and over.
Demand transparency
You should be able to see what your billing team did yesterday. The best setup is a team working directly in your EMR, so notes and actions live where you already look.
Monthly PDF reports alone aren't transparency. They're a summary written by the people being measured.
Understand the pricing
Most therapy billing companies charge a percentage of what they collect. That aligns incentives — they get paid when you get paid. Ask what's included in the percentage and what costs extra.
- Is denial follow-up included?
- Is patient payment posting included?
- Are eligibility and authorizations included or separate?
- Is there a monthly minimum?
Red flags
Walk away, or dig deeper, if you hear any of these.
- Long contracts with steep exit penalties
- No clear answer on who works your claims
- They need to move you to their software to work with you
- They call your patients without your say
- Promises of results before they've seen your data
Quick answers
How much does a therapy billing company cost?
Most charge a percentage of collected revenue, often with a monthly minimum. What's included in that percentage varies widely, so compare scope, not just the rate.
Should a billing company work in my EMR?
It's a strong advantage. Working in your EMR keeps every note visible to you in real time instead of hidden in a separate system.
See exactly what's included in our medical billing services for therapy practices, how our percentage-of-collections pricing works, or browse common questions from practice owners.
Want this handled inside your EMR, every business day?
Our US-Based W2 employees work your claims daily. Tell us about your practice.
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