Simple pricing that scales with what you collect
You pay on money that comes in, not on claims that go out. Most facilities are on a single percentage of collected waiver revenue. Small homes get a flat rate. Historical recovery is priced on results only.
Starter
For one RCFE or ARF with up to six waiver residents. Quoted after the free review so it fits the home, and set so a smaller operation is not paying a large-operator price.
- Weekly electronic submission for ALW and RH
- Remittance reconciliation and denial follow-up
- Monthly summary for the owner
- BAA and secure document exchange
- Introductory first month, credited if you continue
Standard
For seven to thirty waiver residents across one or more homes. Invoiced as remittances pay, with a monthly minimum so the service is sustainable at any census.
- Everything in Starter
- ILS (Kaiser) billing cycles included
- Weekly variance report by facility, resident, and program
- Appeals, inquiries, and chargebacks handled for you
- Audit-ready documentation for CCA and DHCS reviews
- Enrollment guidance for new ALW and RH residents
Multi-site
For operators with thirty or more waiver residents, larger licensed facilities, or a mix of programs and payers. Priced as a percentage or a fixed retainer, whichever suits your budgeting.
- Everything in Standard
- Dedicated remittance analyst
- Consolidated reporting across sites and entities
- Historical recovery review included at onboarding
- Quarterly review with ownership
Historical recovery, on results only
Missed or denied revenue from past months is a separate, one-time engagement: we identify it, remove duplicates, rebill what is still inside the window, and invoice a share of what actually pays. Nothing is owed on balances that do not.
Already using billing software?
Software still needs someone to learn the rules, build the claims, read the remittance, and chase what did not pay. We are that someone. Most clients find the software bill was the smaller cost.
Percentages apply to net collections, the money that actually arrives, never to gross charges. Rates are confirmed in writing after the review, and existing clients keep the rate they signed at.
What 3% means next to the typical rate
Outsourced medical billing is commonly quoted at 4% to 10% of collections, with most small and mid-sized practices paying between 5% and 8%. Move the slider to your monthly waiver collections and see the difference.
Typical ranges from published 2026 medical billing pricing guides. Actual quotes vary by specialty, volume, and payer mix; waiver-only billing is rarely quoted separately, which is one reason we publish ours.
The price is simple because the scope is complete
No per-claim fees
Claims, resubmissions, and corrections are all included. A denied claim costs you nothing extra to fix.
No setup fee for the transition
Enrollment, testing, and the move from paper to electronic submission are part of onboarding.
A term that matches the work
A six-month initial term, then month to month with 30 days' notice. The pilot month is your exit ramp: if the results are not there after the first cycle, you walk away owing nothing further.
Your data stays yours
Rosters, remittances, and reports are yours at any time, in formats you can use without us.
Private pay stays with you
We bill the waiver and ILS programs. Your office keeps private-pay invoicing unless you ask us to take it on.
Honest recovery accounting
We invoice on confirmed payments. Pending and appealed dollars are reported, not billed.
Get a number for your facility.
The free review tells you what is recoverable today and what your weekly billing would cost at 3%. Written, in a week, no obligation.