Reference · FAQ
Vendor questions independent practices actually ask
Quick answer
The most-asked vendor questions from independent practices — on billing (cost of collection, first-pass acceptance), credentialing (payer timelines, delegated vs full), EHR (cost, migration window), AI scribes (pricing, latency, note quality), and consulting (day rates, MSO fees) — answered against our published rubric and primary sources.
Every answer below is grounded in the same rubric we use in our methodology and traceable to the primary sources on our benchmarks page.
Billing & RCM
- What percentage do medical billing companies charge?
- Most percentage-of-collections billing companies charge between 4% and 9% of net collections. Small practices and low-reimbursement specialties trend toward the higher end; large-volume or high-reimbursement practices negotiate to the lower end. Per-claim pricing typically runs $4–$8 per claim depending on complexity.
- Is outsourced billing cheaper than in-house?
- It depends on volume. Below roughly 3,000 claims per month, outsourcing is almost always cheaper than a full-time in-house biller once you include salary, benefits, software, and the cost of coverage during time off. Above that volume the math tightens and depends on your specialty's reimbursement and your current cost of collection.
- What is a good first-pass claim acceptance rate?
- For most specialties, 95% or higher on first-pass acceptance is the mark of a competent billing operation. Below 90% signals rushed submission, weak scrubbing, or credentialing gaps. Ask any prospective vendor for their book-of-business average, then for your specialty's average within that book.
- How long does a billing vendor switch take?
- Plan for 60 to 90 days from contract signature to steady-state. Weeks 1–4 cover credentialing verification, fee schedule loading, and clearinghouse setup. Weeks 5–8 run parallel processing on new claims. Legacy accounts receivable — who works claims filed before go-live — is the single most negotiated point; get it in the contract.
- Should I let the billing company use their own practice management system?
- Only if the contract guarantees daily data exports, that you own the payer credentialing and clearinghouse account, and that data at contract end is delivered in a portable format at no cost. Otherwise the switching cost of leaving that vendor becomes a soft lock-in.
- What's the difference between medical billing and revenue cycle management?
- Medical billing is the narrower activity of coding, submitting claims, posting payments, and working denials. Revenue cycle management (RCM) covers the full arc from patient scheduling and eligibility verification through final collections and reporting. Most modern billing vendors offer RCM; the label matters less than the scope of the statement of work.
Credentialing
- How long does medical credentialing take?
- Realistic ranges by payer: Medicare 45–90 days, Medicaid 60–180 days depending on state, commercial payers 90–150 days, and BCBS plans anywhere from 90 to 210 days depending on state. A full enrollment cycle for a new provider across a typical payer mix runs 90–150 days.
- What does credentialing cost?
- Expect $100–$300 per payer per provider for initial enrollment through a service, plus optional monthly maintenance of $30–$100 per provider. Flat 'full credentialing' quotes without a per-payer breakdown almost always exclude something material.
- Can I do credentialing myself?
- Yes, and many single-provider practices do. Plan for 20–40 hours of upfront work to build CAQH, PECOS, and payer applications, then 1–3 hours per week of follow-up per payer for three to five months. If your time is worth more than $50 per hour, a competent service typically pays for itself.
- What is CAQH and do I need it?
- CAQH ProView is a shared credentialing database most commercial payers pull from. You attest to your information every 120 days. Any US provider treating commercial insurance patients needs a current CAQH profile.
- Can I bill under a group's tax ID before my own enrollment is complete?
- In most cases, no. Payer contracts tie to the individual provider's NPI enrolled under that group's tax ID. A few payers allow retroactive effective dates, but planning around retro-billing is a bad idea. Start credentialing a new hire 90 days before their start date.
- What's the difference between credentialing, enrollment, and privileging?
- Credentialing is verifying a provider's identity, license, education, and history. Enrollment is adding that provider to a specific payer's panel and fee schedule. Privileging is a hospital granting a provider permission to perform specific procedures. All three overlap in vocabulary and none substitute for the others.
EHR
- How much does an EHR cost for a small practice?
- Cloud EHRs for independent practices typically run $200–$600 per provider per month, plus implementation ($1,500–$10,000 per provider) and migration if applicable. Integrated EHR + practice management + billing bundles run higher, $500–$1,200 per provider per month. Three-year total cost of ownership is a better comparison than monthly rate.
- How long does an EHR implementation take?
- For a small practice with no data migration, 60–120 days from contract to go-live is realistic. With historical data migration, plan 4–9 months. Anyone selling a 30-day implementation for a real practice is either doing a minimal setup or setting you up to blame delays on your team.
- What is the best EHR for a private practice?
- There is no single best EHR. The best EHR for your practice is the one purpose-built for your specialty at your size, at a total-cost-of-ownership you can afford, whose reference clients your size in your specialty are genuinely satisfied. A specialty-first shortlist beats a 'top 10 EHRs' list every time.
- Should I choose a specialty EHR or a general one?
- For most independent specialties (behavioral health, PT/OT, dermatology, ophthalmology, pediatrics, and others), a specialty-purpose-built EHR outperforms a general one on documentation speed and reporting. General EHRs make sense for multi-specialty groups and primary care with heavy interoperability needs.
- Can I switch EHRs? How hard is data migration?
- Yes, and thousands of practices switch every year. Structured data (medications, allergies, problem lists) migrates via CCDA. Unstructured historical notes usually come over as PDFs attached to the patient chart. Budget 4–9 months, insist on a fixed-price migration statement of work, and negotiate the export rights from your outgoing vendor before you sign with the new one.
- Do I need practice management software separately from an EHR?
- Most modern cloud EHRs include practice management (scheduling, billing, patient accounts) in the same platform. Standalone PM systems still exist for practices that want to keep a specialty EHR but a stronger billing engine. If you outsource billing, coordinate PM choice with your billing vendor.
AI Scribes
- How much does an AI medical scribe cost?
- Ambient AI scribe pricing typically runs $99–$399 per provider per month. Lower tiers cap usage (encounters or audio minutes). Flat-rate all-you-can-use pricing exists but is trending toward tiered as vendors face real inference costs. Enterprise deals for larger groups can go below $150 per provider per month.
- Do AI scribes work with my EHR?
- Most major AI scribes list integrations with every major EHR. The real question is integration depth: does the note write to the correct chart location automatically, or does the provider copy-paste? Does the scribe write structured data (medications, orders) or only free text? Test this in a real pilot, not from a screenshot.
- How accurate are AI medical scribes?
- Accuracy varies sharply by specialty and by encounter type. General internal medicine visits are the sweet spot for most vendors. Specialty vocabulary (psychiatry, dermatology, ophthalmology, PT/OT), non-English patients, and multi-speaker rooms are where vendors differ. The only way to know is a 2–4 week pilot with your actual providers.
- Is patient data safe with an AI scribe?
- Any legitimate vendor signs a HIPAA BAA. The additional question that matters: does the vendor use your PHI to train their models? Best practice is that PHI is not used for model training by default, with an explicit opt-in. Encryption in transit and at rest, geographic hosting, and defined retention should all be documented.
- Do I need to tell patients an AI scribe is in the room?
- Consent practice varies by state law and by vendor implementation. Most vendors provide patient-facing consent language and signage. Confirm your state's recording law and your vendor's guidance. Many practices treat it like any other documentation aid and include it in general consent-to-treat paperwork.
- How long does an AI scribe pilot take?
- Plan 2–4 weeks with multiple providers using the scribe on real encounters. Week 1 is workflow learning and adjustment; week 2 onward is where you can measure provider edit time per note, error rate on your specialty's vocabulary, and satisfaction. A one-week trial is a demo, not a pilot.
Consulting
- What does a medical practice consultant cost?
- Independent consultants typically charge $200–$500 per hour, with defined-scope projects running $5,000–$50,000 depending on scope. Startup engagements (full practice launch) run $15,000–$75,000. MSO monthly fees are structured as 4%–15% of revenue depending on services included.
- What is an MSO and how is it different from a consultant?
- A management services organization (MSO) is an ongoing operational partner that handles some or all of your non-clinical operations — billing, credentialing, HR, IT, purchasing — in exchange for a percentage of revenue or fixed fees. A consultant solves a defined project in a defined window. MSOs are long-term commitments with meaningful control tradeoffs; consultants are project-based.
- Do I need a consultant to start a private practice?
- No, but many first-time practice owners find one is a good investment for entity setup, credentialing coordination, EHR selection, and payer contracts. A capped $15,000–$40,000 startup engagement typically pays back through faster time-to-first-claim and avoided rookie mistakes. Doing it yourself is possible; plan for 300+ hours over 6 months.
- How do I vet a medical practice consultant?
- Ask for three recent engagements matching your specialty, size, and geography. Call two current clients and one former client. Ask about scope discipline, communication, and whether deliverables landed as promised. Require a written scope of work with fixed or capped fees before you sign anything.
- Are MSOs a good deal for independent practices?
- It depends on what you value. MSOs deliver operational leverage, group-purchasing power, and often capital access. In exchange you give up autonomy on vendor choices, brand, and sometimes clinical decision support. Model 5-year economics against status quo, and understand exit terms fully. MSOs are not inherently good or bad; they are a specific tradeoff.
- Can a consultant help me sell my practice?
- Yes, and this is one of the highest-ROI consulting engagements. A specialty transaction advisor with recent experience selling practices your size in your specialty will typically add multiples to sale price that dwarf their fee. Ask for at least three closed transactions in the last 18 months.