Medical Billing Pricing and Hourly Credentialing | HRG

Your contract renewed itself. Medical billing pricing that looked like a small percentage grew with your collections. Then an invoice arrived with hours nobody could explain.

HRG prices its two service lines differently on purpose. Credentialing runs by the hour on a one-page contract that goes month to month, with no minimums and no auto-renewal, and you review the invoice before we charge it. Billing and RCM runs on a longer-term agreement, with terms scoped to your practice during onboarding.

A note on scope. NPDB queries, credentialing committee determinations, exclusion screening decisions, and privileging approvals remain the responsibility of the client under federal and payer requirements. A credentialing partner like HRG supports the surrounding workflow. That includes documentation, tracking, payer follow-up, and file management. The client retains authority over decisions that require its direct attestation and oversight.

Why HRG Bills Credentialing by the Hour

HRG bills credentialing by the hour because the work comes in bursts and payers set the calendar. A provider's file takes approximately 5 to 10 days to assemble, depending on how quickly the provider returns documents, and then the application enters a payer queue that HRG does not control. Medicare and Medicaid enrollment each run approximately 30 to 45 days. Commercial carrier enrollment runs approximately 90 to 120 days.

A flat monthly fee charges you the same in a quiet month as in the month three providers and a new location all need enrollment. Hourly billing charges for the month you had. You set a monthly hours budget, HRG flags when the work approaches that limit, and you decide whether to add hours or defer the rest. We charge nothing until you have reviewed the invoice.

The hours cover the work in credentialing and contracting that keeps revenue moving, not only the paperwork. HRG pushes stalled applications with the payer, tracks each one through to its effective date, and maintains provider profiles on CAQH, now DataSpring, every 30 days instead of waiting out the 120-day cycle. Since moving to 30-day maintenance, HRG has seen roughly 90 percent fewer A/R issues from outdated provider data.

One page of contract covers all of it, and the month-to-month term means each month of work has to earn the next month's invoice.

How Billing and RCM Terms Are Set

Billing and RCM runs on a longer-term agreement because the revenue cycle itself is long. A claim submitted this week can still be in appeal next quarter, so a relationship measured in weeks would end before the work does.

HRG scopes the terms to your practice during onboarding instead of posting a rate, because the work is not the same for every practice. A group leaving a failing vendor mid-cycle needs different work than a new practice building billing from zero, and both differ from a practice on the far side of an EHR migration.

Three things hold across HRG's medical billing services whatever the scope turns out to be:

• Your systems, not ours. HRG works inside your EHR, practice management system, and payer portals, so your staff sees claim status in real time and never logs into a separate dashboard.
• The actual billers. Weekly and monthly A/R reviews are run by the billers doing the work, not by a management layer.
• No monthly PDF. Reporting lives in real time inside your own systems, so there is nothing to wait for and nothing to reconcile.

Everything else, including the term and the fee structure, gets set in the scoping conversation.

What the Billing Terms Have Produced

HRG's documented billing ranges are a 15 to 30 percent reduction in denials, a 15 to 25 day reduction in A/R days, and a 15 to 30 percent increase in revenue collection, with denial responses in 24 to 48 hours. First-pass claim acceptance runs at 98 percent, a track record confirmed by the CFO.

A 40 percent improvement in collections is what a Kentucky pain management clinic recorded after leaving a billing company that was not filing claims on time. Denials fell 35 percent, and A/R dropped from millions to thousands. The A/R case study walks through what changed. On the credentialing side, HRG holds a 100 percent approval record on the hospital privilege applications it has managed. A pulmonary specialty group that grew from about 4 providers in one state to about 30 in eight saw providers credentialed in 30 to 60 days, up to 90 days faster than standard timelines, as the credentialing case study details.

They have made the process smooth and stress-free for us by getting our group and providers contracted in record time.

Matthew Read, Owner and CEO, Red River Family Clinic

Who Should Look Elsewhere

HRG is the wrong choice in six situations, and knowing them now saves you a call.

• Coding done for you. HRG provides coding consultation as needed, and your coders or coding vendor perform the coding.
• Authorizations handled for you. Prior authorization stays with your practice, and HRG advises on workflow.
• A separate dashboard or monthly PDF. HRG reports in real time inside your EHR and payer portals, so no second system exists.
• Chiropractic billing. HRG credentials and contracts chiropractors and does not bill for them.
• Strictly NCQA-accredited credentialing. HRG does not perform NCQA-accredited credentialing today, so a procurement process that requires it will not fit.
• The lowest hourly rate above all. HRG's team is 100 percent U.S.-based with no offshore handoffs, so we do not compete with offshore pricing.

If none of these describes your practice, the conversation that follows is about scope, not fit.

Pricing Questions, Answered

Why does HRG not post rates?

Credentialing hours and billing scope both depend on your situation, so a posted rate would be wrong for most readers. A health center with many providers, for instance, typically starts with a higher monthly hours budget than a small practice. The consult is where scope gets set, and the number follows from it.

Do we have to buy billing and credentialing together?

No. Each service line stands alone, and practices buy credentialing without billing and billing without credentialing. Neither is a gateway to the other.

What if the problem is urgent?

Emergency engagements often start at a higher hours budget and then step down to standard ongoing support. A lapsed DataSpring attestation, a network termination, and a missed recredentialing deadline all qualify.

Get Terms Built for Your Practice

If you are pricing billing or credentialing and want terms written for your practice instead of a brochure, start with the line you are pricing. Mellissa Harmon covers credentialing and contracting. Andy Garcia covers billing and RCM. Either conversation carries no pitch and no pressure, and you can also call 913-937-2995.

Schedule a Credentialing Pricing CallBook a Billing Pricing Consult or call 913-937-2995