Often, yes, but it depends on who receives the payments and which payers are involved. Medicare allows payment to a billing agent only when the agent’s pay is not related in any way to the dollars billed or collected, under 42 CFR 424.73, and Medicaid has a parallel rule for business agents at 42 CFR 447.10. Some states add their own limits, so have an attorney review the fee terms. Our guide to billing service costs compares percentage, per-claim, and flat monthly pricing.
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