Per-claim vs percentage-of-collections pricing for dental payment posting
How to compare per-claim and percentage-of-collections pricing for dental payment posting, with the break-even rule and a worked example.
Dental billing help is sold in a few ways: an hourly or monthly fee for a person's time, a percentage of the practice's insurance collections, or a price per claim. For payment posting, the choice between the last two is the one most practices face, and the two are easy to compare once you have three numbers from your own practice management system.
The three numbers you need#
- Insurance visits per month: visits with at least one insurance claim. One visit is one claim in most practice management systems.
- Insurance collections per month: what payers actually paid, not what was billed.
- The rate you are quoted: dollars per claim, or a percentage of collections.
The math#
- Per claim: monthly cost = visits × price per claim.
- Percentage: monthly cost = insurance collections × percentage.
The break-even point is the average insurance payment per visit. Divide the per-claim price by the percentage: at $2 per claim against 2% of collections, the two cost the same when the average insurance payment per visit is $100. Above that, per-claim pricing is cheaper; below it, the percentage is.
A worked example#
A practice with 245 insurance visits and $57,000 of insurance collections a month (an average of about $233 per visit):
| Pricing model | Monthly | Annual |
|---|---|---|
| $2 per claim | $490 | $5,880 |
| 1.5% of collections | $855 | $10,260 |
| 2% of collections | $1,140 | $13,680 |
What the headline rate leaves out#
- What is included. Posting only, or also denial follow-up, appeals and patient statements? A percentage that covers the whole revenue cycle is not comparable to a posting-only price.
- Setup fees per location, and whether they are waived.
- Minimums and platform fees. A monthly minimum or a fixed platform fee on top of the per-claim or percentage rate behaves like a flat fee for a small practice. Ask for the effective rate at your volume.
- Which payers are covered. If a vendor connects payers over time, check whether you pay for claims it cannot post yet.
- How the bill grows. A percentage rises with every fee increase and every large case, even though the posting work for a $900 crown and a $50 exam is the same.
When a percentage can make sense#
If the vendor also works your denials and appeals end to end, and is paid only on what it recovers, a percentage ties its income to yours. For posting alone, the work is per claim, so a per-claim price is the more direct match.
Frequently asked questions
How much does dental payment posting cost?
It depends on the model. Per-claim prices are typically quoted in dollars per claim; percentage models as a share of insurance collections. Compare them with your own visit count and collections, using the break-even rule above.
What is the break-even between per-claim and percentage pricing?
Divide the per-claim price by the percentage. At $2 per claim and 2% of collections, break-even is an average insurance payment of $100 per visit.
Does FirstOps charge a percentage?
No. FirstOps is $750 a month under 250 claims, and $249 a month plus $2 per claim from 250 to 1,000 claims, month to month. See pricing.