Small and solo practices
Medical Billing for Small & Solo Practices
Billing help sized for solo, small and new practices: certified billing and coding professionals working inside your EHR, a dedicated contact and no hidden setup fees.
Medical billing services for small practices that run on a few people
Fastora's medical billing services for small practices are built for offices where one or two people cover the front desk, the phones and the billing. In that setup, billing is usually the first task to slip when the schedule is full, and nobody notices until cash flow drops a month later.
We take over the billing work that needs daily attention: coding review, claim submission, payment posting, denials, A/R follow-up and patient statements. Certified medical billing and coding professionals handle every claim, inside the EHR/PM system you already use, and you keep a single dedicated account contact who knows your payers.
The service scope is the same one larger groups get on our main medical billing services page. What changes for a small office is how the work is sized, reported and priced.
Why small practices outsource
Small practice medical billing has a few weak points that larger groups can absorb but a small office cannot.
- One person holds all the knowledge. Payer portal logins, open appeals and the reason a payer stopped paying often live in one biller's head. When that person is out or leaves, follow-up stops.
- Cash flow has little buffer. A week of unsent claims or one payer quietly denying a code can affect payroll in a small office.
- Training is hard to justify. Coding and payer rules change every year, and a solo practice rarely has the budget or time to keep a biller current.
- Software costs are fixed. Billing software, clearinghouse fees and statement printing cost roughly the same whether you see a few patients a day or many.
Outsourced medical billing for small practices spreads that work across a team, so follow-up continues when someone is out and coding rules are tracked as part of the service rather than as an extra job for your staff.
Medical billing for solo practitioners
Medical billing for solo practitioners is mostly about keeping the routine. A practical weekly rhythm looks like this:
- Before visits: eligibility and benefits checked, so co-pays are collected at check-in and inactive coverage is caught early.
- Same or next day: charges entered from signed notes and claims passed through Advanced Pre-Submission Claim Review before electronic submission.
- Daily: clearinghouse and payer rejections corrected, because a rejected claim was never received and the filing clock is still running.
- Weekly: payments posted from ERAs and EOBs, denials worked, and unpaid claims followed up by payer and age.
- Monthly: patient statements sent and a short report plus review call with your account contact.
Your part is mainly signing notes promptly and answering the occasional documentation query. Everything else on the list is handled by the billing team and visible to you in your own system.
Medical billing for startup practice owners: setup before the first claim
Medical billing for new practices starts weeks before the first patient. Claims sent before a provider is enrolled with a payer are usually denied, and some commercial payers will not pay for services before the contract's effective date at all. Getting the order right protects your first months of revenue.
| Step | What it involves | Why it matters for billing |
|---|---|---|
| NPIs | An individual (Type 1) NPI for each provider and, for a group or entity, an organizational (Type 2) NPI through NPPES | Every claim needs the right billing and rendering NPI |
| CAQH profile | A complete, attested CAQH ProView profile with current documents | Many commercial payers pull credentialing data from it |
| Medicare enrollment | Enrollment in Medicare through PECOS, with benefits reassigned to the group if you bill as a group | Sets the date from which Medicare will pay |
| Commercial and Medicaid enrollment | Applications and contracts with each payer you plan to accept | Determines in-network status and the effective date |
| Clearinghouse and ERA setup | Electronic claim and remittance enrollment for each payer | Lets claims go out and payments post electronically |
| Fee schedule and policies | Your charge master, self-pay rates, payment and good faith estimate policies | Patient billing starts on day one |
Medicare sets the effective date of billing privileges under 42 CFR 424.520, and 42 CFR 424.521 allows physicians and other practitioners to bill retrospectively only in limited circumstances, generally up to 30 days before that date. Commercial payers set their own rules in the contract, so check each one before scheduling insured patients.
Fastora's credentialing and enrollment service follows a tracked nine-stage process: consultation, document collection, state licensing, NPI and CAQH setup, payer applications, panel submissions, follow-ups, final approval, and ready to bill. Billing starts once enrollment is confirmed for each payer. Our article on billing for a new practice walks through the start-up checklist in more detail.
Our checklist for setting up billing in a new practice covers each step, and this page on EHR access explains how a billing team works inside your system.
Medical billing for private practice owners who want control
Owners of independent offices often worry that outsourcing means losing sight of their money. Medical billing for private practice works best when the owner keeps the decisions and the billing team does the work.
| You keep | The billing team handles |
|---|---|
| Your EHR/PM system and all your data | Coding review, claim scrubbing and submission |
| Payer contracts and fee schedules | Payment posting and reconciliation |
| Approval of write-offs and refunds | Denials, appeals and A/R follow-up |
| Financial and payment-plan policies | Patient statements and balance questions |
Fastora works under user access your practice grants, with no software to install, and signs a Business Associate Agreement before accessing any PHI. Workflows are aligned with HIPAA and HITECH, with encryption, strict access controls and regular internal audits.
Pricing for small practices
Small offices feel pricing details more than large groups do, especially minimum fees. Fastora quotes after a free assessment, using a percentage of collections, a flat fee per claim or a hybrid, depending on your volume and the services you choose. There are no hidden setup fees, and any minimum is stated in the written quote.
Our pricing page explains each model and the factors that change a quote. When comparing any small practice medical billing company, ask how the fee base is defined, whether there is a monthly minimum, and what happens to open claims if you end the agreement.
Choosing a medical billing company for small practices
Practice billing services for a small office should be judged on how the work is done week to week. A checklist for any vendor:
- A named account contact, not a rotating support queue.
- Certified billing and coding professionals working your claims.
- Work done inside your own EHR/PM system, so your data stays with you.
- Monthly reports written for owners and office managers, plus a review call.
- A clear answer on minimum fees, contract length and how to leave.
- Credentialing support if you plan to add providers or payers.
A free billing assessment is a low-risk way to see where your claims stand before you commit to anything.
Opening a new site or adding a first location? Read medical billing for a new practice before your first claims go out.
FAQ
Small practice billing FAQ
Still have a question? Talk to our team about your billing workflow.
Is there a minimum fee?
Some billing companies set a monthly minimum so the account is covered in low-volume months, which matters most to solo and new practices. Whether a minimum applies to your practice, and at what level, is stated in Fastora's written quote after the free assessment. There are no hidden setup fees, so the quote shows every charge before you decide.
Is outsourcing worth it for a solo provider?
It depends on how much time billing takes from you or your staff and how much revenue is lost to unworked denials and late claims. Compare your current billing costs, including software and staff time, with a written quote. The free billing assessment shows where your claims stand so the comparison uses real numbers from your practice.
Can you help before my practice opens?
Yes. Fastora's credentialing service covers NPI and CAQH setup, payer applications and follow-up through final approval, using a tracked nine-stage process. Billing for each payer starts once enrollment is confirmed, so claims are not sent before the effective date. Starting enrollment early gives the most room before your first insured patients.
Will I need new software?
No. Fastora works inside your existing EHR/PM system under user access you grant, with no software to install. If you are opening a new practice and have not chosen a system yet, choose one that fits your specialty and workflow; the billing team then works inside it under named user accounts.
Who will I talk to about my account?
Each practice gets a dedicated account contact rather than a rotating call queue. You also have 24/7 dedicated client support, transparent dashboards, monthly performance reporting and a monthly review call. Every enquiry gets a reply within one business day, which helps when a small office has billing questions between visits.
Start with a free billing assessment
Tell us about your practice and we will review your claims, denials and A/R, then send a written quote sized for a small office. Every enquiry gets a reply within one business day.
Why small practices lose revenue differently
A large group loses revenue in bulk — one payer policy, one broken workflow. A small practice loses it in drips: a few missed charges a week, one authorization nobody tracked, an A/R report nobody opens because the same person who bills also answers the phones. The amounts look small each month, which is exactly why they go unnoticed. What fixes it is routine: charges reconciled daily, denials worked the week they arrive and authorizations kept current — the work a small staff rarely has uninterrupted time for.
The pattern holds across specialties. A solo therapist loses sessions to visit-limit denials; a two-provider urgent care loses to eligibility mistakes at a busy front desk; a small surgical practice loses to coding lag. The fix is the same in each case — steady follow-up sized to the practice. Our medical billing services page describes the full scope and our pricing page explains how a small-practice quote is built.
Do I need a billing company for a small practice?
Not always. A solo provider with one payer and clean claims can self-bill for a while. The honest test: are denials worked the week they arrive, is A/R over 90 days reviewed monthly, and do you know your denial rate? If the answer is no to two of those, a billing company will usually pay for itself.
When owners compare the best medical billing companies for small practices, the checklist is short: do they work with practices your size today, do they report in plain numbers, and is the fee sized to small-practice revenue? The best billing service for small practices is rarely the biggest name — it is the one that treats a two-provider account with the same routine as a fifty-provider one. That routine — daily claims, weekly denials, monthly A/R review — is what RCM for small practices means in practice. See our medical billing outsourcing page for how the engagement starts.
Billing services for new and startup practices
Medical billing services for new practices start before the first patient: credentialing timelines, EHR setup and a first-claims plan so revenue does not stall in month one. Our practice startup billing services cover that sequence — enrollment tracked to effective dates, systems chosen before go-live, front-desk policies written from day one. For funded teams, medical billing outsourcing for startups offers the same coverage without hiring a billing department before revenue exists. Background: new-practice billing article.
The question behind medical billing services for small practices pricing is simple: will it pay for itself? A percentage-of-collections model scales with you — quiet months cost less — while a flat fee suits steady volume. Either way, the math should be shown against your current cost: staff time, turnover and denials written off. Our pricing page walks through how a small-practice quote is built and our medical billing services page describes the full scope.