What Does It Really Cost to Run Your Practice?
Adjust the numbers below to compare the cost of assembling your own systems, vendors and administrative support with one complete CareVixis practice system.
Do You Need the Whole Jet, or Just the Seat?
Most providers do not need to own an entire practice infrastructure any more than a traveler needs to own a jet. When you fly, you purchase a seat while the airline provides the aircraft, pilots, maintenance, systems and support. CareVixis has already invested in the technology and specialized teams required to operate a modern practice. Because those resources support multiple providers, your practice receives the benefit of the complete system while paying only for the capacity it uses.
If you need to take a trip, you do not purchase an aircraft, hire pilots, employ a maintenance crew, rent a hangar and manage aviation regulations. You purchase the capacity you need while the airline operates the infrastructure.
A modern healthcare practice works the same way. You can separately purchase an EHR, clearinghouse, billing support, credentialing, a website, SEO, communications and administrative labor. You must then make all those pieces work together.
CareVixis has already built and staffed that infrastructure. Because it supports multiple securely separated practices, you pay for the capacity your practice uses instead of financing the entire system yourself.
What You Always Own and Control
- Your practice
- Your brand
- Your patient data
- Your payer contracts
- Your clinical decisions
- Your business direction
You retain ownership of your practice, brand, client relationships and data. CareVixis provides and manages the infrastructure supporting them.
Adjust the Numbers for Your Practice
Defaults represent a typical single-provider practice. Every slider updates all results instantly.
Practice Profile
Basic volume and revenue inputs for your practice.
Billable providers, including physicians, NPs, and PAs.
Keep your own EHR and you pay nothing monthly for software. VixisCare™ is $119 a month for the first provider and $75 for each additional provider, and only if you choose to use it. You do not have to change EHRs to work with CareVixis.
Total billed amount before contractual adjustments and payer reductions.
Payer allowable as a percentage of gross charges. Set this from your own remits; it varies widely by payer mix.
Percentage of claims denied on first submission. The AAFP puts the industry average at 5% to 10% for physician practices, with below 5% preferable.3
Of claims initially denied, what percentage do you ultimately recover? In a survey of 516 hospitals, 54.3% of private-payer denials were ultimately overturned and paid when providers pursued them.1
Deductibles, copays, and coinsurance as a share of the contracted allowable amount. CareVixis charges nothing on patient payments, so its percentage applies only to what insurance payers pay.
Percentage of patient responsibility that goes uncollected. Set this from your own AR; the AAFP benchmark for adjusted collection rate is 95% or better.3
Credentialing is $150 per payer, per provider for revenue management clients, charged once per application. The figures below show the full up-front cost; revenue management clients earn a $75 service credit after six months and $75 after twelve.
Cost and Time Inputs
Independent vendor costs and administrative time estimates. Set any item to $0 if your practice does not currently use it.
Billing companies commonly price on a share of collections, typically 4% to 10%.4 This fee does not include EHR, credentialing, website, or other systems.
One-time cost to credential each provider with each insurance payer. Services typically charge $200-$500 per payer per provider. Total is multiplied by your number of providers and payers.
Ongoing cost to keep credentials current: re-attestation, CAQH updates, license renewals, and responding to payer re-credentialing requests.
Monthly subscription cost per provider for your current EHR. Left at $0, no EHR cost is counted. If you keep your current EHR, you keep paying it, so it is counted on both sides. Major platforms range from $50 to $500+ per provider.
Business phone lines, VOIP system, or virtual phone service. Does not include personal cell phone usage.
Automated appointment reminders, payment reminders, and patient messaging platforms.
One-time cost to build or redesign your practice website. Set to $0 if you do not currently have a website.
Hosting fees, SSL certificates, security updates, content updates, and general website maintenance.
Ongoing cost of retaining a separate SEO or digital marketing agency. Set to $0 if you are not currently investing in SEO.
Cost of managing social media accounts (Facebook, Instagram, Google Business Profile, etc.) either in-house or through an agency.
Hours spent by providers or senior staff on billing follow-up, vendor coordination, and administrative tasks each month.
What is an hour of your time worth when spent seeing patients or building the practice? Used to calculate the opportunity cost of administrative burden.
If your back-office were fully managed, what portion of current admin hours could realistically shift to patient care or practice growth?
Free. No email required. Your numbers never leave this page until you choose to share them.
Your Practice Cost Estimate
All figures update in real time as you adjust the sliders above. Dollar amounts are monthly unless otherwise noted.
Build It Yourself vs. CareVixis Complete System
Dollar amounts update live from your inputs above. CareVixis costs VixisCare™ at $119 a month for the first provider plus 6% of insurance collections, 8% all-in, and nothing on patient payments.
| Practice Requirement | Build and Manage Independently | CareVixis Complete System |
|---|---|---|
| Revenue Cycle | ||
| Medical Billing and Claims | /mo Separate billing company at your selected rate, on top of all other costs |
Included |
| Clearinghouse Access | $50/mo Separate subscription plus potential per-claim fees |
Included |
| Denial Management and Appeals | $500/mo Eligibility and denial support. Active follow-up often costs extra or is not offered. |
Included |
| Rejection Correction | Staff time required. Must catch errors and resubmit before timely filing deadlines. | Included |
| Payment Posting | Manual posting or EHR auto-post requiring reconciliation. Errors lead to incorrect patient balances. | Included |
| Insurance AR Follow-up | Often deprioritized by billing companies. Older AR frequently abandoned. | Included |
| AR Recovery | May require a separate recovery service at additional cost | Included |
| Patient Billing and Statements | Separate software or service. Paper statements $1.50-$2.50 each. | Included |
| Medical Coding Optimization | Often not included in billing. Separate audit $500-$2,000. | Included |
| Practice Infrastructure | ||
| EMR / EHR System | /mo Per provider. Separate subscription, billed per provider. |
You keep your current EHR |
| Credentialing Setup | one-time Per provider, per payer. Typically takes 90-120 days per payer. |
Included |
| Credentialing Maintenance | /mo Per provider. Re-attestation, CAQH updates, license renewals, payer re-credentialing. |
Included |
| Prior Authorization | Often excluded from billing agreements. Requires staff time or outsourced service. | Included |
| Eligibility Verification | $500/mo Standalone tool or clearinghouse add-on |
Included |
| Patient Engagement | ||
| Telemedicine (Practice-Branded) | Separate platform. $50-$300+/provider/month. Generic branding. | Included |
| SMS Reminders (Appointments and Payments) | /mo Per provider. Separate platform requiring integration with scheduling. |
Optional service VixisConnect™, +1% |
| Clinical Transcription | Separate service. $50-$200/provider/month. | Included |
| Digital Presence | ||
| Website Design and Development | one-time Independent web agency. Updates billed hourly on top of this. |
Optional service VixisGrowth™, +1% |
| Website Hosting and Maintenance | /mo Hosting, SSL, security patches, content updates |
Optional service VixisGrowth™, +1% |
| SEO and Digital Marketing | /mo Separate marketing agency or consultant |
Optional service VixisGrowth™, +1% |
| Social Media Management | /mo Agency or in-house. Many practices skip this entirely. |
Optional service VixisGrowth™, +1% |
| Business Telecommunications | /mo Per provider. Separate VOIP or business phone with no clinical integration. |
Optional service VixisConnect™, +1% |
| Accountability and Support | ||
| Vendor Coordination | 5-8 separate vendors Separate support tickets, contracts, renewal dates. No single point of accountability. |
1 organization One contract. One phone number. Direct access to decision makers. |
| Staff Training | 5-8 separate interfaces to learn. Turnover means re-training across all systems. | Included |
| Practice Reporting | Data in multiple systems. Consolidated view requires manual work or separate BI tool ($200-$500/mo). | Included |
| Ongoing Technical Support | Each vendor has separate support hours and ticket systems | Included |
| Custom Development | Vendors have fixed features. Custom requests involve consulting fees and long timelines. | Included CareVixis writes every line of code internally |
| Implementation Time | 3-6 months Research, select, contract, configure and integrate 5-8 systems |
Coordinated One onboarding process instead of eight |
| Number of Separate Vendors | 5-8 vendors EHR, billing, clearinghouse, credentialing, website, SEO, phone, transcription |
1 vendor One accountable organization. One relationship. |
| Your Total | /mo + one-time | a month + one-time 6%, 7% or 8% of insurance collections depending on the services you selected, plus the monthly fee at the EHR cost you entered. Nothing on patient payments. |
The Hidden Cost Nobody Counts
Every calculator that compares billing fees ignores the most expensive line item in most practices: provider time spent on administration.
When you are coordinating between a billing company, an EHR vendor, a clearinghouse, a credentialing service, a website agency, and a phone system provider, you are the integration layer. You are the one who receives the finger-pointing when something breaks between systems. You are the one who spends 20 minutes on hold to learn that the denial came from data missing in a field that two vendors say is each other's responsibility.
The calculator above uses a conservative estimate. You can adjust both the number of admin hours and your value per productive hour to see the opportunity cost specific to your situation. Recapturing even 25% of that time through a fully managed back-office changes the economics of the comparison significantly.
This is separate from the direct cost savings. It is an additional reason the total value of a unified system is almost always larger than the fee comparison alone suggests.
Buying Billing Software Does Not Work the Denials
One of the most common misconceptions in practice management is that purchasing billing software solves the denial problem. Software submits claims. It does not follow up on them. The denial management problem is a people, process, and persistence problem, not a technology problem.
Understanding what you are actually dealing with matters. Not all payment reductions are the same thing:
Contractual Adjustments
The difference between gross charges and the contracted allowable. This is expected and cannot be appealed. The calculator accounts for this automatically using your allowable percentage.
Rejections
Claims returned before processing, usually for missing data or formatting errors. Rejections are correctable and must be resubmitted promptly to stay within timely filing deadlines.
Denials
Claims processed but not paid, with a reason code. Most denials are appealable. The recovery rate in this calculator reflects how many get worked versus written off.
The denial recovery rate in the calculator is the variable that most directly reflects the quality of your current billing operation. Denied revenue you never recover is income you have already earned and delivered care for. Most denied claims are recoverable. In a Premier survey of 516 hospitals across 36 states, 54.3% of private-payer denials were ultimately overturned and paid.1 The money is usually not gone, it is usually not pursued: on the ACA marketplace in 2024 insurers denied about 85 million in-network claims and fewer than 1% were appealed.2 CareVixis works denials the day they arrive and tracks the root cause so the same denial stops recurring.
Published Openly. Two Parts. No Surprises.
Published openly because we have nothing to hide. Your exact percentage within the range is set for your practice, and we tell you before you sign anything.
CareVixis Complete Back-Office
- ✓ 6% of insurance collections, not gross charges, for Core RCM. 7% with VixisConnect, 8% all-in
- ✓ Nothing on patient payments: copays, deductibles, coinsurance and self-pay
- ✓ No hourly rates: billing and AR follow-up are covered by the percentage
- ✓ The monthly fee applies only if you move onto VixisCare™
- ✓ Optional services: Website and SEO, Telecom and SMS, part of what sets your percentage
- ✓ Credentialing at $150 per payer, per provider, charged once per application
- ✓ Revenue management clients earn a $75 CareVixis service credit after six months and $75 after twelve, applied to future invoices rather than refunded; an unearned credit is forfeited if the practice leaves
- ✓ Additional payers: $150 per payer per provider on CareVixis revenue cycle management, against a $225 standalone rate
- ✓ Paper statements $1.75 each, passed through at cost and never part of the percentage
- ✓ Legacy A/R handed over to CareVixis: 10% of what is actually recovered, never on the balance
No commitment. No obligation. Jeff Norton speaks with every prospective partner personally.
All calculations use the inputs you provide together with fixed configuration values based on standard industry rates. No external data is pulled. No information leaves your browser. The formulas are shown below in plain language.
Monthly Allowable Revenue
Monthly Gross Charges x Contracted Allowable %
Initially Denied Revenue
Monthly Allowable Revenue x Denial Rate %
Permanent Denial Loss
Initially Denied Revenue x (1 - Denial Recovery Rate %)
Uncollected Patient Responsibility
Monthly Allowable Revenue x Patient Responsibility % x Patient Noncollection Rate %
Estimated Monthly Collections
Monthly Allowable Revenue - Permanent Denial Loss - Uncollected Patient Responsibility
Insurance Collections
Monthly Allowable Revenue x (1 - Patient Responsibility %) - Permanent Denial Loss. Patient payments are left out because CareVixis charges nothing on them.
Independent Monthly Billing Cost
Estimated Monthly Collections x Independent Billing Fee Rate %
Independent Credentialing Setup
Number of Providers x Number of Payers x Credentialing Cost Per Payer (adjustable, default $225)
Independent EHR Monthly Cost
Number of Providers x Your EHR Cost Per Provider (adjustable)
Independent Monthly Operating Cost
EHR + Clearinghouse ($50) + Website Hosting + SEO + Social Media + Billing + Credentialing Maintenance (per prov) + Phone/Telecom (per prov) + SMS (per prov) + Eligibility Support ($500)
Independent Credentialing Setup Cost
Number of Providers x Number of Payers x $300/payer
Independent First-Year Cost
Website Build + Credentialing Setup + Systems Setup ($500/prov) + (Monthly Operating Cost x 12)
CareVixis Monthly Cost (a Range)
(Insurance Collections x 6%) to (Insurance Collections x 8%), plus VixisCare™ if you use it. VixisCare™ is $119 a month for the first provider and $75 for each additional provider, and is $0 if you keep your current EHR. If you keep your current EHR, its cost is added to the CareVixis side as well, because you keep paying it.
CareVixis Credentialing Cost
Payers x $150/payer x Number of Providers
CareVixis First-Year Cost
Credentialing Cost + (Monthly Cost x 12), at both ends of the range.
Admin Opportunity Value (Annual)
Monthly Admin Hours x Provider Hourly Value x Productive Time % x 12
First-Year Savings
Independent First-Year Cost - CareVixis First-Year Cost, at both ends of the range
Fixed configuration constants (not adjustable via sliders): clearinghouse $50/month, eligibility and denial support $500/month, systems setup $500/provider. All other independent cost inputs (credentialing, EHR, phone, SMS, website hosting, SEO, social media) are adjustable above. Set any to $0 if your practice does not currently use that service.
- Software prices used are illustrative planning assumptions based on publicly available rate ranges. Actual vendor pricing may differ.
- Billing companies commonly use percentage-of-collections pricing. The default independent rate of 6% represents a mid-range industry estimate.
- Credentialing costs vary by payer, provider type and state. Credentialing frequently takes several months to complete.
- Denial rates vary significantly by payer, specialty and practice. The adjustable defaults are illustrative planning assumptions, not guaranteed national averages.
- Contractual adjustments (the difference between gross charges and contracted allowable) are not classified as preventable lost revenue in this calculator.
- CareVixis pricing shown here comes from the site pricing configuration and reflects current published pricing: a range, because each practice's exact percentage is set for that practice.
See What a Complete Practice System Could Look Like for You
The calculator uses estimates. A practice review uses your real EOBs, your actual denial data, and your specific payer mix. Jeff Norton conducts every initial review personally. No sales team. No scripts.
Nothing is off the table. Ever.
Printed from the CareVixis Practice Cost Calculator at carevixis.com/practice-cost-calculator.html. Results are estimates based on inputs provided. Schedule a quick call for a personalized review.
Disclaimer: This calculator provides an estimate based on the information entered and selected industry assumptions. Actual costs, collections, payer contracts, denial rates, credentialing requirements and results vary by practice. This is not a guarantee of revenue, savings or reimbursement. Independent vendor costs used in this calculator are based on publicly available market rate ranges as of 2026 and may not reflect your actual vendor agreements. CareVixis monthly rates and included services are subject to the terms of your individual partnership agreement. This calculator does not constitute a contract, commitment, or binding offer. For a precise analysis based on your actual practice data, please schedule a free practice review with CareVixis at carevixis.com/schedule-consultation.
Sources
- Premier, Trend Alert: Private Payers Retain Profits by Refusing or Delaying Legitimate Medical Claims. Survey of 516 hospitals across 36 states representing 52,123 acute care beds, covering claims from 1 January to 31 December 2022. 54.3% of private-payer denials were ultimately overturned and paid; providers averaged three rounds of review at 45 to 60 days each, at $43.84 per claim. Source. This is hospital data, not physician practice data.
- KFF, Claims Denials and Appeals in ACA Marketplace Plans in 2024. Insurers denied 19% of roughly 451 million in-network claims, about 85 million. Fewer than 1% of denied claims were appealed (262,982), and insurers upheld 66% of those appeals. Source. This covers ACA marketplace consumer appeals, not practice-side appeals.
- American Academy of Family Physicians, Practice Finances and Revenue Cycle Management. A 5% to 10% denial rate is the industry average, with below 5% preferable; adjusted collection rate should be at least 95%, average performance 95% to 99%, top performers 99%+; days in A/R below 50, with 30 to 40 preferable. aafp.org. Physician practice benchmarks, which is the right population for this calculator. Change Healthcare's 12% figure covers hospital claims.
- Tebra, The true cost of medical billing. Billing companies commonly price on a share of monthly collections, typically 4% to 10%. tebra.com. A commercial source, used here because no government or professional-association source publishes billing-company fee ranges.
These figures describe the industry, not CareVixis results. CareVixis does not publish a recovery rate.
Compare the Whole Operating Picture.
Use your own numbers to compare the costs you already carry across billing, technology and supporting vendors. CareVixis is designed to consolidate responsibility where it makes sense without requiring you to replace systems that already work.
Compare the Whole Operating Picture
Use the calculator to compare the costs you actually carry across the practice, not just a billing percentage. Consider staff and vendor responsibilities across revenue cycle, credentialing, technology, communications, operations and growth, then compare the scope being managed.