Claims administration fees: per-claim pricing explained

Service providers that submit a high volume of claims often outsource preparation, submission and follow-up. RBS Claims LLC bills that work on a per-claim fee schedule. Here is how the pricing works and what to look for in any claims-administration agreement.

What a per-claim fee covers

Preparing the claim from the provider's record, checking it for completeness and coding consistency, submitting it to the payer, tracking acknowledgement, and working routine rejections and resubmissions. Appeals, records requests and payer audits are usually priced separately because the effort varies so much.

The fee schedule

Fees are set per claim, often tiered by monthly volume, and stated in the agreement. Some administrators charge a percentage of collections instead; per-claim pricing is simpler to audit because the count is visible on both sides. Our statements list the claims by reference number, so the provider can tie every fee to a claim.

The monthly statement

Once a month the provider receives a statement from RBS Claims LLC: claims prepared and submitted in the period, any separately priced work, and the total, on Net 15 terms. It is paid by ACH or bank transfer through the link on the statement. The provider's own receivables from payers are not touched by the administrator; those payments go to the provider directly.

What to check before signing

• Exactly what counts as a claim and what is billed separately.
• Turnaround commitments and how rejections are reported back.
• Data handling: where records live, who can see them, and how long they are retained.
• Term and notice period, and how files are handed back if you leave.

Terms and payment details are on the payments and invoices page. To discuss volume and pricing, contact us.

Published 2026-08-22 by RBS Commercial, an operating group of Radd Payment Solutions. More insights