I'm answering on two of the posts but deleting the others. You only need to post in one section. I believe you are asking about what the billing service gets their fees based on but I'm not sure. If that is your question it will depend on how you set it up in your contract. Most billing services charge their percentage on what is collected as a result of their billing. For example, if you are doing insurance only billing you would charge based on the amount paid by the insurance carrier. If you also do the patient billing then you would charge based on what is collected from both the insurance carrier and the patient.