Client Invoicing
MSO / SaaS billing — PEPM-based invoicing for all client organizations
Module PEPM Rate Schedule
Claims Processing$2.50 PEPM
Prior Authorization$1.80 PEPM
Enrollment Management$1.20 PEPM
Analytics & Reporting$2.00 PEPM
Care Management$3.50 PEPM
Document Management$0.80 PEPM
API Access$1.00 PEPM
Base Platform Fee: $2,500/mo flat per entity. PEPM rates are in addition to base fee.
AR Aging Summary
3
Current
$142,800
1
31–60 Days
$28,400
0
>60 Days
$0
Margin Analysis
| Client | Revenue | Cost to Serve | Margin |
|---|---|---|---|
| HealthPlan West | $68,400 | $41,040 | 40% |
| MountainCare IPA | $42,600 | $29,820 | 30% |
| Bay Area MSO | $31,800 | $25,440 | 20% |
| Valley Medical Group | $28,400 | $23,492 | 17% |
Client Invoices — April 2026
| Client Name | Month | Members | PEPM (Avg) | Base Platform | Module Add-Ons | Total Invoice | Status | |
|---|---|---|---|---|---|---|---|---|
| HealthPlan West | Apr 2026 | 4,800 | $9.25 | $2,500 | $21,900 | $68,400 | Paid | |
| MountainCare IPA | Apr 2026 | 3,200 | $10.00 | $2,500 | $9,100 | $42,600 | Paid | |
| Bay Area MSO | Apr 2026 | 2,400 | $9.75 | $2,500 | $6,900 | $31,800 | Pending | |
| Valley Medical Group | Apr 2026 | 1,850 | $8.50 | $2,500 | $5,150 | $28,400 | 31–60 Days | |
| Redwood Health Plan | Apr 2026 | 5,100 | $11.20 | $2,500 | $31,620 | $89,520 | Paid | |
| Pacific Coastal IPA | Apr 2026 | 1,200 | $8.00 | $2,500 | $3,100 | $15,200 | Pending | |
| Tri-County Health Net | Apr 2026 | 2,900 | $9.50 | $2,500 | $7,800 | $38,050 | Paid | |
| Cascade Medical MSO | Apr 2026 | 680 | $7.80 | $2,500 | $1,784 | $9,584 | Paid |