- Definitions
Any terms not otherwise defined herein have the meaning ascribed to them in our Terms of Service.- Subscription User Levels
- Provider. Any provider of billable medical services to patients who is a Customer, or who has an employment, contractor, or agent relationship with a Customer, to whom Tebra provides clinical, billing, or marketing services.
- Physician Provider. An individual Provider that is authorized to directly bill Medicare or commercial insurance companies for professional healthcare services rendered to patients, and holds a degree of, including but not limited to, DDS, DO, DMD, DPM, MD, ND, NMD, or OD.
- Non-Physician Provider. Any individual Provider other than a Physician Provider or Therapist. This includes, but is not limited to, acupuncturists, audiologists, chiropractors, mid-wives, nurse practitioners, physician assistants or registered dieticians.
- Supervising Provider. A Physician Provider who monitors and aids Non-Physician Providers by signing/counter-signing notes, as well as prescribing medications. A Provider that has duties in addition to the foregoing shall not constitute a Supervising Provider.
- Facility Provider. An organization, facility, or lab that is authorized to directly bill Medicare or commercial insurance companies for institutional healthcare services rendered to patients. All Facility Providers must be on a transactional agreement.
- Therapist. A physical therapist (PT), occupational therapist (OT), speech language pathologist (SLP), marriage and family therapist (MFT), social worker (LCSW, MSW), or psychologist.
- Billing Transaction. In connection with subscription pricing based on billing transaction volume, billing transactions include the following: (i) electronic claims, (ii) eligibility checks, and (iii) each request/claim submitted, paid and/or denied within an electronic remittance advice (ERA).
- Fees. All fees charged by Tebra are described herein and are determined by the software subscription level selected (Billing, Clinical, or Patient Experience) and specific provider characteristics (Physician or Non-Physician Provider, full- or part- time, or specialty). All prices may change with 30 days’ electronic notice. Customer is responsible for keeping email addresses updated with Tebra.
- Mailing fees. Any fees for mailings like paper insurance claims or paper patient statements, which may be increased at any time to reflect a change in the USPS postage or processing costs.
- Software Subscription Fees. Per Provider/Therapist fees for Billing, Clinical, and Patient Experience modules. Software Subscription Fees are set forth in the applicable Order Form signed by Customer. Customer is responsible for paying the Software Subscription Fees for the duration of their subscription term.
- Transactional Fees. Per transaction fees for electronic claims, eligibility checks, electronic remittance advice, paper claims, and patient statements. Transactional Fees are set forth in Section II below.
- Professional Services Fees. Fees for professional services provided by Tebra outside of a Customer’s software subscription, which may include, for example, Robotic Processing Automation, Cloud, Blog, Social, data import or migration, or live training services. Professional Services Fees are set forth in the applicable Order Form or other written agreement between Customer and Tebra.
- Legacy Products. For Customers who signed a Customer Agreement for legacy products, all references to legacy products correspond to the following terms:
- “Kareo Billing” mean “Billing”
- “Kareo Clinical” and Clinical Essentials mean “Clinical”
- “Kareo Engage,” “Kareo Office,” and “Practice Growth” means “Patient Experience”
- Subscription User Levels
- Support. All subscription levels include unlimited access to general customer support through our Customer Care Center and by phone or live chat, and to Billing Support by phone or email. For more information, please contact us or visit our Customer Support Policy.
- Assisted Enrollment Service. Assisted enrollment services include clearinghouse sign-up and setup of electronic services with insurance companies. Assisted enrollments with unlimited number of payers on initial enrollment are included for all customers without additional fees. Subsequent payers are not included.
- Notice of Non-Renewal. To prevent renewal of a Customer Agreement, either party must give written notice of non-renewal and this written notice must be received at least sixty (60) days in advance of the end of the Customer Agreement then in effect. If Customer decides not to renew, Customer must send the notice of non-renewal by contacting the assigned Account Manager directly or via the communications methods in Tebra’s Customer Support Policy. Any notice received with less than sixty (60) days’ notice will result in auto-renewal of the Customer Agreement for an additional Renewal Term.
- No Refunds/Credits. All fees are nonrefundable and non-cancellable. Tebra does not refund or credit subscription fees for partial months, or any portion of a prepaid plan upon a deactivation of a Provider or account cancellation. Customer is responsible for all fees (including any monthly minimum) for the entire term of the applicable order or subscription agreement.
- Excess Claims. Tebra may change Customer’s pricing from a subscription to a transactional plan after thirty (30) days’ notice if Customer exceeds 500 claims per month.
- Tebra Platform. Any discounted or bundled prices are for the three-module bundle of Clinical, Billing, and Patient Experience only. If one or more modules are canceled at any time, remaining modules revert to full price.
- Practices. All practices must have at least one active Provider within a practice for the practice to remain active. There is a minimum monthly fee for any account that has not activated a Provider as listed in Section II(F) below.
- Multi-Practice Provider. Providers activated within multiple practices within a single Tebra account will be charged one subscription fee, at the highest applicable subscription level (e.g., Practice Operations Clinical, Billing, or Patient Experience), subject to the Provider using and correctly inputting the same name, NPI, and other user information in connection with all relevant practices.
- Fee Changes. Tebra reserves the right to increase its prices by no greater than 4.9% at any one time, no more frequently than once per 12-month period, upon thirty (30) days’ notice to the Customer. This provision shall not apply to RPA customers.
- For Customers with month-to-month agreements, all fees may be changed with sixty (60) days’ notice to Customer.
- For all Customers, Tebra may increase fees to cover the cost of postage rate increases as well as regulatory, compliance, and other cost increases imposed by changes to applicable federal and state rules. Tebra will automatically apply the rate increase to all services impacted by the change with thirty (30) days’ notice to the Customer.
- Invoice Frequency
FEE INVOICE FREQUENCY Onboarding fee One-time fee; billed at sign-up Software subscription fees Billed monthly in advance* EHR integration services fee Billed monthly in advance Website hosting Billed monthly in advance Transactional fees Billed monthly in arrears Professional services Billed monthly in arrears Data import and migration fees Billed monthly in arrears ROBOTIC PROCESSING AUTOMATION INVOICE FREQUENCY Onboarding Fees Billed in advance on a per practice basis Subscription fees Billed monthly in advance on a per practice basis Transactional Fees (Smart Connector for HL7 & Patient Data; Automated Clinical Note Creation) Billed monthly in arrears for each transaction/encounter above the standard monthly allotment Transactional Fees (PDF Note Creation) Billed monthly in arrears for each transaction *Adding or Removing Providers. Any Providers that are removed or deactivated are charged in advance for the last full month and, at Tebra’s discretion, may be subject to an early termination fee for the remainder of the term. Any Providers added or activated during the Term will be charged on a pro-rata basis for the first month.
Pricing Policy
Pricing & Billing Policies for your Tebra Account
I. CUSTOMER ACCOUNT INVOICING TERMS
II. PRICING
A. ELECTRONIC CLEARINGHOUSE SERVICES & FEES | |||
Electronic Claims Submission (ANSI 837) Includes sending electronic claims in the ANSI 837 format to Tebra’s Clearinghouse |
All Tebra Platform customers who exceed 100 claims per provider per month for three consecutive months will be converted to standard pricing.
Legacy Platform customers will be charged $0.99/electronic claim, per provider, per month for Low-Volume subscription plans after the first 50 claims. |
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Electronic Remittance Advice (ANSI 835) Includes receiving electronic remittance advice messages from Tebra’s Clearinghouse in the ANSI 835 format |
No charge | ||
Electronic Real-Time Insurance Eligibility Services (ANSI 270/271) Includes performing electronic verification of insurance benefits from Tebra’s Clearinghouse in the ANSI 270/271 format |
No charge | ||
Electronic Claim Attachments (ANSI 275) Effective January 1, 2025 Submission of claim attachments to payers supporting 275 claim attachments, other than workers compensation and auto accident |
$0.99/document attached to claim (based on the number of PWK loops and segments present within an 837 claim file)
No charge for documents submitted supporting workers compensation and auto accident claims. |
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B. MAILING SERVICES & FEES | |||
Jopari (Workers Compensation and Auto Only) Paper Claims Mailing Services Includes postage |
$1.05/first page $0.20/additional page |
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Non-Jopari Clearinghouse Paper Claims Mailing Services Includes postage |
$1.05/paper claim printed and mailed | ||
Patient Statement Mailing Service Fees Sending batches of patient statements to Tebra-affiliated processor for printing and mailing. Includes postage |
$1.05/first page, per statement $0.24/additional page |
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Undeliverable Mail | Patient statements rejected by the USPS as undeliverable are charged at the normal rate. A report with each reject and an explanation of the error will be provided so that address can be updated for future mailings. | ||
No fee for printing of paper claims or patient statements to your own printer from Tebra. | |||
C. CREDIT CARD SERVICES & FEES | |||
Patient Payment Processing Includes terminal or “card present” transactions |
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Tebra Invoice Processing | Credit card payments will incur a 2% processing fee. | ||
D. ROBOTIC PROCESS AUTOMATION SERVICES & FEES | |||
Subscription Fees | Packaged by ERA Processing, Unapplied Payments | ||
AR Courtesy Calls Transaction Fee |
Packaged by minutes/texts per month | ||
Smart Connector for HL7 & Patient Data Setup Fee |
Per practice for a single file or transaction feed | ||
Smart Connector for HL7 & Patient Data Transaction Fee |
Packaged per any appropriate patient and/or billing data for a single encounter per month | ||
Automated Clinical Note Creation Transaction Fee |
Packaged by encounter per month | ||
PDF Note Creation Transaction Fee |
Packaged per note created each month | ||
E. ELECTRONIC PRESCRIBING OF CONTROLLED SUBSTANCES (Tebra HER) | |||
Application Fee | One-time application fee; $75.00 | ||
Prescription Drug Monitoring Program (PDMP) Add-On Service |
One-time implementation and setup fee of $500 per Facility; and (ii) $50/year per Authorized User | ||
F. AI NOTE GENERATION FEE | |||
AI Note Generation Effective January 1, 2025 |
$0.99/note generated | ||
G. PROVIDER WEBSITE EXPORT FEE | |||
Provider Website Preparation and Export Fee For Provider Websites launched on or after April 1, 2023, this export will include the textual content and overall structure of the Provider Website. Exports for Provider Websites launched prior to April 1, 2023 may be subject to additional technical limitations. Certain dynamic features, such as appointment widgets, will not be included in the Provider Website Export. |
$1,000 | ||
H. ACCOUNT-DEPENDENT ADMINISTRATIVE FEES (IF APPLICABLE) | |||
Minimum Fee There is a minimum monthly fee for any account that has not activated a Provider. When a Provider is activated, subscription fees will be charged accordingly. |
$150/month | ||
Reactivation Fee Tebra reserves the right to assess a reactivation fee to Customers whose accounts are suspended based on late payments received more than fifteen (15) days following the payment due date. |
$49/account reactivation |
III. DATA IMPORT & MIGRATION FEES
- Data Import
- Data import services for the Tebra platform is available for the following data sets:
- Patient Demographics
- Appointments
- Patient Case (Insurance Policy)
- Payer List
- Provider List
- Service Locations
- Patient Balances Forward
- Scanned Documents (Clinical and Non- Clinical)
- Fee Schedule
- Care Summary Document (C-CDA)
- Fees for data imports are determined based on the data sets requested and volume of the specific import. To receive a quote for data import services, please submit a data import to request
- Data import services for the Tebra platform is available for the following data sets:
- Data Migration
- A data migration is the process of moving practice data from a multi-practice account (e.g., a billing company) into a newly created customer account.
- Migrated data may include, but is not limited to, patients, appointments, encounters, claims, payments, documents, settings, and clinical data.
- Data migrations require written permission from the company administrator of the account from which the data originates (e.g., a billing company).
- Fees for data migration are determined based on the details for the specific migration. For more information, please contact us.
What types of files can we accept for data imports?
DATA SET | FORMAT |
Patient Demographics | XLS, CSV |
Insurance Companies, Plans, and Policy Info | XLS, CSV |
Providers | XLS, CSV |
Service Locations | XLS, CSV |
Fee Schedules | XLS, CSV |
Appointments | XLS, CSV |
Balance Forward | XLS, CSV |
Journal Notes | XLS, CSV |
Scanned Documents | PDF, doc, docx, gif, jpg, jpeg, html, png rtf, tif, txt |
Clinical Document CCDA Discrete | XML |
Last updated effective January 20, 2024.
To see previous versions, click here.