Changing billing partners is disruptive enough that it is worth doing once and doing it properly. These are the questions that tend to separate a company that will do the work from one that is good at winning the meeting.
Key takeaways
- Ask for the denial rate in writing, with the measurement defined.
- Find out who owns your aged AR on day one, before you give notice.
- A parallel run turns promises into a comparison you can check.
- If they use AI, ask exactly which decisions a person still makes.
The scorecard
Take this into the meeting. A company worth signing will answer all seven without hedging.
| Question | A good answer sounds like | Walk away if |
|---|---|---|
| What is your denial rate? | A number, in the contract, with a defined measurement | They quote a number but will not write it down |
| Do we have to leave our EHR? | No, or a specific technical reason why | Yes, with no reason beyond preference |
| Who works my account? | A named contact who handles your specialty | A pool, or nobody in particular |
| What does your AI decide alone? | Nothing final without human review | Vague answers about the technology |
| Who works my aged AR? | We do, from this date, at this cost | It is not mentioned until you ask |
| Can we run in parallel? | Yes, it is standard | Resistance, or extra cost to prove themselves |
| What will I be able to see? | A live dashboard, shown to you before signing | A monthly PDF |
1. What is your denial rate, and will you put it in the agreement?
Any company can quote a good number in a meeting. The question that matters is whether they will write it into the contract with a defined measurement. Ask how it is calculated, on which claims, and what happens if they miss it.
We guarantee under 5%, measured on claims we submit as a percentage of total claims submitted in the period, and the definition is written into the agreement rather than described verbally.
2. Do we have to leave our current EHR?
If the answer is yes, understand why. Sometimes there is a real technical reason. Often the billing company simply prefers not to learn another system, and the cost of that preference is a full data migration and retraining your staff during the exact period your cash flow is most fragile.
The hidden cost
An EHR migration during a billing transition means two disruptions at once, while your collections are already unsettled. If a company requires it, that cost belongs in your comparison, not just their fee.
3. Who actually works my account, and do they know my specialty?
Specialty knowledge is most of the value in medical billing. Modifier rules, bundling edits and documentation expectations differ enough between specialties that a generalist will lose money on your claims without ever doing anything you could point at as a mistake.
Ask whether you get a named contact, and whether that person handles other practices in your specialty.
4. If you use AI, what decisions does it make on its own?
This matters more than the marketing suggests. There is a real difference between AI that prepares and flags work for a person to approve, and AI that finalizes a code or submits a claim without a human ever seeing it.
| Step | Fully automated | How we do it |
|---|---|---|
| Claim scrub | AI decides and submits | AI flags, biller reviews |
| Code selection | AI finalizes the code | Certified coder finalizes |
| Denial appeal | Template sent automatically | Person writes the appeal |
| Accountability | Unclear | A named person on your account |
Our position is that AI prepares and a person decides. No claim is submitted and no code is finalized without human review. Ask any company you are considering to state their answer plainly, and to tell you who is accountable when the automation gets something wrong.
5. What happens to my aged AR on day one?
A common and expensive gap. The new company starts on new claims, the old company stops caring the moment notice is given, and everything already in flight quietly ages out in the handover.
Get it in writing: who works the existing aging, from what date, and at what cost.
6. Can we run in parallel before switching fully?
This is the question that gets the most revealing reaction. A parallel run, where the new company bills alongside your existing process for a period, lets you compare results directly instead of taking anyone’s word for it.
No practice should take a billing company’s word for it, including ours. That is what a parallel run is for.
A company confident in its work will welcome it. We build one into every onboarding as standard.
7. What will I be able to see, and how often?
A monthly PDF is a report about the past. Live access to collections, denials and days in AR is the ability to notice a problem in the week it starts.
Ask to see the actual dashboard before signing, not a screenshot of it.
A rough timeline for a switch done properly
| Stage | Typical timing | What should be happening |
|---|---|---|
| Assessment | Week 0 | They review a sample of your claims and aging |
| Onboarding | Weeks 1 to 2 | EHR connection, credentialing check, payer enrollment review |
| Parallel run | Weeks 2 to 4 | Both processes billing, results compared side by side |
| Full switch | Around week 4 | They own the cycle, you keep dashboard access |
One more, if you only ask one
Ask them to review a sample of your recent claims before you sign anything, and to tell you what they find. A company that will not look at your actual claims before quoting is guessing, and a company that looks and tells you your billing is already in decent shape is one worth trusting.
That is what a free consultation with us is. We review a sample of your claims and your aging report, show you where revenue is leaking, and you keep the findings either way.
