Choosing a billing company is a decision about who will handle your practice’s income. The right partner makes revenue more predictable and more visible; the wrong one can leave you with aged A/R and little insight into what happened. These are the questions worth asking before you sign.
Questions about services
- Which parts of the revenue cycle will you handle, and which stay with us?
- Do you work denials and appeals, or only submit claims?
- How do you handle A/R that already exists when you start?
- Do you provide coding, or do we code?
- Can you manage credentialing and payer enrollment?
Questions about systems and data
- Will you work in our existing EHR and practice management system?
- Who controls access to our systems, and how is it removed?
- Who owns the data, and how is it returned if we part ways?
Questions about reporting
- Which reports will we receive, and how often?
- How do you calculate days in A/R, denial rate and net collection rate?
- Will someone review the numbers with us each month?
Questions about security
- Will you sign a Business Associate Agreement?
- How is protected health information exchanged and stored?
- How are your staff trained on privacy and security?
Be cautious of any company that describes itself as “HIPAA certified.” The U.S. Department of Health and Human Services does not certify organizations as HIPAA compliant.
Questions about pricing and contracts
- Is the fee based on gross or net collections, or per claim?
- Are there setup fees or monthly minimums?
- Are appeals and A/R follow-up included?
- What is the contract term and notice period?
Our pricing guide explains the common models in more detail.
What the best medical billing companies have in common
You will find plenty of “best medical billing companies” lists online, and most of them are written by a billing company that ranks itself first. A better test is what a company actually does for you. The good ones tend to share a few habits:
- They quote after looking at your data, not before.
- They explain exactly what the fee covers and what costs extra.
- They work in your EHR and practice management system instead of forcing a switch.
- Their coders hold real credentials, such as AAPC or AHIMA certification.
- They sign a Business Associate Agreement without being chased.
- They send reports with claim-level detail, not just totals.
- They make it easy to leave, with clear exit terms and your data returned.
Red flags
- Guaranteed collection increases before anyone has looked at your data
- Statistics or testimonials that cannot be verified
- Reluctance to explain how fees are calculated
- No clear answer on data ownership or exit terms
- Reporting that shows totals but not the detail behind them
Ask us these questions
Bring this list to a revenue cycle review. We are happy to answer every question on it.