Operations•6 min read
How to Choose a Medical Billing Company.
Every billing vendor promises faster payments. The difference shows up in scope, reporting and accountability. Use these questions before you sign — they separate a billing service from a claim-submission service.
Key takeaways
- Ask for metrics on practices of your size and specialty.
- Confirm who owns denials, appeals, A/R and patient balances.
- Demand reporting access, not monthly PDFs.
- Check the exit terms before you need them.
Questions about performance
Ask for numbers that can be verified in your own system after go-live.
- First-pass acceptance rate and denial rate for similar practices
- Net collection rate, not gross collections
- Days in A/R and the share of A/R over 90 days
- How underpayments against contracted rates are identified
Questions about scope
Most disappointment comes from work everyone assumed was included.
- Who verifies eligibility and obtains prior authorizations?
- Who works denials and files appeals — and within what deadline?
- Is legacy A/R included, and at what rate?
- Who handles patient balances and patient billing questions?
- Is coding review included or billed separately?
Questions about accountability
A named account manager, a defined response time and scheduled performance reviews are worth more than any dashboard.
- Who is our named contact, and what is the escalation path?
- How often do we review performance together?
- Do we keep direct access to claims and payment data at all times?
- How is HIPAA compliance and data security handled?
Questions about the exit
Read the termination clause before signing. Confirm notice period, who works claims in flight, how data is exported and in what format, and whether any records are held during transition.
Frequently asked questions
Clear scope, pricing including every recurring and one-time fee, reporting access, performance review cadence, HIPAA and data-security terms, notice period and a documented transition process for claims in flight.
Related
Talk it through with a specialist.
Free 30-minute call, no obligation — or email contact@wchsb.com.