Key takeaways
- Look for specialty experience and the ability to work in your current systems.
- Get scope, responsibilities, and reporting in writing.
- Understand terms, data access, and how the relationship can end.
Choosing a billing company is a decision about who will handle your revenue every day. A good partner makes billing predictable and visible. A poor fit creates new gaps. These questions help you compare options on what actually matters.
1. Do they know your specialty?
Coding, payer rules, and documentation differ by specialty. Ask which specialties they bill today, what common issues they see in yours, and how they handle specialty specific rules such as therapy units, global periods, or authorization heavy services.
2. Will they work in your current systems?
Ask whether they can work inside your EHR, practice management system, and clearinghouse, or whether they require you to switch. A forced system change adds risk and time to the start.
3. What exactly is included?
- Charge entry, coding, and claim submission.
- Payment posting and reconciliation.
- Denial management and appeals.
- AR follow up on unpaid claims.
- Patient statements and balance questions.
- Eligibility, authorization, and credentialing support.
Get the scope in writing, including who owns each step.
4. How will they report to you?
Ask to see a sample report. You should be able to see claims submitted, payments posted, AR by age and payer, denials by reason, and open priorities. Ask how often you will get it and who will walk you through it.
5. Who is your contact?
Find out whether you will have a named point of contact, how quickly they respond, and how issues are escalated.
6. How do they protect patient data?
Ask how they handle protected health information, who on their team has access, and how access is set up and removed. A business associate agreement should be part of the relationship.
7. How does the transition work?
Ask what happens in the first weeks: access setup, review of open AR, handling claims already in process, and how they avoid a gap in billing.
8. What are the terms?
Understand pricing structure, minimums, contract length, and how either side can end the agreement, including what happens to your data and open AR.
Be cautious of guarantees about exact collection increases or approval dates. Results depend on your payers, documentation, and starting point.
Red flags
- No sample report, or reports you cannot understand.
- Vague answers about who owns denials and follow up.
- Promises of exact results before they have seen your data.
- No clear plan for the first weeks of the transition.
How to compare proposals side by side
Put each proposal into the same simple table: scope by step, systems they will use, reporting and how often, named contact, data access, transition plan, and terms. Gaps become obvious when the answers sit next to each other. Ask each company to fill in any blank, and treat a blank they cannot fill as an answer in itself.
Where Afiable helps
Afiable works inside your current EHR, bills by specialty, agrees scope and reporting in writing, and gives you a named point of contact. Start with a free audit, and judge us on what we find before you decide anything.
Questions practices ask
Should a billing company require a new EHR?
Not usually. Many work inside the systems practices already use. A required switch should come with a clear reason.
What should a monthly report show?
Claims submitted, payments posted, AR by age and payer, denials by reason, and open priorities, with someone available to explain them.
This article is general information for practice owners and managers. Payer policies and regulations change, so confirm current rules with each payer before acting.