My medical biller just quit. What now?

The first 48 hours

Do these before anything else, ideally before the person has finished their notice. Access and knowledge walk out of the door with them, and both are much harder to recover afterwards.

• Get your own logins to the practice management system, clearinghouse and every payer portal. If any credential exists only in their head or their inbox, that is the first emergency.
• Export a full A/R aging report by payer and bucket. This is your baseline for everything that follows.
• Export a list of open claims with date of last activity, so you can see what was actually being worked.
• Ask what is mid-appeal and where the documentation is. Appeals have deadlines and no one else will know they exist.
• Find out what was in progress — a payer dispute, a credentialing application, a patient payment plan. Write it down while they are still there to ask.

What happens if you do nothing for two weeks

Claims stop going out. That is the immediate effect and it is invisible, because deposits keep arriving for another month from claims already submitted.

The gap shows up in week six or eight as a sudden dip, by which point the unsubmitted claims are a month old and the denials nobody worked are approaching appeal deadlines. This delayed feedback is what makes a biller leaving so much more expensive than it first appears.

Two weeks of unsubmitted claims at $100,000 a month in collections is roughly $50,000 of delayed revenue, some proportion of which will not be recovered at all.

Your three options, honestly

Hire a replacement

The right answer if billing was working and you can fill the seat quickly. Be realistic about that second condition — the market for experienced billers is genuinely tight, and a bad hire in this role is expensive in a way that takes months to surface.

Bring in temporary help

A contractor or billing company covering the gap while you recruit properly. This is underrated. It stops the bleeding without forcing a permanent decision in a bad week, and it buys you time to run the numbers calmly.

Outsource permanently

Often the right answer, but make it a decision rather than a reaction. Use the cost calculator and read the comparison once the immediate panic has passed.

What to ask anyone you bring in

• How quickly can you start submitting claims — realistically?
• What do you need from us on day one?
• Will you work the existing A/R, or only new claims?
• What happens to the appeals that are already in flight?
• Can this be temporary if we decide to hire?

That last question matters more than people expect. An arrangement that can flex either way removes the pressure to get a permanent decision right during the worst fortnight.