How to switch medical billing companies

The real risk

Practices usually worry the new company will be worse. That is rarely what happens. What goes wrong is the handover — a few weeks where old claims are no longer worked by the outgoing company and not yet worked by the incoming one. Claims in that gap age, and some cross filing deadlines and become permanently unrecoverable.

Everything below exists to close that gap. The cash-flow sequence covers timing week by week, and the transition checklist is the item-by-item version.

Before you give notice

The order matters. Once notice is given, cooperation tends to become slower and more literal.

• Confirm who owns your data in the current contract, and in what format you can have it.
• Check the notice period and whether there are post-termination fees on money collected after you leave. This is the most expensive surprise in the category.
• Secure your own credentials for the practice management system, clearinghouse and payer portals. If logins exist only inside the billing company, get your own before anything else happens.
• Export a full A/R aging report and a list of open claims with dates of last activity. This is your baseline, and the only way to tell later what was actually worked.
• Confirm where ERAs and EFTs are routed and who controls those enrolments.

During the transition

Agree who works the open A/R, in writing

This single point causes more lost money than everything else combined. The outgoing company has little incentive to chase old claims; the incoming one may not have agreed to inherit them. Decide explicitly: either the outgoing company works them to a defined date, or the incoming company takes them on at an agreed rate.

Run in parallel rather than cutting over cleanly

New claims to the new company, existing claims continuing where they are, for a defined overlap. It costs a little more for a few weeks and removes the gap entirely.

Keep submitting throughout

Whatever else happens, claims should not stop going out. A pause of even two weeks appears in your deposits sixty days later, which is usually exactly when everyone has stopped watching.

What to ask any incoming company

• Will you work our existing A/R, and at what rate?
• What do you need from us before day one, and by when?
• How long until claims are flowing normally?
• Who appeals claims denied during the transition?
• Can we run in parallel for the first month?

A company that has done this before answers all five immediately and will probably volunteer the checklist themselves. Hesitation on the A/R question in particular is worth noticing.