Before hiring a medical billing company, ask ten practical questions about scope, specialty experience, staff, technology, performance, communication, security, implementation, pricing and data exit. Require written answers and demonstrations using your practice’s real workflow. A confident sales presentation is not evidence that the company will handle claims, denials, payments and patient accounts accurately after the contract is signed. Ask who performs each task, who supervises it, how absence coverage works and whether subcontractors are involved. Require comparable references, stable metric definitions, account-level reporting, a business associate agreement, complete first-year and renewal pricing, and sample data exports. Material promises about integrations, response targets, old-account handling, fee calculation and termination should appear in the contract or implementation plan. The final scorecard should weigh verified workflow, people, integration, reporting, support, security, transition, contract and total cost. Reconcile early claim batches and payments before full cutover. Written clarification protects the practice from important scope differences hidden by a low rate or polished demonstration. after launch
1. Which billing tasks will you perform
Ask for a responsibility matrix covering registration review, eligibility, coding, charges, claim edits, submission, rejections, denials, posting, patient statements, refunds and reporting. Identify what the practice retains.
Define response targets and escalation so no task falls between teams.
2. Can you prove experience with our specialty
Provide common and difficult claims, authorizations, modifiers and documentation dependencies. Ask the team to show where each exception appears and who owns it. Request references with similar providers and payer mix.
A broad statement that every specialty is supported is not enough.
3. Who will perform and supervise the work
Meet operational leaders and ask about team structure, qualifications, coverage, subcontractors, turnover and escalation. Determine whether the salesperson remains involved after launch.
Ask references about a difficult denial or support problem, not only general satisfaction.
4. How will your system integrate with ours
Name exact EHR, practice-management, clearinghouse, portal and payment systems. Define fields, direction, timing and support ownership. Test downtime, duplicates and corrections.
A compatibility logo does not prove a complete production interface.
5. How do you measure billing performance
Agree on charge lag, acceptance, rejections, denials, accounts receivable, posting delay, patient balances and credits. Require account drill-down and deposit reconciliation.
Use the billing metrics guide to prevent vague collection-rate claims.
6. How will daily communication work
Ask how documentation questions, urgent deadlines, patient issues and payer problems move between teams. Define channels, operating hours, response expectations and escalation. Preserve messages and outcomes in the account workflow.
Regular meetings should produce owners and follow-up dates.
7. How do you protect our data
Review the business associate agreement, roles, authentication, logs, encryption, backups, subcontractors and incident procedures. Test client separation and user removal.
Ask what data is exported or deleted when the relationship ends.
8. What is the implementation plan
Request owners, dates and acceptance tests for access, conversion, configuration, interfaces, training, payer setup, cutover and stabilization. Protect active claims and define old-account work.
Reconcile initial batches, remittance and deposits before declaring completion.
9. What is the complete price and contract
Ask about percentage or flat fees, minimums, setup, coding, statements, processing, support, increases, renewal, cancellation and termination. Model first-year and renewal cost with actual volume.
Clarify how refunds, takebacks and payments received after termination affect fees.
10. How do we retrieve our complete data
Request sample exports of patients, claims, payments, denials, notes, documents, reports and audit history. Confirm usable formats, timing and transition support. Data ownership without practical access is weak protection.
Use the medical billing company guide and data export checklist. Then submit one detailed medical billing company price request. The written answers should become the scorecard and, where material, the contract.