Common questions
Medical billing questions and answers
If yours isn't here, send it to us and we'll answer it.
For practices
Questions about your billing
What does the free billing audit include?
You'll get a written report within 48 hours of sending us your reports. We go through your outstanding A/R, denied claims, rejection rates, payment delays and workflow gaps, then send you what we found in writing. We only ask for the minimum necessary data, with the right authorization, and you're under no obligation afterward.
How much does medical billing cost?
Ours is 3 to 5% of the payments your practice receives on the claims we manage, with a $500 monthly minimum and no setup fee. Where you land in that range depends on your volume and how much follow up your claims need, and you'll get the exact rate in writing after the audit. See how the fee works.
Do we have to change our EHR?
No, you keep what you have and we log in to it. Our team has hands on experience with Epic, athenahealth, eClinicalWorks and AdvancedMD.
Who does the work on our claims?
Our billers do, inside your system under named user accounts. They review coding changes and appeals before anything goes to a payer, and we won't bill what the record doesn't support.
How do you protect patient data?
We keep HIPAA safeguards in place, and we sign a BAA before accessing patient data. Access is role based and activity gets logged. Read about our safeguards.
Who receives the insurance payments?
You do. They keep going directly to your practice account. We see the remittance data because we need it to post and reconcile, and we don't hold your money.
Can we try you without replacing our current biller?
Yes. The free audit doesn't change anything in your office, and the 30 day denial recovery pilot runs alongside whatever arrangement you have now.
Can you guarantee higher collections?
No, and we'd be careful with anyone who says they can. Results depend on your payers and your documentation, and on your patient mix. We can show you your baseline and what changes from there.
What size of practice do you work with?
Independent practices, from solo providers up to small groups. There's a monthly minimum, though, so if your numbers don't support it, we'll say so before you sign anything.
Which specialties do you bill for?
Mainly primary care, family medicine, internal medicine, geriatrics and house call physicians. We'll also look at small specialty practices, so ask if yours isn't on that list.
How long does it take to get started?
It depends, mostly on what access your EHR and payers require and how much work is moving over. Your proposal will lay out a realistic plan for your practice.
Can you handle credentialing too?
Yes. It's a separate project with a fixed fee per payer application, and any fees charged by payers or states are paid by the practice.
Do you offer care management billing?
Yes, on the billing and administrative side. That covers CCM, Complex CCM, CPO, RPM, PCM and behavioral health integration. Your clinical team provides the care and the documentation.
Where is the work done?
In the United States. If your payer contracts have rules about where patient data can be accessed, send them over and we'll check them together.
Are you taking on new practices?
Yes, we're taking on new practices now. Most start with the free audit, so we both know what we're looking at.
Is percentage pricing allowed in my state?
It depends on state law, payer contracts and federal rules. Some states restrict percentage billing, and Medicare and Medicaid limit percentage fees when a billing company receives the payment. Under our model, payments go directly to your practice. If a percentage arrangement isn't appropriate in your case, we'll quote a different structure.
What happens if we want to leave?
You give us 30 days' written notice. It's month to month, so there's no long contract to get out of. Your data stays yours, and your agreement covers how open claims get handed back.
For billing company owners
Questions about selling your business
How does a revenue share work?
You receive an agreed share of the revenue collected from the clients who transfer, for an agreed period, with no fixed price and no loan. It's our preferred structure. The share and its length, plus any cap, get negotiated with you and written into the agreement.
Do you pay anything upfront?
It depends on the business. Our preferred structure ties payments to revenue, so we aren't looking to pay a large upfront sum. If upfront money is important to you, bring it up early and we'll tell you what we can do.
What happens if a client leaves after the sale?
Your payments drop along with that client's revenue. They can also drop if we perform poorly as the buyer and clients leave because of it. That's why we'd work out the transition plan and your introductions in detail before signing.
Can my client contracts be transferred?
It depends on the contract. Some can be assigned, and others need client consent or a new agreement. We review each one during diligence, and clients can always say no.
Do I have to sell everything?
No. You can sell a selected group of accounts and keep the rest, and we'll write down how the remaining clients are treated.
How long do I need to stay involved?
That's something we'd agree on with you. You might want a short handover, or you might prefer to cut your hours over a longer period. Clients generally need some time with you to feel comfortable.
What about my staff?
We'd talk about them early. If you have employees or contractors, their roles depend on the structure of the deal, and we'd discuss that with you before anyone else hears about it.
What changes for my clients during the handover?
As little as we can manage. We'd keep service steady while you're still involved, and any changes to how the work gets done would come in slowly, with our billers reviewing coding changes and appeals.
Is this legal and tax advice?
No. Each sale has legal and tax consequences, including how payments are treated, so you should have your own attorney and tax adviser review any agreement.
Find out what your claims are leaving behind
Send us your denial and A/R reports and you'll have a written report within 48 hours, for free. You can keep your current biller while you decide.
