What to Ask Before Signing a Contract With a Medical Billing Company

What to Ask Before Signing a Contract With a Medical Billing Company

Choosing the right billing partner can make or break your practice’s revenue flow. At Medical Biller, where providers can explore the Top medical billing companies in California and beyond, we’ve seen how the right questions—asked up front—can prevent months of frustration, lost revenue, or compliance risk.

If you're preparing to outsource your billing or switch companies, this guide covers the critical questions to ask before signing a contract with any medical billing provider. Asking the right questions now will help you find a company that’s aligned with your goals, your specialty, and your practice’s future.

Why the Right Billing Partner Matters

Billing isn’t just about claims—it’s about compliance, collections, communication, and patient experience. A poor billing partner can lead to:

• Delayed or denied payments

• Patient complaints over unclear statements

• Gaps in revenue cycle reporting

• Legal and HIPAA risks

• Staff burnout due to rework or poor support

That’s why vetting a billing company thoroughly before you sign anything is essential.

Key Questions to Ask Before Signing a Billing Contract

1. What Services Are Included in Your Billing Package?

Ask what’s included (and what’s not):

• Charge entry and claim submission

• Payment posting

• Denial management and appeals

• Patient statements and collections

• Reporting and analytics

• Credentialing or payer enrollment

Why it matters: Some companies charge extra for services you may assume are included.

2. What Is Your Fee Structure?

Understand:

• % of collections vs. flat fee vs. hybrid

• Minimum monthly fees or thresholds

• Additional charges for reworking denials, old AR, or special reports

Why it matters: A low headline rate may come with hidden costs.

3. How Do You Handle Claim Denials?

Ask:

• Who manages rejections and denials?

• How quickly are they addressed?

• Is there a process for appeals?

• Do you track and report denial trends?

Why it matters: Denial resolution directly impacts your cash flow.

4. Do You Have Experience With My Specialty?

Specialty-specific billing includes:

• Unique CPT codes and modifiers

• High audit risk areas (e.g., pain management, behavioral health)

• Payer rules for bundled services or time-based codes

Why it matters: Experience with your specialty reduces learning curves and billing errors.

5. What Software or Systems Do You Use?

Clarify:

• Whether they use your current EHR/PM system or theirs

• How you will access billing data and reports

• Any setup, integration, or data migration fees

Why it matters: You need visibility into your billing activity at all times.

6. How Often Will I Receive Reports?

Ask about:

• Standard report frequency (daily, weekly, monthly)

• Report types (A/R aging, collections, denial rates, etc.)

• Customization options for your needs

Why it matters: Transparent reporting helps you monitor performance and spot problems early.

7. Who Will Be My Point of Contact?

Get clarity on:

• Whether you’ll have a dedicated account manager

• Their availability (email, phone, video meetings)

• Escalation process for urgent billing issues

Why it matters: Ongoing communication is key to trust and performance.

8. What Happens If I Decide to Terminate the Contract?

Find out:

• Contract length and cancellation terms

• Notice period required to exit

• How your data and records will be returned

• Whether there are early termination fees

Why it matters: You need a clean exit strategy if expectations aren't met.

9. How Do You Ensure HIPAA Compliance?

Verify:

• Staff HIPAA training

• Data encryption and access controls

• Secure portals for patient communications

• Business Associate Agreement (BAA) inclusion

Why it matters: You're legally responsible for patient data, even if a third party handles it.

10. Can You Provide References or Case Studies?

Ask for:

• Client references from similar specialties or practice sizes

• Case studies showing how they reduced denials or improved collections

• Customer satisfaction ratings or testimonials

Why it matters: Past performance is a strong predictor of future results.

Bonus: Questions for Billing Company Red Flags

Watch for vague answers or hesitation when you ask about:

• Denial resolution timelines

• Reporting transparency

• Staffing turnover or outsourcing

• Financial penalties or performance guarantees

These could signal a lack of structure, accountability, or experience.

How to Build a Bulletproof Denial Management Strategy

Final Thoughts

Outsourcing your billing is a big decision—but it doesn’t have to be a risky one. When you ask the right questions up front, you gain clarity, reduce surprises, and build a partnership that protects your revenue.

At Medical Biller, we help practices find billing companies that answer these questions with confidence—and deliver results. Whether you’re a solo provider or a multi-location group, we help you compare the Top medical billing companies in California and beyond, all in one place.