Short answerChoose a billing company by checking its experience with your specialty's codes and denials, the credentials of the people coding your claims, how it reports results, how it prices (and on what), its HIPAA safeguards including any AI tools, and whether it works inside your existing systems.
A billing company built for primary care may struggle with a spine fusion or an anesthesia case. Procedural practices need different questions.
Eight questions to ask
- Which of our codes do you see most? Ask for specifics: instrumentation add-ons, bilateral injections, medical direction modifiers.
- Who codes our claims? Look for AAPC or AHIMA credentials.
- How do you handle denials? Ask about root-cause tracking, not just appeal counts.
- Do you check for underpayments? Ask how allowed amounts are compared with contracts.
- What do you report, and how often? Collections, NCR, days in AR, denial trends.
- How are you paid? Percentage of net collections, setup fees, minimums, lock-in.
- What are your HIPAA safeguards? BAA, access controls and how AI tools handle PHI.
- Do we have to change systems? A good partner works inside your PM/EHR.
Red flags
- guaranteed results or collection lifts
- long lock-in contracts with termination fees
- vague answers about who does the work
- free services offered to get in the door, then high fees later
What a first meeting should cover
A short review of where revenue stalls in your specialty, how onboarding would work, and pricing in writing. Book a 10-minute Google Meet.
This article is general billing information, not legal or coding-compliance advice. Payer rules, CPT descriptors and federal guidance change; check the current versions for your claims.