Buyer's guide
Print this. Take it into every meeting you have, including the one with us. Each question has an answer that is hard to fake, and we have written down what a good one sounds like.
Why it mattersThe revenue cycle has eight stages and most billing companies own five. The three they usually leave alone — eligibility, prior authorisation and registration — produce roughly a third of all denials.
A good answer sounds likeA boundary, stated plainly. If the answer is a list of services rather than a boundary, they have never thought about it.
Why it mattersAnyone can resubmit a denial. Reducing denials means tracing each one to the stage that caused it and fixing that stage.
A good answer sounds likeA breakdown by originating stage, and at least one category that got smaller. Grouping by payer or CARC code alone means they are processing denials, not managing them.
Why it mattersCompliance training focuses on billing too much. The predictable result is systematic conservatism that costs a mid-size practice five figures a year and never triggers an alert.
A good answer sounds likeA number. Zero, or “we have never tracked that”, means they audit in one direction only.
Why it mattersWorking an aging report oldest-first is intuitive and close to the worst method. Claims approaching a filing deadline expire while somebody chases a balance with no time pressure.
A good answer sounds likeFiling deadline first. Any other answer means claims are dying on a technicality.
Why it mattersThe most common billing failure is not a rejection. It is a correctly submitted claim that nobody looks at again until it appears on an aging report.
A good answer sounds likeA defined follow-up day per payer. “We work the aging report” means follow-up begins after the claim is already old.
Why it mattersAn expired licence, DEA registration or CAQH attestation makes every claim behind it unbillable, silently, often until several have passed timely filing.
A good answer sounds likeA calendar with lead time, and a straight answer to the second half. Everyone has a system. Not everyone has a story.
Why it mattersAn authorisation obtained after the service is worth nothing. The check has to happen when the appointment is booked, not when the patient arrives.
A good answer sounds likeAt booking. “Before the visit” usually means the morning of, which is too late to reschedule anything.
Why it mattersA free audit that exists only as a walkthrough on a sales call is a sales call.
A good answer sounds likeYes to both, with no conditions. If keeping the findings depends on signing something, it was never free.
Why it mattersData portability is the only thing that makes switching credible. Without it, a month-to-month contract is still a lock-in.
A good answer sounds likeA defined export format and a stated number of days, written into the agreement rather than promised on a call.
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We code and price five of your recent claims alongside whatever your current biller produced. No charge, no commitment.
In most cases we find more than the previous process was capturing.
Typical result, not a guarantee — outcomes depend on your payers, contracts and current process. A business associate agreement is signed before we receive anything.