Should the old billing company keep working my accounts receivable?

That depends on your contract and transition agreement. If the outgoing company retains legacy accounts receivable, define the cutoff date, responsibilities, reporting requirements, and final handoff in writing.

How to Switch Medical Billing Companies Without Losing Revenue

Table of Contents

Changing your medical billing company can feel risky, especially when your practice depends on every claim being submitted, followed up, posted, and reconciled correctly.

But the biggest transition risk is usually not the fact that you are changing vendors. It is the handoff.

A poorly organized handoff can create unanswered claims, unclear A/R ownership, missing billing data, delayed payer transactions, payment-posting problems, and confusion over which company is responsible for the next action.

The good news is that you can reduce these risks by treating the change as a planned revenue-cycle transition, not a one-day event.

This guide explains how to switch medical billing companies without losing revenue using an eight-step process designed for physicians, practice managers, medical groups, clinics, and healthcare administrators.

You will learn what to collect before giving notice, how to divide new claims from legacy A/R, what payer and electronic transaction information to verify, how to structure the cutover, and which numbers to monitor during the first 90 days.

Important: There is no universal transition timeline, payer deadline, or credentialing requirement that applies to every practice. Contract terms, payer rules, specialty, software, claim volume, and your existing billing setup all matter. Use this guide as an operational framework and verify payer-specific requirements before taking action.

What Is the Safest Way to Switch Medical Billing Companies?

The safest transition is one where you know what is moving, who owns each task, when it must happen, and how you will measure the result.

Before switching vendors, you should:

Review your current billing contract.
Establish a financial and operational baseline.
Export and verify your billing data.
Create a claim-by-claim A/R ownership list.
Verify payer enrollment, EDI, ERA, and EFT requirements.
Define the exact cutover date and responsibilities.
Use a controlled overlap or parallel-processing plan where appropriate.
Review KPIs at 30, 60, and 90 days.

The goal is not simply to replace one billing company with another.

The goal is to make sure claims keep moving while responsibility changes hands.

When Should You Switch Medical Billing Companies?

Before you give notice, ask a more basic question:

Is the problem actually the billing vendor, and have you documented it?

A practice may start considering a new billing company after seeing:

Increasing claim denials
Growing 90+ or 120+ day A/R
Slow claim follow-up
Poor communication
Delayed payment posting
Repeated eligibility-related denials
Coding or documentation problems
Missing reports
Difficulty obtaining billing records
Lack of specialty-specific experience
Credentialing or payer enrollment problems
Patient complaints about billing communication
Lack of visibility into outstanding claims

One isolated problem does not automatically mean you need a new vendor.

A repeated pattern is different.

Before making the switch, create a simple list with three columns:

Problem	Evidence	What You Expect From the New Vendor
High denials	Current denial report	Weekly denial analysis
Aging A/R	120+ day A/R report	Defined follow-up workflow
Slow reporting	Reports arrive late	Weekly dashboard
Poor communication	Missed responses	Dedicated contact
Data access issues	Missing claim history	Complete data handoff

This turns a vague complaint into a measurable transition objective.

What a Billing Transition Can Put at Risk

Suppose your practice normally collects $180,000 per month.

That averages approximately:

$180,000 ÷ 30 = $6,000 per day

This does not mean that every day produces exactly $6,000 in cash, and it does not mean a delay automatically creates a permanent $6,000 loss.

But it gives management a useful way to think about cash timing.

If a transition creates a five-day disruption in expected collections, the practice could have roughly:

$6,000 × 5 = $30,000

of average collection volume moving later in the cash cycle.

That is a planning example, not an industry benchmark or claim of permanent revenue loss.

The practical question for your practice is:

“How much expected cash could be delayed if claims, posting, or follow-up are interrupted?”

Calculate that before the transition, not after the first difficult month.

Audit Your Current Medical Billing Vendor Before You Give Notice

Do not start by sending a termination notice.

Start by collecting information.

Review Your Current Contract

Look for:

Notice requirements
Contract expiration date
Termination provisions
Data-return obligations
System-access terms
Record-retention requirements
Post-termination A/R responsibilities
Final reporting obligations
Any runoff or transition language

Do not assume that another practice’s contract works the same way as yours.

Your contract controls your notice period and the mechanics of the handoff.

Download Your Recent Billing Reports

At minimum, ask for recent reports showing:

Total charges
Total payments
Adjustments
Denials
Rejections
Clean claims or first-pass metrics, where available
Days in A/R
A/R aging
Insurance A/R
Patient A/R
Write-offs
Open claims
Payment posting activity

You can also use your Medical Billing Services workflow review to identify which parts of your current revenue cycle need improvement before the new vendor takes over.

Build a Payer and Enrollment Inventory

Create one spreadsheet containing:

Payer	Provider	Tax ID	NPI	Enrollment Status	EDI	ERA	EFT	Notes
Medicare	Practice provider	Practice TIN	Practice NPI	Active	Yes	Yes	Yes	Verify
Medicaid	Practice provider	Practice TIN	Practice NPI	Active	Yes	Pending	Yes	Follow up
Commercial Payer	Practice provider	Practice TIN	Practice NPI	Active	Yes	Yes	Pending	Verify

The NPI is a standard identifier used in HIPAA administrative transactions, and CMS notes that covered providers, health plans, and clearinghouses use NPIs in adopted transactions.

The purpose of this spreadsheet is simple:

You should know what exists before you ask a new company to manage it.

Step 2: Establish Your KPI Baseline and Document Every Open Claim

Do not judge the new billing company using memory.

Judge it using numbers.

Create Your Baseline

Record:

KPI	Your Current Number	Date Measured
Monthly collections	Enter actual	Pre-switch date
Clean claim rate	Enter actual	Pre-switch date
Denial rate	Enter actual	Pre-switch date
Days in A/R	Enter actual	Pre-switch date
90+ day A/R	Enter actual	Pre-switch date
120+ day A/R	Enter actual	Pre-switch date
Open claims	Enter actual	Pre-switch date
Rejection volume	Enter actual	Pre-switch date
Payment posting lag	Enter actual	Pre-switch date

These are your baseline numbers, not universal industry targets.

That distinction matters.

For example, if your practice begins at 91% clean claims and moves to 95% after a transition, that is a different story from a practice that begins at 98%.

Create a Claim-by-Claim Handoff File

This is one of the most important documents in the entire transition.

For every open claim, record:

Date of service
Payer
Claim number
Charge amount
Submitted amount
Current status
Rejection or denial reason
Last follow-up date
Next action
Appeal deadline, when applicable
Timely-filing deadline, when applicable
Assigned owner

Your new billing company should not receive a vague instruction such as:

“Please handle our old A/R.”

It should receive a controlled list showing exactly what exists and what happens next

Step 3: Build a Transition Timeline With the New Billing Partner

A billing vendor change should have a project plan.

Do not make “go-live” the only date on the calendar.

Phase 1: Discovery

During the first phase:

Review the contract
Identify the reason for switching
Establish baseline KPIs
Identify key payers
Review A/R
Identify software systems
Identify clearinghouse relationships
Assign transition contacts

Phase 2: Data and Workflow Preparation

Request data exports
Build the claim inventory
Review provider information
Verify payer relationships
Confirm system compatibility
Review EDI/ERA/EFT setup
Define legacy A/R responsibility

Phase 3: Cutover Preparation

Before go-live:

Test workflows
Verify access
Confirm data import
Validate claim records
Confirm submission routing
Confirm payment-posting procedures
Finalize the ownership matrix

Phase 4: Go-Live and Monitoring

After the switch:

Monitor new claims
Continue legacy A/R follow-up
Check rejections
Check denials
Reconcile payments
Review collections
Hold regular transition meetings

The exact number of weeks will vary by practice.

A three-provider office with one payer mix and a clean billing system is not the same project as a multi-specialty organization with multiple systems and a large aged A/R file.

Questions to Ask Before Hiring Your New Medical Billing Company

Do not choose a billing company only because its percentage fee looks attractive.

Ask how it will execute the transition.

Ask These Questions

1. Who will manage my transition?

You should know the person’s role and how to escalate issues.

2. Who owns legacy A/R?

This should be written down.

3. How will claims submitted before cutover be handled?

Do not assume.

4. How will denied claims be assigned?

Especially claims that were submitted by the old vendor.

5. How will my historical billing data be transferred?

Ask exactly what data will be imported.

6. Which payer-related changes will your team handle?

Ask about enrollment, EDI, ERA, EFT, and portal access separately.

7. How will you protect PHI during the transfer?

Ask about the Business Associate Agreement and secure transfer method.

8. Which KPIs will you report after go-live?

Ask to see a sample dashboard.

9. How often will we review the transition?

Weekly may be appropriate during an active migration.

10. What happens if collections, submissions, or denials move in the wrong direction?

The answer should include an escalation process, not just “we will monitor it.”

Step 4: Transfer Your Medical Billing Data Securely

Data transfer should be treated as a controlled project.

Your new vendor cannot properly manage claims if important history is missing.

What Should You Export?

From Your EHR

Depending on your system:

Patient demographics
Insurance information
Subscriber information
Provider information
Authorization data
Billing-related documentation

From Your Practice Management System

Collect:

Claim history
Open claims
Claim status
Charges
Payments
Adjustments
Write-offs
A/R aging
Patient balances
Insurance balances
Denial history
Fee schedule information where applicable

From Your Clearinghouse or EDI System

Where available, preserve:

Payer enrollment information
EDI setup information
Submitter information
Routing data
ERA files
835 remittance files
Claim acceptance and rejection history

Validate the Data Before the Old Vendor Disappears

Do not assume that “export complete” means “migration complete.”

Choose a sample of records and compare:

Old system → exported file → new system

Check:

Patient/account identifiers
Claim amounts
Claim status
Payment history
Denial information
A/R balances

A small reconciliation sample can uncover large migration problems before they affect active claims.

HIPAA and Medical Billing Data: What Practices Need to Know

Medical billing commonly involves protected health information.

HHS explains that billing and claims-processing companies can be business associates when they perform functions involving PHI on behalf of a covered entity. HHS also states that covered entities generally need a written Business Associate Agreement or other written arrangement with a business associate that establishes permitted uses and safeguards for PHI.

During a transition:

Confirm the BAA requirements
Use approved secure transfer methods
Limit access to people who need it
Keep an audit trail of transferred information
Confirm data-retention and return requirements
Avoid casually sending patient files through ordinary email

HHS also explains that, in general, a business associate cannot use PHI to block the covered entity’s access simply because the relationship has ended; the return of PHI is addressed through the applicable agreement and HIPAA requirements.

For a practice manager, the takeaway is practical:

Do not let a billing-company transition become a data-access emergency.

Step 5: Assign Claim Ownership Before Cutover

Every open claim needs an owner.

There are two common models.

Model A: The Outgoing Vendor Continues Legacy A/R

The old vendor keeps working claims submitted before the agreed cutoff date.

This can work when the contract and transition agreement clearly define post-termination responsibilities.

Model B: The Incoming Vendor Takes Over Legacy A/R

The new company assumes the open claim inventory.

This can also work, but the incoming vendor needs enough documentation to continue the claim without starting from zero.

The Ownership Matrix

Create a table like this:

Claim Type	Cutoff Rule	Owner	Required Action
New claims after go-live	New vendor	New vendor	Submit + follow up
Open claims before cutoff	Written agreement	Named vendor	Continue follow-up
Denials received before cutoff	Written agreement	Named vendor	Appeal/resubmit
Patient balances	Written agreement	Named team	Statements/follow-up
Unposted ERAs	Transition responsibility	Named team	Post + reconcile
Unidentified payments	Transition responsibility	Named team	Research + reconcile

This prevents one of the most dangerous transition problems:

“I thought they were handling it.”

Timely Filing: Do Not Let a Vendor Change Put Old Claims at Risk

Payer filing deadlines vary.

For Medicare fee-for-service claims, CMS generally requires claims to be filed within 12 months, or one calendar year, from the date of service, subject to specific exceptions.

Commercial payer deadlines can be different.

That means you should not create one generic “timely filing” number for every payer.

Instead, build a deadline tracker:

Payer	Filing Rule	Oldest Open Claim	Days Remaining	Owner
Medicare	Verify CMS rule	From A/R report	Calculate	Assign owner
Commercial A	Contract/payer rule	From A/R report	Calculate	Assign owner
Commercial B	Contract/payer rule	From A/R report	Calculate	Assign owner

Prioritize claims that are closest to the relevant deadline.

Step 6: Use a Controlled Overlap or Parallel Billing Strategy

Parallel billing is not about paying two companies indefinitely.

It is about creating a controlled period where responsibilities are clearly separated.

For example:

New Claims Lane

The incoming vendor handles:

New claim creation
Claim submission
Rejection follow-up
New denial workflow
New payment posting

Legacy A/R Lane

The designated vendor handles:

Existing open claims
Existing denials
Appeals
Payer follow-up
Older balances

Payment Lane

The assigned team monitors:

ERA
EFT
Deposits
Payment posting
Reconciliation

CMS explains that EFT and ERA can help streamline revenue-cycle processes, including payment handling and automated posting, and encourages providers to enroll in both with participating health plans.

How Long Should the Overlap Be?

There is no universal four-week or six-week rule.

The right length depends on:

Practice size
Claim volume
Specialty complexity
Payer mix
A/R size
Number of providers
Software systems
Clearinghouse configuration
Payer-related changes

The overlap should end when your practice has enough evidence that the new workflow is functioning consistentl

A Simple Two-Lane Transition Map

Use this with your billing team:

Area	Old Vendor	New Vendor	Practice
Historical claims	Assigned role	Assigned role	Oversight
New claims	No/limited role	Primary owner	Monitor
Legacy A/R	Assigned role	Assigned role	Escalation
Denials	Defined responsibility	Defined responsibility	Review trends
Payment posting	Defined responsibility	Defined responsibility	Reconcile
ERA/EFT	Verify transition	Verify transition	Confirm
Data migration	Export	Import/validate	Approve
KPI reporting	Final baseline	Ongoing reporting	Review

Put this in writing before the cutover.

Step 7: Verify Payer Enrollment, CAQH, EDI, ERA, and EFT

One of the biggest mistakes in medical billing transitions is treating “credentialing” as one single task.

It is not.

You should review:

Credentialing

Payer enrollment

EDI

ERA

EFT

Portal access

as separate items.

Credentialing vs. Enrollment

Credentialing is about verifying provider qualifications.

Enrollment establishes the provider’s relationship with a specific payer.

Your practice should therefore verify the exact status of each payer relationship before assuming anything needs to be restarted.

Revex Square’s Medical Credentialing Services page also distinguishes credentialing from enrollment and describes support for CAQH, payer enrollment, application tracking, and ongoing maintenance.

CAQH Review

CAQH’s Provider Data Portal allows providers and practice staff to maintain professional and practice information and share that information with participating organizations for credentialing and related processes. CAQH’s guidance also includes authorization, attestation, and document-management steps.

Before switching vendors, check:

Provider name
Practice address
License information
NPI
Tax information
Specialty
Affiliations
Malpractice information
Supporting documents
Attestation status

Do not wait until a payer asks for missing information.

ERA and EFT Should Have Their Own Checklist

CMS notes that providers need practice Tax Identification Number and clinician NPI information when enrolling for EFT and ERA, and describes standardized EFT/ERA operating rules.

Create a payer-by-payer checklist:

Payer	ERA	EFT	Confirmation	Date
Medicare	✅	✅	Confirmed	Enter date
Medicaid	✅	⏳	Pending	Enter date
Commercial A	✅	✅	Confirmed	Enter date
Commercial B	⏳	⏳	Pending	Enter date

Do not mark the task complete simply because an application was submitted.

Use:

Submitted → Pending → Approved → Tested → Confirmed

Step 8: Monitor KPIs at 30, 60, and 90 Days

The vendor switch does not end when the login credentials are handed over.

The first 90 days should have a formal review process.

30-Day Review

Check:

Claim submission volume
Rejections
Clean claim performance
Denial rate
Collections
A/R aging
Payment posting
High-value open claims
Legacy A/R ownership issues

The question is:

Did normal billing activity continue?

60-Day Review

Add:

Payer-level denial analysis
60+ and 90+ day A/R
ERA status
EFT status
Appeals
Underpayments
Recurring rejection reasons
Unresolved legacy claims

The question is:

Where is the new process breaking down?

90-Day Review

Perform a full reconciliation.

Compare:

Opening A/R

New charges

− Payments

− Adjustments

= Expected ending A/R

Then compare the expected result with the actual ending A/R.

Investigate any significant unexplained difference.

Your 90-Day Medical Billing Transition Scorecard

Metric	Pre-Switch	30 Days	60 Days	90 Days
Monthly collections	Enter actual	Enter actual	Enter actual	Enter actual
Clean claim rate	Enter actual	Enter actual	Enter actual	Enter actual
Denial rate	Enter actual	Enter actual	Enter actual	Enter actual
Days in A/R	Enter actual	Enter actual	Enter actual	Enter actual
90+ day A/R	Enter actual	Enter actual	Enter actual	Enter actual
120+ day A/R	Enter actual	Enter actual	Enter actual	Enter actual
Open claims	Enter actual	Enter actual	Enter actual	Enter actual
Rejections	Enter actual	Enter actual	Enter actual	Enter actual
Payment-posting lag	Enter actual	Enter actual	Enter actual	Enter actual

This table turns the vendor change into a measurable project.

Real Public Case Studies: What the Numbers Actually Show

Case studies can make an RCM article more useful, but there is an important distinction:

The case studies below are publicly published case studies from healthcare billing/technology companies. They are not being presented as independent proof that switching vendors caused the reported outcomes.

The value for a practice manager is understanding what changed, what was measured, and what should be tracked during your own transition.

Case Study 1: Internal Medicine Practice — Nearly $300,000 Less A/R

AMS Solutions publishes a case study involving a Michigan internal medicine practice.

According to AMS, the practice reduced accounts receivable by nearly $300,000 and brought 70% of A/R current after structured revenue-cycle work that included same-day denial activity. AMS says the figures were taken from client billing, claims, and A/R reporting, while client names were withheld for confidentiality.

Why this matters to a practice switching vendors

The important lesson is not simply “A/R went down.”

It is that the practice had measurable numbers before and after the intervention.

When changing billing companies, ask your new vendor to show:

Opening A/R
Current A/R
30+ day A/R
60+ day A/R
90+ day A/R
120+ day A/R
Amount recovered
Remaining unresolved balances

That creates accountability.

Do not accept “we improved your A/R” without a report showing how.

Case Study 2: Three-Location Neurology and Sleep Practice — 98.9% Clean Claims

AMS also reports a case involving a three-location neurology and sleep practice.

According to the published case study, the practice reached a 98.9% first-pass clean claim rate and 12% year-over-year revenue growth after changes that included next-day claims processing. AMS says these results came from client billing and claims data and notes that outcomes vary by practice characteristics.

What a switching practice should take from this

A billing company should not be evaluated only on total collections.

Your transition dashboard should also answer:

Are claims being submitted promptly?
Are claims being accepted cleanly?
Are denials increasing?
Which payers are generating rejections?
Are problems concentrated in one specialty or provider?
Is the new team identifying root causes?

For a specialty practice, payer-level and provider-level reporting can be much more useful than one overall billing number.

Case Study 3: Billing-System Migration for a 260-Provider Billing Company

A Tebra case study published through CaseStudies.com describes Medical Billing Unlimited, an El Paso-based billing company serving 260 providers.

The company migrated its clients onto an integrated Kareo platform over six months. According to the published case study, the time required to generate a full financial report fell from about three hours to 30 minutes, while average A/R days declined from approximately 40 to 35.

Why this is relevant to a vendor transition

This is not a case study of a medical practice switching billing vendors, so it should not be presented as one.

It does, however, illustrate a critical transition principle:

Data migration is an operational project.

The technology can change, but the practice still needs usable reporting, accessible records, reconciled A/R, and a billing workflow that staff can understand.

A successful migration is not:

“The data was imported.”

A successful migration is:

“The data was imported, validated, usable, reconciled, and connected to the workflow.”

What Real Case Studies Teach You to Measure

Across published healthcare billing case studies, the most useful metrics tend to fall into four groups:

Revenue

Collections
Net collections
Underpayments recovered
Revenue leakage

Claims

Clean claim rate
Rejection rate
Denial rate
Claim turnaround

A/R

Days in A/R
30+ A/R
60+ A/R
90+ A/R
120+ A/R
Recovery from aged balances

Operations

Payment-posting time
Reporting time
Claim follow-up activity
Data accuracy

The most useful question is not:

“What percentage improvement did another company advertise?”

The better question is:

“Which numbers should my practice be able to verify before and after the transition?”

Real Data: Why Electronic Transactions Matter

Administrative efficiency is not just a theoretical concern.

The 2024 CAQH Index estimated an $18.4 billion medical-industry cost-saving opportunity associated with moving remaining manual and partially electronic administrative transactions toward greater electronic adoption. The same report estimated average medical-provider transaction costs of $7.93 for manual transactions versus $3.39 for electronic transactions in 2024.

This does not mean your practice will automatically save a specific amount by changing billing companies.

It does show why a transition plan should examine:

Electronic claim submission
Eligibility transactions
ERA
EFT
Automated payment posting
Reporting
Data exchange

When evaluating a new billing company, ask:

“Which parts of our current process still depend on manual work?”

That question can reveal operational problems that are bigger than the vendor relationship itself.

The Medical Billing Transition Checklist You Can Actually Use

Before Giving Notice

☐ Review the current contract
☐ Confirm notice requirements
☐ Download recent billing reports
☐ Record current collections
☐ Record denial rate
☐ Record clean claim performance
☐ Record A/R aging
☐ Identify your biggest billing problems
☐ Request payer/enrollment information
☐ Confirm access to billing systems

Before the New Vendor Goes Live

☐ Sign the new agreement
☐ Assign a transition manager
☐ Define legacy A/R ownership
☐ Export billing data
☐ Validate migrated data
☐ Build claim inventory
☐ Review payer setup
☐ Review CAQH information
☐ Review EDI setup
☐ Review ERA
☐ Review EFT
☐ Confirm portal access
☐ Define cutover date
☐ Define overlap responsibilities
☐ Establish KPI dashboard

During Cutover

☐ Monitor new claim submissions
☐ Monitor claim rejections
☐ Continue legacy A/R work
☐ Track denials
☐ Verify payment posting
☐ Check ERA activity
☐ Check EFT activity
☐ Reconcile deposits
☐ Escalate ownership issues
☐ Hold transition meetings

First 90 Days

☐ 30-day KPI review
☐ 60-day payer review
☐ 90-day A/R reconciliation
☐ Review aged claims
☐ Review recurring denials
☐ Review payment delays
☐ Review unresolved migration issues
☐ Document remaining legacy A/R
☐ Compare results with baseline

Common Mistakes When Switching Medical Billing Companies

Mistake 1: Giving Notice Before Securing Your Data

The practice may discover too late that it cannot easily retrieve a report, claim note, denial record, or historical file.

Better approach: Build your data inventory before the transition becomes urgent.

Mistake 2: Assuming the New Vendor Owns Every Old Claim

This creates the classic:

“We thought they were handling it.”

Better approach: Use a written claim ownership matrix.

Mistake 3: Treating Credentialing as One Universal Process

Payer relationships differ.

Better approach: Review each payer separately and determine whether a change, transfer, update, or new enrollment is actually required.

Mistake 4: Forgetting ERA and EFT

You can have a perfectly configured claims workflow and still have payment reconciliation problems if electronic remittance or funds-transfer processes are not verified.

CMS specifically addresses EFT and ERA as standardized administrative transactions and encourages provider enrollment for both.

Mistake 5: Measuring Only Collections

Collections are important.

But collections alone can hide problems.

Also monitor:

Denials
Clean claims
Rejections
A/R aging
Claim volume
Payment posting
Appeals
Legacy A/R

Mistake 6: Using Someone Else’s KPI as Your Target

A 98% clean claim rate from another practice does not automatically become the correct target for your practice.

Start with your actual baseline.

Mistake 7: Assuming a New Vendor Will Fix Everything Automatically

A new company does not eliminate:

Weak documentation
Incorrect patient information
Missing authorizations
Payer-specific rules
Poor front-desk workflows
Incomplete provider data

Sometimes the vendor is part of the problem.

Sometimes the workflow is.

Often, both need attention.

How to Make the Transition Easier for Your Staff

Your billing team and front office need clear answers too.

Before go-live, tell staff:

Who handles new claims?
Who handles old claims?
Where do billing questions go?
Who handles patient billing?
Who handles payer calls?
Who handles denied claims?
Who approves write-offs?
Who receives billing reports?
Who escalates urgent issues?

If the staff does not know where a question belongs, the transition will create unnecessary delays.

For practices that need additional administrative capacity during a billing transition, Virtual Medical Assistant Services can also support tasks such as scheduling, eligibility verification, billing support, and EHR-related administrative work.

How to Protect Patient Billing During the Transition

The patient side of the revenue cycle is easy to overlook.

If your practice is changing vendors, review:

Patient balances
Statements
Payment instructions
Phone numbers on statements
Online payment options
Patient-billing contacts
Unpaid balances
Returned statements

Your patient should not be confused because your internal vendor relationship changed.

For practices reviewing this area, see Patient Billing Services.

The patient should experience continuity even when the back office changes.

When Denials Increase During a Transition

A temporary denial increase should not automatically lead to a conclusion that the new vendor is failing.

First ask:

Which payer increased?
Which denial reason increased?
Which provider or specialty is affected?
Did claim volume change?
Did coding change?
Did eligibility workflows change?
Did payer configuration change?
Are denied claims actually being worked?

Your Denial Management Services workflow should ideally connect denial correction with root-cause analysis, rather than treating every denial as an isolated claim.

For example:

Repeated eligibility denials → investigate front-end verification

Repeated coding denials → investigate coding/documentation

Repeated payer-specific denials → investigate payer rules and claim configuration

The goal is not only to recover the individual claim.

The goal is to stop the same error from generating another hundred denials.

When Your A/R Is the Main Problem

Sometimes the reason for changing billing companies is not poor new-claim submission.

It is old A/R.

In that case, the transition should include an explicit legacy A/R recovery plan.

Break the A/R into:

Current
30–60 days
61–90 days
91–120 days
120+ days

Then add:

Claim count + dollar value + payer + next action + owner

Your Accounts Receivable Services workflow can be connected to this process so that older claims are prioritized instead of being treated as one large undifferentiated balance.

A $500 claim that is 125 days old and a $25,000 claim that is 125 days old should not necessarily receive the same level of attention.

A Practical Decision Test for Your New Vendor

Before signing the agreement, ask the vendor to explain this situation:

“We have 1,200 open claims, $750,000 in A/R, three major commercial payers, a large Medicare population, and our existing billing company has not maintained detailed claim notes. Show us how you would transition this account.”

A strong operational answer should discuss:

Data inventory
Claim ownership
A/R segmentation
Timely filing
Payer verification
Denial history
System access
ERA/EFT
Reporting
Cutover
Post-go-live monitoring

The point is not whether the company gives the “right sales answer.”

The point is whether the company demonstrates a repeatable transition process.

What Evidence Should a Billing Company Show You?

This is where E-E-A-T becomes practical for a buyer.

Do not rely only on:

“We have experienced billers.”

Ask for evidence such as:

Named transition process
Sample KPI report
Sample A/R report
Description of escalation process
Explanation of data migration
HIPAA/BAA process
Payer enrollment workflow
Client references where available
Documented specialties served
Public case studies
Clear service scope

Public testimonials can help, but a good decision should not depend on testimonials alone.

Look for a combination of:

Experience + process + evidence + transparency.

How Revex Square Fits Into the Transition

Revex Square provides medical billing and revenue-cycle support for healthcare practices, including Medical Billing Services, Medical Coding Services, Medical Credentialing Services, Eligibility Verification Services, Denial Management Services, Accounts Receivable Services, and Patient Billing Services.

That matters during a vendor change because the transition often exposes problems in more than one part of the revenue cycle.

For example:

Credentialing problem → enrollment review

Eligibility problem → front-end verification

Coding problem → coding review

Denial problem → denial management

Old A/R problem → A/R recovery

Patient balance problem → patient billing

A transition plan should look at the complete workflow rather than just the claim-submission step.

You can also review Revex Square’s RCM Services for broader revenue-cycle support.

Revex Square Published Performance Snapshot

The following figures are published on Revex Square’s own website and are included here as vendor reference data—not as universal industry benchmarks or guaranteed outcomes.

Metric / Capability	Published Revex Square Data	Website Source
Clean claim submission rate	99%+	Medical Billing Services
Claim rejection rate	Less than 1%	Medical Billing Services
Average days in A/R	Less than 30 days	About Us
Reporting	Real-time performance dashboards and detailed monthly RCM reports	About Us
Service coverage	Billing, coding, credentialing/enrollment, eligibility, denial management, A/R, and patient billing	Medical Billing / About Us

How Much Should You Expect From Your New Billing Company?

Do not make the vendor promise:

“Your collections will increase by X%.”

No reputable transition plan can guarantee a universal result because practice performance depends on:

Payer mix
Specialty
Documentation
Coding
Patient volume
Existing A/R
Contract rates
Eligibility
Authorization
Current denial patterns
Staffing
Technology
Practice workflows

Instead, require the vendor to define:

What They Will Do

For example:

Claim submission
A/R follow-up
Denial resolution
Payment posting
Reporting
Enrollment support

When They Will Do It

For example:

Daily
Weekly
Monthly
At defined escalation points

How You Will Measure It

For example:

Clean claims
Denials
A/R
Collections
Posting turnaround
Claim volume

This is a much stronger approach than asking for a revenue guarantee.

The 10 Numbers You Should Have Before You Fire Your Billing Company

Before giving notice, save these numbers:

Average monthly collections
Average monthly charges
Clean claim rate
Denial rate
Rejection rate
Days in A/R
90+ day A/R
120+ day A/R
Number of open claims
Amount of patient A/R

Then save the same numbers at:

30 days

60 days

90 days

That creates a before-and-after record.

Frequently Asked Questions

How do I switch medical billing companies without losing revenue?

Start before the contract termination date. Establish your billing baseline, secure your data, inventory every open claim, define A/R ownership, verify payer and electronic payment processes, and use a controlled transition plan.

How long does it take to switch medical billing companies?

There is no universal timeline. Contract notice requirements, practice size, payer mix, system integrations, data migration, provider count, and A/R volume all affect the schedule.

Will switching billing companies affect my claims?

It can if the transition is poorly coordinated. The main operational risks are delayed submission, unclear claim ownership, missing data, payer-setup issues, and payment-posting problems.

What happens to old medical claims after switching billing companies?

They should be assigned to a specific owner based on your written transition agreement. The outgoing vendor may retain responsibility, or the new vendor may take over legacy A/R.

Do I need to re-credential with every payer when changing billing companies?

Not automatically. Credentialing and enrollment requirements vary by payer and by your existing arrangement. Review each payer relationship to determine whether an update, transfer, re-enrollment, or no change is required.

Should the old billing company keep working my A/R?

That depends on your contract and transition agreement. If the outgoing company retains legacy A/R, define the exact cutoff date, responsibilities, reporting, and final handoff requirements.

How do I transfer billing data to a new company?

Request the relevant EHR, practice-management, clearinghouse, claim, payment, adjustment, A/R, and denial information available to your practice. Confirm file formats and validate imported records before cutover.

What should I export from my old medical billing company?

At minimum, request claim history, open claims, A/R aging, payment and adjustment records, denial information, payer information, and other billing data needed for continuity.

Should I run parallel billing when switching vendors?

A controlled overlap can be useful, especially when the practice has a large A/R file, complex payer mix, multiple providers, or complicated system integrations. The exact overlap period should depend on operational readiness.

What KPIs should I monitor after changing billing companies?

Track collections, clean claim rate, denial rate, rejection rate, days in A/R, aging A/R, claim volume, payment posting, and unresolved legacy claims.

What is a claim ownership map?

A claim ownership map assigns responsibility for every open claim. It shows who is responsible, what the current status is, and what action needs to happen next.

What is the Medicare timely-filing deadline?

CMS generally requires Medicare fee-for-service claims to be submitted within 12 months, or one calendar year, from the date services were furnished, subject to specific exceptions. Other payers can use different filing rules.

What is the difference between ERA and EFT?

ERA provides electronic remittance information explaining payment and claim adjudication details. EFT is the electronic transfer of funds. CMS describes both as standardized administrative transactions and encourages providers to enroll for both with participating health plans.

Does HIPAA apply when sending billing information to a new billing company?

Medical billing can involve PHI, and HHS identifies billing and claims-processing companies as examples of business associates when they perform covered functions involving PHI. Covered entities generally need an appropriate written business associate arrangement with a business associate handling PHI.

What should I ask a new medical billing company?

Ask about transition management, legacy A/R ownership, data migration, payer setup, EDI/ERA/EFT, HIPAA safeguards, reporting, KPIs, escalation procedures, and post-go-live support.

Final Takeaway: A Billing Vendor Change Should Be Managed Like a Project

A medical billing company transition should never be:

“We fired the old vendor on Friday and the new company starts Monday.”

It should be:

Audit → Baseline → Data → Ownership → Payer Review → Cutover → Monitoring

The most important protection is not a promise that nothing will ever go wrong.

It is having enough documentation and visibility to catch a problem while it is still manageable.

Before the transition, know:

What do we have?

After the transition, know:

What changed?

During the transition, know:

Who owns the next action?

That is the practical foundation for switching medical billing companies without creating unnecessary disruption to your revenue cycle.

Need Help Reviewing Your Billing Transition?

Before you give notice to your current billing company, review your:

A/R aging
Denial patterns
Claim inventory
Payer enrollment
Data-access requirements
ERA/EFT setup
Reporting
Transition responsibilities

Revex Square works with healthcare practices on medical billing, coding, credentialing, eligibility verification, denial management, A/R, and patient billing workflows.

Learn more about Medical Billing Services or contact Revex Square to discuss your current billing operation and transition requirements.

A well-planned billing transition starts before the old vendor leaves.