Quick answer: Don’t decide from one good or bad month. First, score six billing numbers. Then give your current team a 90-day plan to fix anything in the red. If the numbers still don’t move, switch, but plan the handoff around credentialing, software, old AR and your staff so revenue doesn’t dip.
In this episode of the NatRevMD Podcast, Dr. Heather Signorelli talks to practice owners who feel stuck in the middle. The numbers feel off, yet a past transition meant months of slow cash. So they stay, and the cost shows up as a slow drift instead of one bad quarter.
Six numbers that tell you if billing is the problem
One strong month of collections doesn’t prove your revenue cycle is healthy. Instead, look at these six numbers over a 12-month period that ends about four months ago, so pending claims don’t skew the picture.
| Number | What healthy looks like |
|---|---|
| Net collection rate | About 95% or higher |
| Denial rate | Under 5% |
| Insurance AR over 90 days | Under 15% (under 20% for surgical specialties) |
| Patient AR over 90 days | Under 5–10% |
| Days in AR | Under 40 days, ideally under 35 |
| Charge lag (visit to claim sent) | You know the number, and it stays short |
Want to score these quickly? Our free billing performance scorecard turns each number green, yellow or red and gives you a one-page 90-day plan.
How to fix billing without switching
- Meet with your billing team every month to review the six numbers. A good partner already reviews them weekly.
- Ask how they send problems back to your office, such as eligibility issues, unsigned charts or coding questions.
- For every red or yellow number, set a 90-day goal, name one owner, and agree on how you’ll track progress.
- If 90 days pass with vague answers or no movement, start evaluating other options.
Where billing transitions lose money
When a switch goes badly, the problem is usually the handoff, not the new team’s skill. In practice, cash gets stuck in five places:
- Credentialing and enrollment: nobody knows the status for each provider, location and payer.
- Software and ERA/EFT enrollment: nobody confirmed who owns the system or the payer connections.
- Charge lag: charges back up while the teams change over.
- Old AR: the old team stops working claims before the new team picks them up. This is the most common cause of a cash dip.
- People: the front desk and office manager never walked through the new claims process.
What a safe switch looks like
- Get a credentialing tracker by provider, location and payer before you change anything.
- Confirm who holds the software contract. Ideally, you own it and the billing team works inside it.
- Read the exit terms in your current contract, then decide who works the old AR.
- Move payer portal access to the new team before go-live.
- Pick a clean cutover date, such as the first of the month, so everyone knows which dates of service each team owns.
- Walk your staff through the full claims process ahead of time, including how patient calls and statements get handled.
- Hold a weekly transition meeting until things settle.
We cover this checklist in more detail on our switching medical billing companies page.
Frequently asked questions
Not if you plan the handoff. Practices usually lose money in three places: credentialing gaps, a software change, and old accounts receivable that nobody works. So sort out all three before your go-live date, and cash flow should stay steady.
Give them 90 days. Pick the numbers that scored red, agree on who owns each fix, and meet every month. If the numbers still don’t move, or you can’t get straight answers after 30 days, start looking at other partners.
Either team can, as long as someone clearly owns it. If your old team keeps it, meet with them weekly until it rolls off. If your new team takes it, move the payer portal logins to them before go-live.
Usually very little. Your front desk and office manager feel it most. That’s why the team walks through the full claims process before go-live, so only a few small things change on day one.
Two or more reds on your scorecard? Send us your monthly numbers for a free metrics audit, and a physician-led team will tell you what the pattern says and where we’d look first.
