The most important questions to ask a medical billing company cover performance, denied claims, A/R follow-up, transparency, and cost. Start with your insurance collection rate, since it shows how much revenue actually reaches your practice. If a biller can’t answer these questions, treat that as a red flag.
Knowing the right questions to ask a medical billing company can protect thousands of dollars in earned revenue. Many practices sign a billing contract after a quick sales call. Later, they discover their biller rarely follows up on denials or shares meaningful reports. By then, months of revenue may already be gone.
Join us as we go deep with the specific questions to ask a medical billing company before you sign, renew, or switch. Each answer explains what a strong billing partner should tell you. Use it to evaluate a new vendor or check how well your current biller is performing.
Questions to Ask a Medical Billing Company About Performance
Among all the questions to ask a medical billing company, performance questions come first. These answers reveal whether your biller tracks the numbers that actually matter.
What is my insurance collection rate?
Your billing company should answer this question immediately. Of all the questions to ask a medical billing company, this one matters most. Your insurance collection rate shows the percentage of collectible insurance revenue your practice actually receives. A healthy practice should collect between 95% and 99% of what it’s owed.
How do you measure my clean claim rate?
A good biller will explain exactly how they calculate it. Some count claims that pass clearinghouse edits. Others count only claims paid on first submission, which is far more meaningful. In fact, clean claims are getting harder to submit. A 2025 survey found that 68% of providers say clean claims are more challenging than a year ago. Therefore, a clean claim rate should always be reviewed alongside your insurance collection rate.
How long does it take for my claims to get paid?
Your biller should know the average time from submission to payment for each major payer. Medicare, Medi-Cal, and commercial plans all move at different speeds. For that reason, ask for numbers by payer instead of a single average. Long delays often point to stalled claims that no one is working. In addition, ask how quickly claims go out after each patient visit.
Questions to Ask a Medical Billing Company About Denied Claims
Denials are where revenue quietly disappears. For that reason, they belong on every list of questions to ask a medical billing company.
What percentage of my claims are denied?
Your biller should report your denial rate regularly and explain how they calculate it. This question matters more every year. According to Experian Health, 41% of providers now face denial rates of 10% or higher, a figure that has grown each year since 2022. Ask to see both your rate and your most common denial reasons. Patterns in those reasons point directly to fixable problems.
What happens after a claim is denied?
The answer should describe a clear, repeatable process. A strong biller reviews the denial reason, corrects the claim, and resubmits or appeals it quickly. They should also track each denial until it’s resolved. If the answer is vague, denied claims may be sitting untouched. A revenue audit helps uncover denials that were never worked.
How many times will you work a claim before escalating it?
Every billing company should have a clear escalation point. At California Medical Billing, any claim worked three times without payment goes directly to our CEO, Jennifer Tullius. She reviews the claim history, finds the root cause, and makes sure it gets resolved. Without a rule like this, stubborn claims can cycle for months. Meanwhile, appeal and timely filing deadlines keep running.
Questions to Ask a Medical Billing Company About A/R Follow-Up
Accounts receivable follow-up separates strong billers from average ones. These questions to ask a medical billing company show how much effort goes into collecting what you’re owed.
How much of your team’s time goes to A/R follow-up?
This question surprises many billing companies, and the answer tells you a lot. Submitting claims is quick. By contrast, following up on denied, underpaid, and stalled claims takes real time. At CMB, 50% of our work hours go to accounts receivable.
How do you handle claims that stall with the payer?
A stalled claim has no denial and no payment. Instead, it simply sits in the payer’s system. Your biller should monitor claim aging and contact payers before claims go stale. Ask how often they review aging reports and when they call the payer. Insurance companies often count on practices not following up, so consistent pressure is essential.
Will my staff have to fix claims you’ve submitted?
Your staff may occasionally need to supply missing documentation or patient details. However, correcting and resubmitting claims should be your biller’s job. Some billing companies send denied claims back to the practice instead. That arrangement means you pay a billing fee and still do much of the work. Ask for a clear answer before you sign.
Questions to Ask a Medical Billing Company About Transparency
Transparency questions show whether you’ll be able to see what’s happening with your revenue. Yet these are some of the most overlooked questions to ask a medical billing company.
Will I have access to my own billing system?
You should be able to see your own claims data at any time. Many billing companies own the license to the system they use, and physicians often have no access. Without access, you can’t see which claims are aging, denied, or missing. Ask whether you’ll have login credentials or, at minimum, on-demand reporting.
What reports will I receive, and how often?
Expect regular reports covering collections, denials, and A/R aging. A monthly summary is a good baseline. In addition, a quarterly business review gives you a clear view of trends and recovered revenue. Reports should also explain how state rule changes affect your claims. If a report only shows activity, ask what it leaves out.
Who owns my billing data if I leave?
Your practice should own its billing and claims data. Ask how the data will be returned if you end the contract, and in what format. You should also ask how long the handoff takes. Data ownership is one of the questions to ask a medical billing company before signing, not after. If the contract is unclear, ask for the terms in writing.
Questions to Ask a Medical Billing Company About Cost
Cost is usually the first topic practices raise. However, it belongs near the end of your questions to ask a medical billing company, because a low fee can still cost more if collections suffer.
How is your fee calculated?
Many billing companies charge a percentage of collections, while others charge per claim or a flat monthly rate. Ask exactly which payments the percentage applies to. For example, some companies charge on patient payments your office collects at the front desk. Make sure you understand the full formula before comparing quotes.
Are there setup, minimum, or exit fees?
Some contracts include onboarding fees, monthly minimums, or penalties for leaving early. These costs rarely appear in the headline rate. Therefore, ask for a full fee schedule in writing. You should also ask about the notice period required to end the contract. Clear terms make it easier to switch if performance slips.
How do I compare your cost with my current biller’s?
Compare what each biller charges with what each one actually collects. A biller with a slightly higher fee and a stronger insurance collection rate can still put more money in your pocket. As a result, the lowest quote is not always the best deal. The calculator below makes this comparison simple.
What If Your Biller Can’t Answer These Questions?
If your current biller struggles with these questions, take that seriously. Strong billing partners know their numbers and share them openly. On the other hand, vague answers often point to weak follow-up and lost revenue.
Start by running your numbers through our revenue calculators. Then, book a free billing consultation for a closer look at your performance. Finally, keep these questions to ask a medical billing company handy at every contract renewal.
More Questions to Ask a Medical Billing Company
A few final questions can reveal how a billing company will handle your switch and your long-term needs.
How do you handle the transition from my current biller?
A strong biller will walk you through a clear onboarding plan before you sign. That plan should cover data transfer, payer enrollment updates, and a timeline for the first claims. Ask how they prevent gaps in cash flow during the switch. In addition, ask who manages the handoff with your previous biller. A smooth transition protects revenue you’ve already earned.
What happens to the unpaid claims my old biller left behind?
Your new biller should have a clear plan for legacy accounts receivable. Old claims don’t disappear when you change vendors. Instead, many of them can still be corrected, appealed, or resubmitted before filing deadlines pass. Ask whether the company will work those claims and how they’ll prioritize them.
Do you work with California payers like Medi-Cal?
California practices bill a payer mix that often includes Medi-Cal, managed care plans, and commercial insurers. Each one has its own rules, timelines, and denial patterns. Therefore, ask whether the company has experience with the payers you bill most often. A California-based billing partner understands how these plans work and how they change.
