Medical billing and revenue cycle management
Whether they quit, sold, or you ended it, the same question decides how much this costs you: who works the claims submitted before the handoff.
If your runway is short, call rather than fill this in. 307 293 0124
Count backward from the date you lose coverage. Your new claims start going out inside seven to fourteen days, so the billing itself does not stop. Full cutover runs six to eight weeks at the top end, and almost all of that is payers re-routing EFT and ERA in the background while you are already being billed and already getting paid.
The basics, since you will check anyway
Each one leaves your reports looking healthy.
The visit happened and the note exists. The charge was never built, so nothing was submitted and nothing came back denied.
The claim went out correctly and came back paid, at a level below what the documentation supports.
The payer's own fee schedule says one number and the remittance says another. Nobody reconciles the two.
A client kept running long on follow-up visits. The schedule said one thing, the claim numbers said another, and the two never lined up. Our team asked about the gap.
The practice had been providing a service they did not know was covered. It was documented in the notes every time. It had never been submitted. We filed retroactively and it kept paying going forward. The level of care they wanted to provide stopped being a time cost, and growth became an option.
Step one
You check it yourself. The self-check above takes one report and about ten minutes. You do not need us for that part and you do not have to tell us what you found.
Step two
Twenty minutes on the phone. You tell us what you found and what you run on. We tell you what we would expect to find underneath it and what it takes to fix.
Step three
If you move, payer contract renegotiation is part of onboarding, at no separate fee. Rates set back when the practice was smaller are usually the second thing we find.
Ask the outgoing vendor, not us. Get every answer in writing before the cutover date, and do it whether or not you ever speak to us.
What is your cutover date, in writing?
Who works the claims submitted before that date?
How many of your payers need EFT and ERA re-routing, and where does the money land until they do?
Do you have the claim list as of the cutover date?
What happens to a claim that hits its filing deadline during the gap?
When does the outgoing vendor's obligation to work your A/R actually end?
Every one of these you cannot answer is money that belongs to nobody during the gap. We will tell you what to demand from the outgoing vendor even if you do not use us.