Most billing problems don’t announce themselves. Collections dip a little, then recover. The monthly report looks roughly the same. Then one day a payer letter arrives, or an audit, or you finally pull an AR aging report and find six figures sitting past 120 days.
Billing companies rarely lie outright. More often they report what looks good and leave out what doesn’t. Here are 8 signs something is being left out, and how to check each one yourself.
1. You only ever get a collections number
If the report is one total and a short note, you can’t see AR aging, denials or clean claim rate. Check: ask for the 7 numbers in our monthly KPI checklist. A healthy operation sends them within a day.
2. Your AR over 90 days keeps growing
Old AR is where unworked claims hide. Check: pull an AR aging report straight from your own practice management system, not from the billing company. Compare the 90+ and 120+ buckets with three months ago.
3. Denials are reported as a rate, never as a list
A rate can look stable while the same denials sit untouched. Check: ask for last month’s denials by claim, with the action taken on each. If nobody can produce it, nobody is working it.
4. The same denial reasons repeat every month
Repeat denials for eligibility, authorization or the same modifier mean the root cause is never being fixed upstream. Check: sort 90 days of denials by reason code. If one or two reasons dominate, ask what has changed to prevent them.
5. Timely filing write-offs appear in your adjustments
A timely filing denial is almost always avoidable. It means a claim sat too long. Check: search your adjustment report for timely filing codes (CARC 29 is the common one). Any meaningful amount is a red flag.
6. You can’t name the person working your claims
When your account is handled by “the team,” nobody owns the result. Check: ask who worked your claims last week and how many hours they spent. You should get a name and a number.
7. Questions take days to answer
Slow answers usually mean the answer requires digging, and the digging hasn’t been done. Check: send one specific question (for example, the status of a claim over 60 days old) and time the reply.
8. Your front desk hears about coverage problems after the visit
If eligibility issues only surface as denials weeks later, nobody is checking coverage before appointments. Check: ask how many eligibility problems were caught before visits last month. The right answer is a number, not “we verify as needed.”
What to do if you see three or more
Don’t switch in a panic. First, request the data: AR aging from your own system, a denial list with actions, and the month’s adjustments. Then have a direct conversation with specifics. Some billing companies fix things fast once they know you are watching.
If the data doesn’t come, or the conversation goes nowhere, plan a switch carefully. We cover how in How to Switch Medical Billing Companies Without Losing a Month of Cash.
Billing you can see
DrBillerz was built around the idea that you should never have to dig for this. Clients see their claims, denials, eligibility checks and collections in a live portal, with a named biller and a dedicated RCM manager on every account.
Results include 99% of claims paid within 60 days and a 190-day aged AR backlog cleared for a two-provider family medicine practice. Billers start from $7 an hour, with a 4-week free pilot and no contract.
FAQ
How do I know if my medical billing company is doing a good job?
Look beyond collections. Check days in AR, AR over 90 days, clean claim rate, denial rate, denials worked and net collection rate. Pull AR aging from your own system to verify what you are told.
How do I audit my medical billing company?
Compare an AR aging report from your own practice management system with three months ago, request a claim-level denial list with actions taken, and review adjustments for timely filing write-offs.
Can I get my data back if I leave my billing company?
Your claims and patient data belong to your practice. Your contract should specify how and when data and system access are returned. Review that clause before giving notice.