Your biller just put in their notice. Or worse, they didn’t. They just stopped showing up.
Either way, you’re looking at a billing gap. Claims are sitting unsubmitted. The denial queue is growing. AR is aging. And you still have patients to see today.
Here’s what to do, in order.
Hour 1: Assess the Damage
Before you post a job or call anyone, you need to know what you’re dealing with. Log into your EHR and check four things:
- Unsubmitted claims from the last 30 days. Sort by date of service.
- Open denials with no follow-up date assigned.
- Unpaid claims approaching timely filing limits. Most payers allow 90 to 180 days from date of service. Some allow less.
- Pending prior authorizations expiring in the next 30 days.
Write those numbers down. That’s your actual problem. Everything else is secondary.
Hour 2: Stop the Bleeding on Timely Filing
Timely filing denials are permanent. A claim past the filing deadline cannot be resubmitted. You lose that revenue entirely.
Pull every unsubmitted claim with a date of service older than 60 days. Those go first. Get them submitted today if possible. Even a partially worked claim stops the clock with most payers.
If you’re on Athena, eClinicalWorks, or Kareo, the AR aging report will show you the oldest open claims sorted by payer. Start with whoever has the shortest filing window.
Hours 3 to 24: Decide Who Covers While You Hire
This is where most practices make the mistake that costs them. They post a job on Indeed, wait two weeks, interview, hire someone with no specialty experience, and spend another month onboarding.
Meanwhile, that AR gap quietly grows from $8,000 to $40,000.
You need billing coverage before you need a permanent hire. Options in order of speed:
- Ask your EHR vendor if they have a billing services division. Most do. They’re expensive and they take a percentage, but they can start fast.
- Contact a billing staffing company that can place a dedicated biller within 7 to 10 days. This keeps costs predictable and keeps the work in your EHR.
- Call your billing company if you have one. Ask them to absorb the volume temporarily, even at an increased rate.
The worst option is doing nothing while you take two weeks to hire. Every day without a biller is revenue that ages out of collectability.
Days 2 and 3: Document What Your Biller Knew
Before they leave, or if they’ve already left, you need to recover institutional knowledge. Specifically:
- Which payers does your practice have contracts with and what are the current fee schedules?
- Which claims are currently in appeals and what’s the status?
- Are there any payer-specific workflows or submission quirks your biller handled manually?
- What are the login credentials for each payer portal?
- Are there any credentialing renewals coming up in the next 90 days?
If your biller is still serving a notice period, get all of this documented before their last day. If they’re already gone, your EHR audit logs will show you the last 30 days of their activity. Use that to reconstruct what was in flight.
What This Situation Is Actually Telling You
One biller leaving should not put your practice’s cash flow at risk. If it does, that’s a structural problem, not a staffing problem.
Practices that don’t feel this pain when a biller leaves are set up one of two ways. They either have a billing team with redundancy built in, or they’re working with a model where the billing function doesn’t depend on a single person.
The staffing model that solves this is a dedicated biller backed by an RCM manager who knows your practice and can provide coverage. When one person is out, the manager knows the workflow. The AR doesn’t stop.
Frequently Asked Questions
How long can I go without a biller before it seriously hurts revenue?
Most practices start seeing meaningful AR impact after 2 weeks. After 30 days without billing coverage, expect to spend 60 to 90 days recovering. The older a claim gets, the harder it is to collect.
Should I hire a temp medical biller?
Temp billers are hard to find with specialty-specific experience. Most temp agencies don’t screen for EHR proficiency. You may spend more time training a temp than doing the work yourself. A dedicated offshore biller who knows your EHR is usually a faster, cheaper path to coverage.
What do I do about claims that are already past the timely filing limit?
Some payers accept late timely filing appeals with documentation of extenuating circumstances, including staffing gaps. It’s worth submitting with a letter of explanation. You may recover a portion. But the honest answer is that past-timely claims are largely lost, which is why speed matters.
How do I know if my new biller actually knows my EHR?
Ask them to walk you through how they’d work the denial queue in your specific system. A biller who knows Athena, eCW, or NextGen will describe platform-specific steps. A biller who’s guessing will describe generic steps that could apply to any system.
If your practice is dealing with a billing gap right now, we can place a dedicated HIPAA-trained biller who knows your EHR within 7 to 10 days. Start a 4-week free pilot with no contracts and no obligation. Or book a 15-minute call to talk through your situation first.