Seven signs your billing company is underperforming

1. The reporting only contains good news

A monthly report showing collections and nothing else is a marketing document. Ask for the initial denial rate, the percentage of accounts over 90 days, the net collection rate, and what was written off and why. A partner who cannot produce those quickly is not measuring them.

2. Write-offs are rising and nobody flagged it

Adjustments are where uncollected money goes to be forgotten. If the write-off line is growing while collections look stable, claims are being abandoned rather than worked. Ask for write-offs categorised by reason for the last six months.

3. Nobody can tell you who works your account

If the answer is a team or a pool rather than a name, nobody owns your payer mix. The value in month three comes almost entirely from a person having learned which plan does what — a rotating pool never accumulates it.

4. The over-90 bucket only ever grows

Since payers ultimately pay roughly 90% of the claims they initially deny (Kodiak Solutions), a permanently growing old bucket is not a payer problem. It is a labour problem: those accounts are collectable and nobody is reaching them.

5. Calls have no reference numbers

Ask to see the notes on ten aged accounts. Every payer call should carry the reference number, the name of the person spoken to, what they said, and the date to follow up. Notes that read "called, pending" are indistinguishable from no call at all, and they make the next call start from zero.

6. The same denial reason recurs every month

Working a denial fixes one claim. Categorising it fixes the cause. If the same reason code is in the top three every month for six months, the loop between billing and the front desk is broken — which is a fixable process problem that nobody has raised with you.

7. You are on a percentage and the old accounts never move

This one is structural rather than a failing. Published percentage rates run 4% to 10% of collections (Neolytix), and a vendor paid that way is rationally pointed at whatever collects fastest. The 120-day pile has the worst effort-to-reward ratio for them and the best for you. If that is what is happening, the answer may be a change of model rather than a change of vendor.

What to ask for this week

Days in accounts receivable, percentage over 90 days, initial denial rate, net collection rate, write-offs by reason, and the notes on ten aged accounts. Any competent partner can produce that in a day. How long it takes, and how they react to being asked, is itself the answer.