Choosing the best medical billing company for your practice is one of the most important financial decisions you will make. The right partner shortens days in A/R, cuts denials and gives you clear reporting. The wrong one quietly loses revenue for months before anyone notices.
This 20-point checklist helps Florida practices compare medical billing service companies on what actually matters, from specialty experience and pricing to reporting, security and exit terms.
Experience and Fit
- Specialty experience. Ask how many practices in your specialty they bill for. Dental-medical cross coding, behavioral health and physical therapy each have unique rules.
- Florida payer knowledge. Medicare, Florida Medicaid managed care plans, Florida Blue, PIP and workers’ compensation.
- Practice size match. A company built for 50-provider groups may neglect a two-provider office, and vice versa.
- References. Speak to at least two current clients similar to you.
- Software experience. They should already work in your EHR or practice management system.
Process and Performance
- Claim submission timeline: charges entered and claims sent within 24 to 48 hours.
- Claim scrubbing: payer-specific edits before submission.
- Denial management: every denial worked, appealed and tracked by root cause.
- A/R follow-up cadence: how often unpaid claims are chased, by age bucket.
- Eligibility verification: insurance checked before visits.
- Patient billing: clear statements, payment plans and online payment.
- Credentialing support: enrollment and CAQH maintenance included or available.
Reporting and Transparency
- Monthly KPIs: clean claim rate, denial rate, days in A/R, A/R over 90 days and net collection rate.
- Dashboard access: live visibility, not just a monthly PDF.
- A named account manager who knows your payer mix.
- Benchmarks: what they consider good performance, in writing.
Contract, Pricing and Security
- Pricing model: percentage of collections (commonly 4% to 10%) or per claim; know exactly what is included.
- Contract terms: notice period, termination and transition support.
- HIPAA and data security: a signed Business Associate Agreement, access controls and secure offshore policies if any work is done outside the US.
- Data ownership: your data and reports stay yours, with a clean handover if you leave.
Red Flags
- Fees on charges billed rather than money collected.
- No KPI reporting or vague answers on denial rates.
- Long contracts with heavy exit penalties.
- No BAA or unclear data handling.
- Refusal to provide references.
How to Compare Proposals
Ask each company to review a 90-day sample of your claims and denials. Compare what they find, their proposed improvements and the expected impact on collections, not just the percentage fee. A company charging 6% that collects 8% more than your current biller is far cheaper than one charging 4% that collects less.
Medihike offers a free A/R audit for Florida practices so you can compare on real numbers. See medical billing services.
Benchmarks a Good Medical Billing Company Should Hit
| KPI | Healthy target |
|---|---|
| Clean claim rate | 95% or higher |
| Denial rate | Under 5% to 10% |
| Days in A/R | Under 30 to 40 |
| A/R over 90 days | Under 10% to 15% of total A/R |
| Net collection rate | 95% or higher |
| Charge lag | 1 to 2 days |
Targets vary by specialty and payer mix, but a company that cannot tell you its averages on these numbers is not managing them.
Transitioning to a New Billing Company Without Losing Cash Flow
- Give your current biller notice according to the contract and request all open A/R reports.
- Set up system access, clearinghouse enrollment and ERA/EFT changes with payers.
- Run a parallel period: the new company takes new claims while old A/R is worked down.
- Agree who owns old A/R follow-up and for how long.
- Review weekly for the first 60 days until the new process is stable.
A good medical billing company will run this plan for you and show you collections week by week during the transition. If a company is vague about transition, expect a cash flow dip.
Final Advice
Choose on demonstrated results, transparency and fit, not on the lowest percentage. Ask hard questions, check references and insist on monthly KPI reporting. The best medical billing service companies welcome that scrutiny, because their numbers speak for themselves.
How Medihike Can Help
Want this done for your practice? These services put the ideas in this article into practice:
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Frequently Asked Questions
How does medical billing work?
Visits are coded, claims are created and scrubbed, submitted through a clearinghouse, paid by payers with an ERA or EOB, posted, and any denials are corrected or appealed before patients are billed for their share.
How is medical billing done by an outsourced company?
The billing company works inside your EHR or practice management system and handles coding, submission, posting, denials and follow-up, reporting results monthly.
Can medical billing be replaced by AI?
AI automates parts such as eligibility checks, scrubbing and posting, but denials, appeals and payer follow-up still need experienced people.
What percentage do medical billing companies charge?
Most charge 4% to 10% of collections depending on specialty, volume and scope.