The best medical billing company for your practice is the one that knows your specialty's payers and codes, works the whole revenue cycle (not just claim submission), shows you clear numbers every month, signs a proper HIPAA business associate agreement, and lets you see results on your own claims before you commit. Rankings and reviews help less than a structured comparison. Below is the checklist we would use ourselves, and the steps to switch without losing cash flow.
What separates a good billing company from an average one
| Area | Good sign | Warning sign |
|---|---|---|
| Specialty fit | Can name your common codes, modifiers and payer rules without looking them up. | "We bill every specialty the same way." |
| Front end | Checks eligibility and authorizations before visits. | Starts work only when charges arrive. |
| Denials | Works every denial by reason code, inside deadlines. | Works only high-dollar denials, or resubmits without fixing causes. |
| Reporting | Monthly report you can read: collections, denials by reason, aged AR. | Reports only on charges submitted. |
| Access | You keep access to your own system and data. | Data locked in their platform. |
| Pricing | Fee basis and extras written down in plain words. | Vague scope, surprise fees. |
| Contract | Reasonable notice period, clear exit steps. | Long lock-in, termination penalties. |
| Compliance | Signs a business associate agreement before touching patient data. | Hesitates or offers a generic NDA instead. |
Questions to ask in the first call
- Which specialties and payers make up most of your work?
- What happens between scheduling and claim submission?
- How do you track and work denials, and how fast?
- Can I see a sample monthly report?
- Who is my named contact, and how quickly do they respond?
- Do you work in our EHR and practice management system?
- Exactly what is the fee based on, and what costs extra?
- What notice do we give to leave, and how do we get our data back?
- Will you sign our business associate agreement, or provide yours?
- Can we start with a trial on our own claims?
For pricing specifically, our guide to how much medical billing costs covers the four pricing models and the fees to ask about.
The HIPAA business associate agreement
A billing company handles protected health information on your behalf, which makes it a business associate under HIPAA. The Privacy Rule allows you to share that information only with satisfactory assurances that it will be safeguarded, documented in a written contract that meets the requirements of 45 CFR 164.504(e). In practice: no signed business associate agreement, no patient data.
Eligibility verification (EV), benefits verification (BV), prior authorizations, and denial management at no cost for your first 30 days.
30-Day Free TrialHow to tell it is time to switch
- Collections are falling while visit volume is steady.
- Denials keep repeating for the same reasons month after month.
- Aged insurance balances keep growing.
- You cannot get a straight answer or a readable report.
- Claims go out late or in batches instead of daily.
- You learn about problems from patients, not from your biller.
Our article on in-house versus outsourced billing also covers when bringing billing back in-house is the better answer.
How to switch billing companies without losing cash flow
- Read your current contract for the notice period, termination terms and what the old company must hand over.
- Sign the new company's business associate agreement and agree a start date for new claims.
- Secure your data and access: practice management logins, clearinghouse, payer portals, fee schedules and open AR reports in your own name.
- Agree who works the old AR. Usually the outgoing company finishes claims it submitted for an agreed run-out period, or the new company takes them over. Write it down so nothing falls between them.
- Move the clearinghouse and electronic remittance enrollments so payments and remittances reach the new team.
- Watch filing deadlines during the handover; claims that sit for weeks between companies can miss them.
- Reconcile after the first month: compare charges, payments and open balances to make sure nothing was lost.
How Sterling Global Solution LLC compares
We specialize in behavioral health, ABA, fertility, cardiology, orthopedics and OB-GYN billing; work eligibility, authorizations, claims, denials and AR; work inside your existing systems; send a readable monthly report with a named account manager; and sign a business associate agreement before we see any patient data. If you are switching, we plan the handover with you, including the old AR. The simplest way to compare us is the 30-Day Free Trial on your own claims.
Frequently asked questions
How do I choose the best medical billing company?
Does a medical billing company need a business associate agreement?
How do I switch medical billing companies?
What are signs my billing company is not doing a good job?
Can I try Sterling Global Solution LLC before switching?
Sources
Code of Federal Regulations, 45 CFR 164.502(e) and 45 CFR 164.504(e): disclosures to business associates and business associate contract requirements.
This guide is general information, not legal advice. How we verify this guidance.
Related reading
- How much does medical billing cost?. Pricing models and fees to ask about.
- Private practice billing services. What full-service billing looks like for small practices.
- In-house vs outsourced billing. When each option makes sense.
- HIPAA checklist for AI billing vendors. Security questions to ask any vendor.
- 2026 Medical Billing Benchmark Report. Benchmarks to hold any partner to.
Compare us on your own claims
Eligibility verification (EV), benefits verification (BV), prior authorizations, and denial management at no cost for your first 30 days.
30-Day Free TrialNo setup fee. No long-term contract.