The right billing company protects your revenue. The wrong one quietly drains it while sending you clean-looking reports. These 12 questions force a vendor to prove performance, reveal hidden fees, and confirm you keep control of your data before you’re locked into a contract. Most practices pick a billing company on price and a good sales pitch. Then the denials pile up and nobody can explain why. The problem isn’t always the vendor. It’s that the wrong questions got asked, or none did. A billing partner touches every dollar you earn. You want proof they’ll collect it, not promises. Ask these 12 questions before you sign, and listen for specifics. Vague answers are the answer. The single most useful question is: “What is your first-pass claim acceptance rate, and can you show me the report?” A strong billing company reports 95% or higher and proves it with data. Everything else in this list confirms whether that number is real and whether it will last. Performance questions: can they actually collect your money? Start here. A billing company that can’t prove performance is asking you to trust a story. These first questions turn the story into numbers. 1. What is your first-pass claim acceptance rate? This is the share of claims paid on the first submission. It’s the cleanest signal of how good a billing team really is. Ask for the number and the report behind it. A good answer is 95% or higher, shown on a dashboard. A weak answer is “very high” with nothing to back it. 2. How do you handle denials and appeals, and who does the work? Denials are where revenue leaks. Ask who owns the appeal, how fast they file it, and how they track root causes. You want a named workflow, not “we work them.” If a vendor can’t tell you their denial rate or how they fix the top reasons, they probably aren’t fixing them. 3. What are your days in AR for practices like mine? Days in AR shows how long your money sits unpaid. Under 40 days is healthy for most specialties. Ask for their typical range and whether they trend it monthly. A partner who watches AR every month catches problems early. One who reports it once a quarter is guessing. Money questions: what will this really cost? 4. What is my total cost, including every fee? Get it in writing. Ask about setup fees, clearinghouse fees, statement fees, minimum monthly charges, and any per-claim add-ons. A 4% rate with hidden fees can cost more than a 6% flat rate. The vendor who gives you one clear number is usually the honest one. 5. Is credentialing included, sold separately, or not offered? Enrollment gaps cause denials. If billing and credentialing sit with different teams, claims fall through the cracks. Ask whether the same partner handles both. Bundling them under one roof removes a common and expensive source of lost revenue. 6. What happens to my rate if my volume or specialty mix changes? Practices grow. Payer rules shift. Ask how pricing adjusts and whether you’re locked into terms that stop fitting. A fair partner explains this plainly. A vague answer here means surprises later. Control questions: do you stay in charge of your practice? 7. Who owns my data, and what do I get if I leave? You should own every patient, claim, and payment record. Confirm in the contract that you get a full export in a usable format at exit, with no ransom. If a vendor gets cagey here, walk. Your data leaving with them is a business risk you can’t undo. 8. What software and clearinghouse do you use, and do I keep access? Ask whether you can log in and see claims in real time. You want visibility, not a black box. If the vendor’s system locks you out and only they can read it, you’ve lost control of your own revenue cycle. 9. How do you stay compliant with HIPAA and coding rules? Ask about their HIPAA safeguards, coder certifications, and how often they run internal coding audits. Healthcare billing is high stakes. A partner who treats compliance as routine protects you from audits, penalties, and fraud exposure. 10. Where is your team based, and who codes my claims? Ask who actually touches your claims and where. You’re not looking for one right answer. You’re looking for a straight one. A vendor that dodges this question is hiding something about how the work gets done. 11. What is your experience with my exact specialty? Coding for cardiology isn’t coding for behavioral health. Ask how many practices in your specialty they bill for and what your top denial reasons usually are. A partner who knows your specialty spots problems before they cost you. A generalist learns on your revenue. 12. Who is my point of contact, and how will I know what’s happening? Ask for a named account manager, a reporting cadence, and the exact KPIs you’ll see each month. You want a person to call and a dashboard to check. If the answer is a shared inbox and a quarterly PDF, you’ll be the last to know when something breaks. How Qualigenix answers these questions We built our service around the questions above, because they’re the ones our best clients asked us first. At Qualigenix, we report a 99% claim accuracy rate and a 95% first-pass acceptance rate, and we show you the dashboard, not a summary. Our practices see an average 36-day collection cycle and a 30% reduction in AR days. You own your data, you keep real-time access, and you get a named account manager with monthly KPI reporting. We handle medical billing, denial management, and credentialing under one team, so enrollment gaps stop turning into denials. We serve 38+ specialties and onboard in as few as 6 days.