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Switching Medical Billing Companies Without a Cash Gap
A switch goes wrong in the overlap: claims the old company stops working before the new one can see them, remittance files still routing to the old clearinghouse, and payer portals locked to someone else’s login. The order below keeps claims going out and puts every open dollar under one owner on a known date.
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Cutover plan
What has to move when you switch billers
Four things move: data, enrollments, access, and responsibility for open claims.
Data is the claim history, payment history, open A/R, credit balances, and patient balances. Enrollments are the clearinghouse’s claim (837) and remittance (835) set-ups with each payer. Access is payer portals, the EHR or practice management system, CAQH, and PECOS. Responsibility is who works each open claim after the cutover date.
If Medicare is in the mix, the billing agency on the practice’s Medicare enrollment changes too. The CMS-855 enrollment application has a billing agency section, and Medicare requires changes of this kind to be reported within 90 days (42 CFR 424.516(d)).
Agree these before notice goes out
- A cutover date, by date of service, in writing
- Who works claims with dates of service before that date
- The export format for claims, payments, and patient balances
- Who transfers or closes each portal and clearinghouse login
Switching order, step by step
Each step has one owner. Skipping one moves money into the gap.
| Step | What happens | Owner |
|---|---|---|
| 1. Read the current contract | Notice period, run-out terms, fees on payments after termination, and the data-return clause. | Practice |
| 2. Sign the new agreement and BAA | Before any patient data is shared with the new company. | Practice and new company |
| 3. Take a baseline | Aged A/R by payer, open denials, unposted payments, and credit balances as of the notice date. | New company, from the practice’s system |
| 4. Set the cutover date | Claims with dates of service on or after it go to the new company. | Both companies, in writing |
| 5. Move claim and remittance enrollments | New clearinghouse enrollments where needed, and 835 remittance enrollments updated so payment detail reaches the new posting team. EFT stays pointed at the practice’s own bank account; Medicare uses form CMS-588 only if the bank changes. | New company, signed by the practice |
| 6. Transfer access | Payer portals, EHR and practice management users, CAQH, and PECOS surrogate access. Old users removed. | Practice |
| 7. Run-out | The old company works earlier dates of service for the agreed window, or hands them over with notes. | Old company |
| 8. Reconcile | Compare the baseline with what was paid, adjusted, or transferred 60 to 90 days after cutover. | New company and practice |
Old A/R that the previous company did not finish is priced on its own: old A/R recovery.
Where a switch loses money
Most losses come from claims nobody owns for a few weeks.
Timely filing during the gap
Unsubmitted claims keep aging while two companies hand over. Medicare allows 12 months from the date of service, New York Medicaid 90 days, and many commercial contracts 90 to 180 days.
Remits going to the old clearinghouse
The money reaches the bank, but the 835 file that explains it goes to the old company’s queue. Payments sit unposted and denials go unseen.
Denials with no owner
A denial received in the overlap still has an appeal clock. Medicare’s first-level appeal, a redetermination, is due within 120 days of the initial determination.
Two sets of patient statements
If both companies send statements, patients pay the wrong one or neither. Agree who sends statements from the cutover date.
Credit balances left behind
Overpayments do not leave with the old company. Medicare overpayments must be reported and returned within 60 days of being identified (42 CFR 401.305).
Fees on payments after you leave
Many contracts let the old company take its percentage on payments for claims it submitted, even after termination. Read the clause and agree a cut-off.
How Vector handles a switch
What the monthly fee covers and what is priced separately.
Written rate
The fee is a percentage of net collections (flat or per claim in New York). No setup fee on the monthly cycle. Month to month, with 30 days’ written notice.
See pricing or request a written rate after the free audit.
Separate work
Old A/R left by the previous company, credentialing clean-up, and re-enrollment with payers where the practice’s own enrollment has lapsed are scoped on their own.
Plan the switch before you give notice
Send the current contract’s notice terms, monthly charges, top payers, and your EHR name. We send back a cutover plan, an audit of open A/R, and a written rate.
Written
Monthly rate
98%
Published NCR
50
US States
BAA
Every Client
Switching billing companies: questions
Short answers for practices changing billers.
How long does it take to switch medical billing companies?
Plan around the notice period in your current contract, often 30 days. Clearinghouse and remittance enrollments can take from a few days to several weeks per payer, so they start the day the new agreement is signed.
Do we have to tell Medicare when we change billing companies?
Yes. The CMS-855 enrollment record has a billing agency section, and Medicare requires changes like this to be reported within 90 days under 42 CFR 424.516(d). The update is made in PECOS.
Who works the claims the old company submitted?
Whoever the contracts say. Usually the old company works dates of service before the cutover for an agreed run-out window, or hands them over with notes. If nothing is agreed, those claims tend to be worked by no one.
Will our payments stop during the switch?
Not if EFT stays pointed at the practice’s own bank account. Payments keep arriving; what can lag is the 835 remittance detail until its enrollment moves to the new posting team.
Can we switch billing companies without changing our EHR?
Yes. Vector works in the system that already holds the encounters, so the switch changes who works the claims, not where they live.
What data should the old billing company return?
Every claim with its status, payment and adjustment history, open A/R by payer and age, patient balances and statements sent, credit balances, payer correspondence, and appeal files in progress.