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Managing the relationship with your billing company
August 19, 2026 | Daniel Doll
Every medical practice or laboratory handles billing differently—some outsource it entirely, some lean on a partner to help a stretched-too-thin internal team, and others keep it all in-house.
However you do it, the effect of that relationship shows up in one place: your healthcare organization's revenue. It could be denials that never get explained. Reports that arrive late, or not at all. KPIs nobody discusses until something goes wrong.
Those are the quiet signs a billing partnership isn't pulling its weight.
Ask Dawn Arnold, Customer Success Manager with ARIA Health Services, what separates a good billing relationship from a bad one, and she narrows it to three things: "Visibility into performance, shared definitions of success, and written expectations for the work."
Start with reporting you can actually use
“This is where most billing relationships build trust, or lose it,” says Ebony Potts, PSPO, PSM I, PSM II, Customer Experience Manager with ARIA Health Services. Good reporting on medical billing KPIs comes down to four things:
- Denial detail: The shape of the problem, whether it's coding, payer, or provider driven, alongside the raw count
- Root cause: The reason behind each denial, whether that's a mismatched CPT® code or a missing authorization
- Trend analysis: Whether denials are rising or falling over time, not just where they stand today
- Fixed cadence: Delivered on a predictable schedule, rather than whenever someone remembers to send it
A strong billing partner doesn't stop at data—they surface the reports that explain it:
| Report | What It Shows | Why It Matters |
|---|---|---|
| Denial Trend Report | Denials broken down by payer, reason code, and provider over time | Shows whether denial problems are improving or getting worse, and where to focus |
| Aging A/R Report | Outstanding claims grouped by age (0–30, 31–60, 61–90, 90+ days) | Flags claims at risk of never being collected, while there's still time to act |
| Clean Claim / First-Pass Rate | Percentage of claims paid on the first submission vs. those needing rework | Rework costs staff time and delays revenue you're already owed |
| Charge, Payment & Adjustment Summary | What was billed, collected, and written off | Your top-line financial picture for the period, at a glance |
| Credit Balance Report | Accounts with overpayments needing review or refund | Protects your organization from compliance risk tied to unrefunded overpayments |
| Payer Performance Report | Actual reimbursement vs. contracted rates, by payer | Reveals whether payers are really paying what they agreed to |
| Bank & PM Reconciliation Report | Confirms bank deposits match what's posted in your practice management system | Catches missing or misapplied payments before they become accounting discrepancies |
| Issue & Open Item Tracker | A running log of open questions and action items, with owners and status | Confirms flagged issues actually get resolved, not just identified |
Medical billing KPIs worth tracking
Targets only matter once both sides agree on how they're calculated, and which report counts as the source of truth. Here's the baseline most medical practice revenue cycle benchmarks converge on:
| Metric | Target |
|---|---|
| Clean claim rate | 95% or higher |
| Denial rate | Under 5–8% |
| Days in AR | Under 35–40 days |
| Net collection rate | 95% or higher |
| Aged AR (90+ days) | 15–20% or lower |
| First-pass resolution rate | 90% or higher |
MGMA's own benchmarking data puts top-performing practices under 35 days in AR, with claims aged past 90 days ideally kept under 15% of total receivables. Collectability drops fast the longer a claim goes unpaid.
HFMA reports an industry-wide denial rate of 5% to 10%, with anything under 5% considered strong, and recommends resolving actionable denials within 30 days before they risk becoming a write-off.
Net collection rate measures something different entirely: what you actually collect against what you're owed, not what you billed.
© CompuGroup Medical
Track these six numbers consistently, and you'll always know whether your revenue cycle is healthy or where it's starting to slip.
Reporting is only half the job
Numbers on a page don't move cash. What changes day to day is how your partner actually behaves between reports:
- Real-time flags: Cash flow issues get raised as they happen, rather than surfacing weeks later at the next scheduled call
- Joint problem-solving: "A partner should bring solutions, not just an update," Potts says
- Documented plan for aging claims: Anything sitting between 45 and 60 days needs a specific next action and an owner
As Brittany Self, CMC, Solutions Consultant with ARIA Health Services, puts it: "Denial management tends to fall to the wayside in an office. It's the one thing you know you need to get to, but it keeps aging out because it's never the task in front of you that day."
Staying ahead of payer and coding changes
Payer policies shift often—new prior authorization requirements, updated documentation standards, coverage changes tied to specific CPT or HCPCS codes. Add in the annual CPT and ICD-10 updates, plus CMS's own regulatory changes, and there's rarely a quiet stretch where nothing is moving.
A good billing partner treats staying current as part of the job.
That means flagging a payer's new prior-authorization rule before it causes a wave of denials, not after the fact. It means having a named point of contact on both sides, so when something does change, there's someone who actually owns telling you about it, rather than a support inbox you're hoping gets read in time.
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Building a predictable reporting rhythm
Best practices suggest starting weekly and stepping down to monthly reporting as trust builds. This reflects how a practice or laboratory's relationship with its billing partner naturally matures over the first few months.
A weekly reporting cadence is typically used to cover denial trends, claim rejections, and anything crossing an aging threshold.
Once trust is established, that rhythm shifts to a monthly, full KPI review and clean claim rate check, with a deeper, quarterly trend analysis for the bigger picture.
Signs of a strong billing partnership vs. when to worry
A few concrete signals can help you tell which side of the line your own partnership falls on.
Working well:
- Reporting arrives on schedule, without you having to chase it
- You get visibility into why something changed, not just that it changed
- Your partner flags cash flow issues before you notice them yourself
- KPIs are reviewed together against targets both sides agreed to
- Unfavorable results get reported just as readily as the wins
Worth addressing:
- Reports are inconsistent, late, or hard to interpret
- The same denials repeat month after month with no real root-cause fix
- You're the one flagging cash flow concerns
- KPIs only come up when you ask for them
If more of your experience lands in the second list, it's worth raising directly with your billing partner. Expectations, not the relationship itself, are usually what need resetting. “Accountability should never be one-sided,” Arnold says.
What good billing partners commit to in writing
A verbal understanding isn't a written commitment, and vague answers here are worth treating as a warning sign. Look for defined turnaround times that establish real billing partner accountability:
| Task | Why the Timeline Matters | Typical Turnaround |
|---|---|---|
| Charge entry & claim submission | The faster claims go out the door, the faster you get paid | 1–3 business days |
| Insurance & eligibility verification | Catches coverage problems before they turn into denials | 2 business days |
| Payment posting | Keeps your financial picture accurate and current | 3 business days |
| Denial & rejection management | Every day a denial sits unworked is revenue at risk of write-off | 3–5 business days |
| Insurance follow-up | Claims left untouched are the ones that quietly become write-offs | 30–45 business days |
| Patient billing & inbound calls | Directly shapes how patients experience your organization | Real-time |
| Credit balance review | Protects your organization from compliance issues tied to unrefunded overpayments | 30 business days |
| Credentialing & enrollment | Delays here can block billing entirely for a new provider | Set per payer |
Written commitments give both sides a shared definition of "timely" and a clear line between what your organization owns versus what your billing partner owns.
Payment posting is a good example: CAQH's own industry cost data shows manual remittance processing costs the industry meaningfully more per transaction than posting electronically. A fast, accurate three-day turnaround is realistic precisely because of that gap.
Accountability runs both ways, too. A billing partner can only hit its numbers if documentation, charge submission, and enrollment information come in on time from your side.
Visibility, shared definitions, and written expectations
No billing partner avoids every denial or every delay. What separates a strong billing partnership from a shaky one is visibility, shared definitions of success, and a documented understanding of who owns what.
Get those three things right, and problems get caught earlier and resolved faster, with both sides staying accountable for the outcome.
“Not every organization needs the same level of support,” Self says. “The right approach looks different depending on your needs and your internal resources.”
Want more like this? ARIA Academy is a free monthly educational series from the billing and coding experts at ARIA Health Services, covering revenue cycle topics all year. If you'd like a closer look at your own numbers, ARIA Health Services also offers a complimentary billing analysis for your practice or laboratory.
