Switching Medical Billing Companies: Transition and Exit Checklist

To switch medical billing companies safely, go in this order for a planned handoff: read your contract, sign the new company, then give written notice. Before the handoff, get your records and authorized access in place, agree in writing on who finishes the old claims, and confirm the Medicare and payer changes you need. Do not miss a notice deadline or delay an urgent privacy response while choosing a replacement.

The day the new company starts and the day the old company is truly finished can be two different days. Claims, payments, and deadlines still need an owner in the gap between them.

Below is a 42-step checklist. Enter your notice date, notice period, and the way your contract starts the clock, and the steps get planning dates. No email needed.

Set my dates

Jump to the checklist

Old company already holding your records? Go straight to what to do if they stall. Still need a replacement? Compare billing options.

The safe order

1. Read the contract. Check the notice deadline before announcing a planned switch.
2. Save your own authorized copies of every key report while access is still friendly. Record urgent filing and appeal deadlines now.
3. Choose the new company and sign. That includes a new business associate agreement (BAA), the privacy contract required before the new billing vendor receives protected patient data for this work.
4. Give written notice the way the contract says. Send your records request the same day.
5. Move the paperwork during the notice period: Medicare, payers, logins, patient statements.
6. Track every old claim until it is resolved or a new owner accepts it with its next step and deadline. An appeal is still an open claim. Then close out the old company in writing.

Think of it as three separate yes-or-no calls:

• Ready to give notice? You know your exit terms and you have a signed replacement, or a documented continuity plan if a notice deadline or urgent problem means you must act sooner.
• Ready to start new claims? The new company can send claims, see payment reports, and your deposits still land in your bank.
• Ready to close out the old company? Every old claim is resolved or an accepted new owner has its next step and deadline, and your data is accounted for.

A yes on one is not a yes on the next.

Your dates and your checklist

Your contract sets the clock. Enter the notice date, notice period, and whether the clock starts when notice is sent or received. If it starts on receipt, enter your delivery estimate. You can also set a planned start date, check a renewal window, and model fees on old claims. The planner does the arithmetic; it does not decide when your contract legally ends or whether your payer connections are ready.

A worked example

Say you send notice on October 12, 2026. Your contract asks for 60 days, and the clock starts when the billing company receives the letter. You estimate 3 calendar days for delivery. This example adds 60 elapsed calendar days to the estimated receipt date; your contract may count days differently.

Now add a renewal check. Say the contract renews on March 1, 2027 unless it receives notice 90 calendar days earlier. Counting back 90 days, plus 3 estimated delivery days, gives a modeled send-by date of November 28, 2026. October 12 is earlier than that calculated date. November 28 is a Saturday: delivery estimates and the contract's notice rules still decide whether notice is timely.

The planner counts calendar days. It does not read your contract or adjust for legal holiday rules. Confirm receipt, the actual contract end date, and payer readiness. Its 14- and 30-day preparation targets and 30/60/90/120-day reviews are planning choices, not universal deadlines. The separate Medicare enrollment calculation appears only when you confirm the physician/NPP-practice billing-agency-only scope and enter the actual effective change date.

Before you give notice: nine things to find in your contract

The contract decides when you can leave, what it costs, and how you get your data back. Read it before the billing company knows you are leaving. How you give notice can move your last day by weeks.

We can't tell you what your contract says. If you are leaving mid-term, or the contract charges fees after you leave, have a healthcare lawyer read those two parts before you send anything.

What is yours: the money, the data, the logins

The billing company works for your practice. You need control of payment instructions, access to your billing records, and a clear handoff of the accounts it uses. Access to patient data does not mean ownership of the vendor's software or a right to share every login.

Keep Medicare payments under the authorized payee's control. When Medicare pays a billing or collection agent under 42 CFR 424.80(b)(5), payment is made in the name of the supplier or its eligible employer, facility, or system. The agent must meet the conditions in 42 CFR 424.73(b)(3), including payment instructions the provider may change or revoke.

You are still responsible for the claims. The current CMS enrollment forms say that using a billing agency does not remove your responsibility for the accuracy of claims sent on your behalf (CMS-855I, Section 8; CMS-855B, Section 8).

Account for the patient data at the end. A BAA must require return or destruction of protected patient data at termination if feasible, including copies. If return or destruction is infeasible, the protections continue and further use or disclosure is limited to the purposes that make it infeasible. HHS's sample wording also provides for an authorized transfer to your next vendor (HHS, Business Associate Contracts; 45 CFR 164.504(e)).

They can't lock you out to win a fight. HHS says that when a vendor blocks a practice's access to the patient data it holds, for example to settle a payment dispute, that is an impermissible use under the HIPAA Privacy Rule (HHS FAQ 2074). This covers your patient data. It does not give you a right to keep using the vendor's software, and it does not cancel fees you owe.

Now find out who holds the keys today. Tick the boxes that apply and name any other or shared control. Request the authorized practice or delegated role each system supports; do not share another person's password.

Every vendor-controlled or shared item needs a written handoff plan before the access you need ends.

Pick the replacement before you give notice

For a planned switch, sign the new company first. Giving notice without a replacement starts a clock you can't stop. If a renewal cutoff is close or an urgent privacy problem means you must act sooner, have your practice lead and lawyer settle the notice and continuity plan without waiting for vendor selection.

Ask each company you are considering to answer these in writing.

The last question is the one people skip. Ask it now, and your next exit is easier than this one.

Our comparison shows what billing companies publish about fees, minimums, software, and contract terms. It does not show which ones will take over your old claims. Ask each one.

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No email is needed to view the examples. You contact the company yourself. We don't send your details to anyone.

Small practice? See how a monthly minimum changes the real cost.

How to give notice

Send it in writing, the way the contract says. Keep proof of delivery. Send the records request the same day.

This letter is a starting point, not legal advice. Match the section number, the address, and the delivery method to your contract.

Subject: Notice of termination, [Practice name] billing services agreement

[Date]

[Billing company name]
[The notice address named in the agreement]

This letter is written notice that [Practice name] is ending the billing services agreement dated [date], under section [number].

Under section [number] and the applicable notice terms, the last day of services will be [contract-verified date].

Until that date, please keep sending claims, posting payments, and following up on open claims as the agreement requires.

Our records request is attached. Please reply in writing to confirm three things: that you received this notice, the last day of services, and the name of the person who will handle the handoff.

[Name]
[Title]
[Practice name]
[Phone and email]

What records to ask for

Ask in writing. Give a due date. Name the file type. A spreadsheet you can sort beats a PDF you can only read.

Subject: Records request, [Practice name] billing handoff

Under our billing services agreement and our business associate agreement, please send the items below for [Practice name] by [date]. Please send them as [CSV or Excel] files unless noted, using [agreed secure transfer method].

1. Every open insurance claim, one per line: patient account, payer, date of service, amount billed, amount still owed, date sent, payer claim number, current status, and the date and note of the last follow-up.
2. Every open denial: reason code, notice and receipt dates, whether an appeal was filed, its level and current status, supporting records, the next action, the owner, and the filing or appeal deadline.
3. Every charge not yet billed, with the reason.
4. Payments received but not yet posted.
5. Every credit balance, by patient or payer.
6. Every open patient balance and every active payment plan, with its schedule.
7. Every account sent to a collection agency: agency name, date sent, and balance.
8. Prior authorization numbers and letters tied to open claims.
9. A full export of claim, payment, adjustment, and reversal history, including closed claims and related notes and attachments.
10. A list of every system and portal you use for us, and who the admin is on each.
11. View-only access to our billing records through [date].

Please do not send passwords by email. We will coordinate practice-authorized admin or delegated access under each system's rules.

Please confirm you received this request and name the person responsible.

[Name]
[Title]
[Practice name]

Don't have passwords emailed around. Put authorized practice or delegated access in place using each system's process. Add the new company's named users with the access their work needs. Remove the old company's access when its authorized work ends; do not wait for a closeout letter to revoke access that is no longer needed.

Who finishes the old claims?

Someone has to keep working the claims sent before the switch. Decide who, and put it in writing before the old company's last day.

If you don't, both companies may assume the other is doing it. The new company may be missing the notes it needs. A claim nobody works sits until the payer's deadline passes.

If the old company keeps working after the main service handoff, its contract and BAA must still cover that work. Ask for that in writing. For a real example of separate pricing, Recoup publishes a separate agreement and fee for old-balance work; that is the company's stated offer, not a quote for your practice (Recoup pricing).

Whichever you choose, write down three things.

1. The split. Pick an exact rule both contracts support. One simple example uses the date of service: "Visits through December 14 are old claims. Visits from December 15 on are new." Record any exceptions and name an owner, next action, and deadline for each open claim.
2. The end date. After it, anything unresolved is handed over with its notes and deadlines.
3. Who gets paid on what. Agree which receipts earn a fee for each company. Any overlap should be an explicit choice tied to the work, not a surprise.

What a clear handoff looks like

This example uses the dates from the planner example above and an agreed date-of-service split.

One more rule: don't resend old claims in bulk to "start clean." Check each claim's status with the payer first. Sending a claim that is already in process or already paid creates duplicates.

The fee trap: paying twice on the same dollars

These are example numbers to show the math. They are not a quote or a typical rate.

• Your old contract pays the old company 5% of everything collected for 90 days after its last day.
• Your new contract pays the new company 5% of everything collected from day one.
• In those 90 days, $60,000 arrives on old claims.

One option to negotiate in the new contract is that the new company's fee applies only to visits on or after the agreed date-of-service split, unless you hire it separately to work old claims. Match that wording to the old contract's fees after you leave and the actual work each company will do.

Paying both is not always wrong. Sometimes both companies do real work on old claims. It should be a choice you made, not a surprise on an invoice.

Check the data before you trust it

A list of balances is not enough. The new team needs the history behind each balance: what was sent, what the payer said, and what happens next.

Ask for a sample export early. Before the new company receives protected patient data, have the BAA signed and use an agreed secure transfer method with access limited to the work it needs to do (HHS Security Rule summary; HHS minimum necessary guidance). Then check the final export three ways.

1. Count and identity. The same open claims in the old system and the new one, matched by claim and patient identifiers, with approved exclusions documented.
2. Dollars. The same total owed for that same set of claims, with any difference explained.
3. History. Start with ten sample claims, including denials, old balances, and claims with urgent deadlines. Are the notes, denial reasons, attachments, and payer claim numbers there? Ten is a practical spot-check, not proof that the entire export is complete; expand the check when gaps appear.

Here is what a failed check looks like, with example numbers.

Don't accept the export until someone finds those 2 claims and that $1,500. Matching totals alone can fool you, too. One missing claim and one duplicate can cancel each other out.

If the old system stays in use after the first export, ask for a final "changes since" export on the last day.

Claims, payment reports, and deposits are three separate things

Getting claims out the door does not mean payment reports reach the right team. And neither one decides where the cash lands.

• Electronic claims go out through an authorized submitter, often using a clearinghouse.
• Payment reports come back as an ERA (electronic remittance advice, also called an 835). It lists what the payer paid, denied, or adjusted on each claim.
• Electronic deposits arrive by EFT (electronic funds transfer). That is the money itself. Paper checks have a separate mailing route.

CMS treats EFT and ERA as separate transactions that must be matched, or reassociated, using their payment information (CMS, EFT and ERA operating rules).

Changing billing companies is not a reason to change your bank account. If anyone asks you to change deposit details during the switch, confirm it by calling a number you already trust.

The Medicare enrollment update and EDI setup are separate jobs. A 90-day reporting window does not authorize an unapproved submitter to send claims. The CMS-855I instructions also say an individual reassigning 100% of Medicare benefits should not complete Section 8; check the applicable enrollment record and form instructions.

How long does payer paperwork take? It depends on the payer and the change. Here is what the current instructions and linked forms show:

• DMBA says to allow 7 to 10 business days for payment report sign-up.
• Aetna Better Health of Virginia now directs electronic payment and ERA changes through ECHO and its EERS process. An older form still online quotes 10 to 15 business days, but that is not a confirmed processing time for the current route. Get the change date from the current enrollment contact.
• Louisiana Blue (Blue Cross and Blue Shield of Louisiana) says the existing ERA trading partner is terminated 30 days after the new partner's enrollment date. Its June 2025 form allows one ERA trading partner ID at a time and says it does not set up ERAs for out-of-state providers. Do not assume two vendors will get duplicate feeds for 30 days.

That last one matters. It is not a promise of two simultaneous ERA feeds. If the old company is still finishing claims, it may lose sight of what that payer paid. Ask each payer the same question before you file: "Will this change cut off the company finishing our old claims?" Agree who receives the report and how the other authorized team gets the information it needs.

What "the claims are going through" should mean

Ask the new company to show you the report, not just tell you.

Start with a small first batch of real claims and check each acceptance or rejection before releasing a broad batch. Follow those claims all the way to the bank. Do not submit made-up test claims to a production payment system; use a payer-authorized test environment if one is available. Never send the same claim through both companies without checking its status and the payer's correction process.

Patients and statements

Pick one handoff date and one statement owner for each account. After it, only that owner sends the account's patient statements.

When two companies bill the same account without a clear handoff, patients can get duplicate statements and conflicting phone numbers. Your front desk needs to know who can answer the question.

Before that date:

• Put the new phone number and payment link on the statement.
• Move every payment plan with its balance and schedule.
• Move patient credits, so refunds come from one place.
• Get the list of accounts already at a collection agency. Find out whose contract it is and where the agency sends money now.
• Give the front desk one sentence to say: "We changed billing companies. Here is the number for questions about this statement." Confirm the balance before telling a patient it has not changed.

Don't collect an old balance twice because the system changed.

Keep charting and entering charges as usual during the switch. Holding charts "until the new company is ready" is how claims pile up and deadlines slip.

The first 30 days: three checks

These are review targets, not promises that every payer will issue a report or payment in this window. A filing deadline can require action sooner.

1. Days 1 to 7. Check the first real batch before releasing more claims. Ask for each claim's acceptance or rejection and fix rejects promptly.
2. Days 7 to 21. Check ERAs from the first expected report. If a report is missing, follow up then; do not wait until day 21.
3. Days 7 to 30. Match deposits that have arrived to the reports and posted payments. Track anything that has not arrived against that payer's expected timing.

If one of these fails, check the paperwork table above, the claim-level responses, and the payer's status. Record the cause and the person fixing it.

Plan for late cash. Here is a planning scenario, with example numbers. A practice that collects $60,000 a month averages about $13,846 a week ($60,000 × 12 ÷ 52). Three weeks of those average collections is about $41,538, calculated before rounding. That is a way to model a possible cash delay, not a forecast that exactly that amount will arrive late or eventually be paid. Compare the scenario with payroll, other bills, switching costs, and available reserves. Payroll doesn't wait.

MGMA's July 28, 2026 poll received 203 applicable responses; 32% reported higher days in A/R than a year earlier. Respondents named changing billing companies and systems among several reasons, and one reported a two-month billing delay during a system change. Those are reported experiences, not an estimate of how often a switch causes a delay (MGMA Stat, July 30, 2026).

Close out the old company

You are done when every claim that was open on the last day is resolved or a new owner has accepted it with its next step and deadline, and the old company has told you in writing what happened to your patient data. Filing an appeal is an action, not a closed claim.

The old company's work can end while some claims are still open. That is fine, as long as a named person has taken over each one, with its notes and its deadline.

Work by deadline, not by age. Start the deadline sheet before notice or handoff and keep it current at claim level. The handoff date does not reset the payer's clock. Record the payer, claim number, service date, notice date, receipt date if known, next deadline, next action, and owner.

• Original Medicare: claims generally must reach the contractor within one calendar year of the applicable service date. For claims spanning several dates, check which date applies to the claim type. An incomplete or invalid submission may not count as filed, so keep the acceptance history and fix rejections promptly (CMS Claims Processing Manual, Chapter 1, §§70.1–70.3). There are specified exceptions; when the filing period ends on a federal nonworkday, the regulation provides for the next succeeding workday (42 CFR 424.44). A vendor switch is not a new filing period.
• Original Medicare, first-level redetermination: the request generally must be received within 120 days after receipt of the initial determination. Receipt is presumed to be 5 days after the notice date unless there is evidence to the contrary. If the last day falls on a weekend, federal holiday, or other contractor nonworkday, CMS's manual provides for the next working day. CMS also provides a good-cause process for late appeals (CMS redetermination guidance; CMS Claims Processing Manual, Chapter 29, §§240 and 310.2). Minor errors and omissions use the correction or reopening route, not this appeal process.
• Example: a denial notice dated November 20, 2026 is presumed received November 25. Adding 120 elapsed calendar days gives March 25, 2027, a Thursday. That is the modeled receipt deadline if the presumed receipt date and ordinary rule apply; use the actual receipt evidence and contractor calendar when they change the calculation.
• Medicaid, Medicare Advantage, and commercial plans have their own applicable filing, correction, and appeal rules. Find the rule for each open claim in the payer contract, provider manual, and applicable law; do not apply the Original Medicare deadline to every payer.

Return money you owe. Escalate a suspected overpayment promptly to the practice's billing or compliance lead. For Medicare Parts A and B, an identified overpayment generally must be reported and returned by the later of 60 days after identification or the date any corresponding cost report is due. Identification uses the rule's “knowingly” standard: actual knowledge, deliberate ignorance, or reckless disregard. A timely, good-faith investigation of related overpayments can suspend the deadline until the investigation ends and the aggregate amount is calculated, or 180 days after the initial identification, whichever is earlier. Other specified suspensions and cost-report reconciliation rules can apply; the 180 days is not an automatic extra period for every refund (42 CFR 401.301, 42 CFR 401.305, 31 USC 3729(b)). Have the practice's compliance lead record the identification facts, applicable reporting route and deadline, and each refund. A credit balance needs review; it is not by itself proof of a Medicare overpayment.

Make the numbers tie out. Here is the check, with example numbers. The same set of old claims totaled $150,000 on the last day. Since then, $35,000 was paid, $5,000 was written off with your approval, and a payer took back $1,000 it had paid. In this example, that recoupment restores a $1,000 receivable in the same set of claims. Assume these are the only changes to that claim group.

$150,000 − $35,000 − $5,000 + $1,000 = $111,000 should still be open.

If the report shows a different number, reconcile the claim-level differences. Missing claims, duplicate postings, other adjustments, transferred balances, and timing differences can all explain a gap. A recoupment that does not restore this receivable does not belong in this formula. Don't adjust the books to force a match.

Check the final invoice against the contract. If you are thinking of holding back money the contract says you owe, talk to your lawyer first.

Get the data answer in writing. Ask what was returned, what was destroyed, and what was kept and why, including copies held by subcontractors. If anything must be retained, document the purpose, continuing safeguards, permitted uses, eventual return or destruction, and how your practice can reach the history it needs. One caution: HIPAA's Privacy Rule does not set how long medical records must be kept. State law generally does, and other applicable duties can matter (HHS FAQ 580). So don't order everything destroyed on the way out. Make sure you can still reach the history you need.

Remove access when the work ends. Revoke the old company's users and permissions in your software, clearinghouse, and payer portals when its authorized work is finished. Remove your practice's link to its Medicare submitter ID through your contractor's process; do not cancel a vendor's ID for all of its clients. Do not wait for the final data letter to remove access that is no longer needed.

If the old company stalls or blocks your records

Put it in writing, set a date, and start rebuilding from other sources the same day.

1. Send a written follow-up. Name the contract section and the BAA. List exactly what is missing. Set a new date.
2. Keep a log. Date, person, what was promised.
3. Rebuild what you can. Your clearinghouse has reports of what was sent and rejected. Payer portals show claim status and past payments. Your bank shows deposits.
4. Find the urgent deadlines first. Denials with appeal dates coming up can't wait for the dispute to end.
5. Know where you stand. HHS has said a vendor that blocks a practice's access to its patient data to settle a payment dispute has made an impermissible use under HIPAA (HHS FAQ 2074).
6. Call a healthcare lawyer if data or access is withheld, and before you hold back any payment.

If you think patient data may be at risk, tell the person who handles privacy at your practice today. That comes before anything on this checklist.

Special cases

You are changing software at the same time. Two changes at once add migration and training work. If you can, switch the company first and the software later. If you can't, arrange the retained history or authorized view-only access you need before the old system becomes unavailable.

Your biller is one person who just left. The same continuity work applies, but any notice or other duties depend on the employment or vendor agreement. Start with steps 4, 5, and 6: reports, authorized access, and where the money lands.

You are bringing billing back in-house. The exit steps are the same. Your own staff is "the new company."

You run a small practice. The number of payers and systems still decides the handoff work. A monthly minimum at the next company can have a large effect on your real fee. See how a minimum changes the real cost and what small practices should check.

Should you switch at all?

Switch when the problem is how the company works. Don't switch for a problem that will follow you.

Ask three questions.

1. Is it your side? Late notes, wrong insurance at check-in, charges entered late. A new company inherits all of these.
2. Is it the payers? Slow payment, record requests, claims paid at a lower code. A new company cannot change payer policy, but it may handle submissions, follow-up, and appeals better. Ask what it would do differently.
3. Is it them? Claims going out late, denials nobody appeals, reports that don't answer your questions, no one to call. This is the reason to leave.

One number can help frame the discussion. MGMA says first-submission denial rates have hovered around 7% to 8% over four years and describes focused work toward rates below 5% (MGMA Stat). Ask your billing company for your rate using a consistent definition and your own trend. That comparison is context, not a universal threshold for firing a billing company.

If the answer is mostly "them," you have two fair choices. Give one written chance with clear targets and dates. Or start the checklist.

More questions

How long does it take to switch medical billing companies?

There is no standard number we could back with data. Your contract sets when the old services can end; payer and system readiness set when the new company can safely take over. DMBA quotes 7 to 10 business days for ERA enrollment, and First Coast says to allow two weeks for its EDI form. Neither is a universal switch time. Old claims can remain open after the handoff, so agree who works them and when they transfer. Use the planner above for planning dates, then confirm each dependency.

Do we have to redo credentialing?

A billing-company-only change does not itself change your tax ID, providers, or payer contracts. For Medicare, the current forms treat billing-agency details as a change of information, not a fresh credentialing application (CMS-855I, CMS-855B). Update the applicable record, electronic-file permissions, and portal access. Confirm each payer's process. If ownership, tax ID, location, or providers are also changing, ask about those changes separately.

Can we leave before the contract ends?

Your contract answers that. Look for the early exit charge and the "ending for cause" steps. Sometimes waiting for the renewal window costs less than leaving now. A new company saying it can start next week does not end the old contract.

Will collections go up right away?

No one can promise that. Money from old claims can keep arriving after the new company starts, so total deposits alone won't tell you how the new company is doing. Track old claims and new claims separately.

What does it cost to switch?

Count these lines: any early exit charge, fees the old company earns after its last day, setup at the new company, any software change, and staff time. Ask both companies for each number in writing. An unknown charge is unknown, not zero.

Does Medicare ban percentage-based billing fees?

Not as a blanket rule. CMS says the payment-to-agent conditions do not apply when an agent only prepares bills, without receiving or negotiating the provider's checks. When the payment-to-agent exception applies, the agent's pay cannot depend on amounts billed or collected, or on collection itself (CMS Claims Processing Manual, Chapter 1, section 30.2.4). Have a healthcare lawyer review the actual fee and payment-control arrangement; a practice-named bank account alone does not resolve every condition.

How we checked this page

We read the federal rules, current CMS enrollment forms, HHS guidance, and payer instructions linked above on October 6, 2026 (UTC). Where a source covers one payer or one Medicare contractor, we say so. We distinguished the older Aetna form from its current ECHO enrollment route. We did not test any billing company's handoff. The dollar examples are made up to show the math, and they are marked as examples.

This page is general information. It is not legal advice. Your contract, your payers, and your state set the real rules. Read more about how we research, or tell us if something is wrong.

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