Getting started
How starting works, including what can go wrong
No patient data moves until the Business Associate Agreement (BAA) is signed. You keep your EMR. We plan the handover before anything changes.
Two ways in
Pick the one that matches how your practice bills today. Both end with your first month-end report.
From in-house billing
- 01
Sign the service agreement and the BAA
No patient data moves before the BAA is signed.
- 02
Set up access to your EMR and clearinghouse for your billing team
You keep your EMR.
- 03
Share your fee schedule and financial policy
- 04
Name one contact at your front desk
- 05
We list every open claim with an owner and a deadline.
- 06
Your written billing plan says who works claims sent before your start date, and whether that work is priced separately.
- 07
Your first month-end report
What was billed and paid, and what we need from you.
From another billing company
- 01
We plan the handover with you before you give notice.
- 02
Sign the service agreement and the BAA
No patient data moves before the BAA is signed.
- 03
Set up access
Your EMR and clearinghouse, for your billing team. You keep your EMR.
- 04
Every open claim at handover is listed with an owner.
- 05
Your written billing plan says who works claims sent before your start date, and whether that work is priced separately.
- 06
Remittances move payer by payer
Each insurance company sends a practice's electronic remittances to one clearinghouse at a time, so remittances move payer by payer.1
- 07
Your first month-end report
What was billed and paid, and what we need from you.
Why cash can dip in any switch
These rules set the pace, whoever does the billing.
- Earliest day Medicare can pay a clean electronic claimDay 14
Source: CMS, Rev. 13826, 2026-06-112
- Medicare's limit to pay or deny a clean claim30 days
Source: CMS, Rev. 13826, 2026-06-112
- Per insurance company at a time, for electronic remittancesOne clearinghouse
Source: Stedi, 2026-06-241
- Remittance enrollment times on 2021 clearinghouse forms: Medicare Part B through Novitas 5 to 10; WPS 10 to 14; Optum360 10 to 305 to 30 business days
- We plan the handover around these, and tell you which insurance companies are still moving.
What we need from you
Before we start
A signed service agreement and BAA
Before any patient data moves.
Access to your EMR and clearinghouse for your billing team
You keep your EMR.
Your fee schedule and financial policy
So charges, statements and payment plans follow your rules.
One contact at your front desk
For coverage problems and questions only your practice can answer.
Your biller leaves next month?
Tell us the date. We will say honestly whether we can be ready, and what your front desk should keep doing until then.
If you leave
You keep your EMR and your records. At the end, the BAA requires us to return or destroy your patients' information and keep no copies.5
Questions about switching
No patient data moves until the Business Associate Agreement (BAA) is signed.
We list every open claim with an owner and a deadline. We agree a start date with you and plan who works claims for visits before and after it.
Your first month-end report follows.
Tell us the date. We will say honestly whether we can be ready, and what your front desk should keep doing until then.
Your written billing plan says who works claims sent before your start date, and whether that work is priced separately.
Next question: what does it cost?
What the fee covers, and what one in-house biller costs.