Red Flags to Avoid When Hiring a Medical Billing Company
Hiring a medical billing company is a major decision for any healthcare practice. The right partner can increase revenue, streamline administrative tasks, and ensure compliance with ever-evolving healthcare regulations. However, choosing the wrong provider can lead to claim denials, compliance risks, lost revenue, and damaged patient relationships. That’s why it’s vital to be aware of the red flags that indicate a medical billing company may not be the right fit.
At Thrive Medical Billing, we understand what a successful billing partnership should look like—and we also know the warning signs that practices should avoid. In this article, we’ll guide you through the top red flags to look out for when selecting a medical billing company, so you can make an informed and confident decision.
Lack of Transparency
One of the biggest red flags is a medical billing company that lacks transparency in its operations, pricing, or performance metrics. If a company is vague about their processes or unwilling to provide regular reports, it should raise serious concerns.
Thrive Medical Billing believes in complete transparency. From onboarding to monthly reports, we keep clients informed with real-time dashboards, KPI tracking, and open communication lines.
What to Watch For:
Unwillingness to share performance data or denial rates
Vague responses to questions about billing practices
Hidden fees or unclear pricing models
No Experience in Your Specialty
Every medical specialty has unique coding requirements, billing procedures, and payer relationships. Hiring a medical billing company that lacks experience in your area of practice can result in coding errors, delays, and denied claims.
At Thrive Medical Billing, we have extensive experience across a wide range of specialties—from family medicine and dermatology to orthopedics and behavioral health. Our coders are specialty-trained, ensuring accurate claims and maximum reimbursement.
What to Watch For:
Generic promises without proof of specialty knowledge
No references or case studies relevant to your field
High denial rates due to coding mistakes
Poor Communication
A strong billing partnership depends on clear, consistent communication. If a medical billing company is difficult to reach, takes days to return calls, or fails to respond to urgent issues, it’s a sign of poor internal processes and client service.
Thrive Medical Billing assigns a dedicated account manager to every client, ensuring consistent communication and immediate support when needed.
What to Watch For:
No dedicated point of contact
Delays in answering emails or phone calls
Missed deadlines without explanations
No Performance Guarantees
Reputable billing companies are confident in their ability to deliver results. If a medical billing company doesn’t offer any kind of service level agreement (SLA) or performance guarantees, it could be a sign they’re not fully committed to your success.
Thrive Medical Billing sets measurable goals with every client and backs them up with SLAs that define expected turnaround times, clean claim rates, and collections performance.
What to Watch For:
Refusal to commit to performance benchmarks
No discussion of KPIs or reporting frequency
Lack of accountability for errors or delays
Outdated Technology
Modern medical billing relies heavily on technology—from electronic claim submissions to automated denial tracking. If a medical billing company still relies on outdated tools, manual processes, or doesn’t integrate with your existing systems, your practice may suffer delays and inefficiencies.
Thrive Medical Billing uses industry-leading technology to connect with your EHR, automate claim tracking, and provide real-time reporting. Our secure platforms are HIPAA-compliant and constantly updated to ensure peak performance.
What to Watch For:
No integration with your current EHR or PM system
Manual data entry or paper-based processes
Lack of HIPAA-compliant software
Unclear Fee Structures
Another red flag is a pricing model that’s either too vague or too good to be true. A medical billing company that charges extremely low rates may be cutting corners, leading to poor service quality. Conversely, unclear or overly complex pricing may lead to hidden costs that eat into your revenue.
Thrive Medical Billing provides clear, competitive pricing with no hidden fees. Our pricing is based on collections, aligning our success with yours.
What to Watch For:
Pricing that’s not explained upfront
Hidden fees for reports, consultations, or support
Unrealistically low fees that compromise quality
Inadequate Reporting and Analytics
Without regular reporting, your practice won’t know how well the billing company is performing. A reliable medical billing company should provide detailed reports on collections, denial rates, A/R days, and claim turnaround times.
Thrive Medical Billing delivers comprehensive monthly reports and offers clients access to real-time dashboards. These insights help you monitor performance and make data-driven decisions.
What to Watch For:
No reporting or limited access to billing data
Infrequent or hard-to-read reports
Lack of customization in reporting
Negative Reviews or No References
A trustworthy medical billing company should have a strong reputation, with satisfied clients willing to share their experiences. If the company can’t provide references or has a pattern of negative online reviews, that’s a major red flag.
Thrive Medical Billing has built long-standing relationships with clients who are happy to vouch for our services. We’re proud of our track record and are always open to sharing testimonials and case studies.
What to Watch For:
Unwillingness to provide references
Consistent complaints about the same issues in reviews
Lack of an established online presence
Inflexible Service Packages
Every healthcare practice is different. A medical billing company that offers only one-size-fits-all solutions may not meet your unique needs. Whether you want full-service billing or just support with claims and collections, flexibility is key.
Thrive Medical Billing offers scalable, customized solutions tailored to your goals, specialty, and workflow. We adjust our services to grow with your practice.
What to Watch For:
No customization or flexibility in services
Inability to scale as your practice grows
Forced to pay for services you don’t need
No Focus on Compliance
Medical billing is tightly regulated. A lapse in compliance can result in audits, fines, and legal trouble. A medical billing company that doesn’t prioritize HIPAA, payer policies, and up-to-date coding guidelines puts your practice at risk.
Thrive Medical Billing maintains the highest compliance standards. Our team undergoes regular training, and our systems are designed to protect your data and ensure regulatory compliance.
What to Watch For:
No mention of HIPAA compliance or staff training
Lack of audit support
Outdated knowledge of billing regulations
Final Thoughts
Choosing the right medical billing company is critical to the success and sustainability of your healthcare practice. Red flags like poor communication, unclear pricing, lack of experience, and outdated technology should never be ignored.
Thrive Medical Billing is committed to helping practices avoid these common pitfalls. With transparent pricing, industry-leading technology, specialty-specific expertise, and unwavering client support, we provide the reliability and performance your practice deserves.
If you’re looking for a trustworthy, results-driven medical billing company, Thrive Medical Billing is here to help. Let us take the stress out of billing so you can focus on delivering exceptional patient care.