If you're searching for the signs your practice needs a new billing company, you already suspect something's off. Usually it's not one dramatic failure. It's a slow drift: a claim here, a vague answer there, a report that raises more questions than it answers. This post covers the specific, measurable signs worth checking against real benchmarks, not just a gut feeling.
A rising days-in-A/R number, a climbing denial rate, and monthly reports that don't explain why claims were denied are the three clearest signs. If your current vendor can't give you a straight answer on any of these, it's worth a second opinion.
Each of these is measurable against real industry numbers, not opinion, which is what makes them worth checking first before you look at anything softer like responsiveness or bedside manner from your account rep.
The industry average sits around 42 days and has been climbing. If your practice is meaningfully above that, or your vendor can't explain which claims are aging and why, that's a red flag worth investigating.
AMS Solutions' 2026 State of Medical Billing benchmark report puts the average days in accounts receivable at 42, up from 38 the year before. MGMA's own polling tells a similarly uneven story: in a July 2026 MGMA Stat poll of 203 medical groups, 32% said their days in A/R had gotten worse over the past year, against 22% who said it had improved. The same MGMA piece makes a point worth repeating: "each denied claim restarts the collection clock," which is exactly why a rising A/R number is usually a denials problem wearing a different hat.
A healthy first-pass denial rate is roughly 7 to 8 percent, with the best-run practices pushing below 5 percent. Industry-wide, about 4 in 10 providers now report denial rates of 10 percent or higher, which is the territory worth questioning your vendor about.
MGMA's polling has held the typical first-submission denial rate at 7 to 8 percent over the past four years, noting that practices focused on the fundamentals can bring it under 5%. Meanwhile, Experian Health's State of Claims 2026 report found 40% of providers now report denial rates of 10% or higher, up from 31% in 2022. The same report found that 53% of respondents said errors in submitted claims are increasing, and "services not covered" has become the single most common denial reason for the first time since the survey began.
| Sign | What's normal | When to worry |
|---|---|---|
| Days in A/R | Mid-30s, trending flat or down | Approaching or past 42 days, with no clear explanation |
| First-pass denial rate | Roughly 7-8%, best performers under 5% | 10% or higher, or denials with no stated reason |
| Monthly reporting | A clear breakdown of exactly why each claim was denied | A vague summary, a dashboard with no explanation, or no report at all |
| Backlog recovery | A documented, resourced plan the moment A/R starts aging | "We're working on it," repeated for months with no visible progress |
A practice came to us through a referral from an existing client. Most of her claims were being denied, and on top of that she had a late-filing problem, because her previous billing company had let a backlog build up without catching it. Nothing dramatic had gone wrong on any single claim. It was months of inattention that had quietly piled up.
We split the work across two dedicated teams: one focused entirely on clearing the existing backlog, the other ran her current billing so new claims didn't fall into the same hole while the old ones were being fixed. Within a few months everything was aligned, and from that point forward claims moved through smoothly.
What actually closed the loop with her, though, wasn't the backlog getting cleared. It was the reporting that came after. We sent her detailed, easy-to-read reports every month that stated the specific reason behind every denial, not just a total count, and a dedicated client rep was with the practice every time to walk through those reports in detail, helping them understand exactly where the lags were and what could be improved, which made the whole thing far easier to act on. Once that visibility existed, something became obvious: the overwhelming majority of her remaining denials, in practice closer to 99.9%, traced back to her own front office, not the billing side. Missing demographic data, or a prior authorization that hadn't been secured before the visit.
That's worth sitting with. A lot of the "billing problem" a practice is frustrated about is actually an intake problem a billing company should be catching and reporting on, loudly, every single month, not quietly absorbing and hoping nobody asks. That's really the core of how we support clients: we don't just hand over a report, we walk them through what can be done on their end so they're not losing money without realizing it.
The technical handoff itself can happen in a matter of days once a practice is ready to move. The bigger variable is usually how quickly the practice wants to start, not how long the switch takes on the billing company's end.
In our experience, the limiting factor is almost never the mechanics of the transition. It's how quickly the doctor or practice manager wants to move, once they've decided. Full onboarding, including getting new reporting and workflows fully in place, typically wraps up within 7 to 14 business days of signing, so the switch doesn't mean weeks of limbo on your revenue.
None of these signs on their own means you need to fire your billing company tomorrow. But rising A/R, a denial rate you can't explain, and reporting that doesn't actually tell you why claims are getting denied are three things worth checking against your own numbers this month.
If you want a clear read on where your practice actually stands, request a Free Billing Audit and we'll walk through your real numbers with you, not just a sales pitch. Contact us or call (631) 870-7998 to get started.
A rising days-in-A/R number, a climbing denial rate, and monthly reports that don't explain why claims were denied are the three clearest signs. If your current vendor can't give you a straight answer on any of these, it's worth a second opinion.
The industry average sits around 42 days and has been climbing. If your practice is meaningfully above that, or your vendor can't explain which claims are aging and why, that's a red flag worth investigating.
A healthy first-pass denial rate is roughly 7 to 8 percent, with the best-run practices pushing below 5 percent. Industry-wide, about 4 in 10 providers now report denial rates of 10 percent or higher, which is the territory worth questioning your vendor about.
The technical handoff itself can happen in a matter of days once a practice is ready to move. The bigger variable is usually how quickly the practice wants to start, not how long the switch takes on the billing company's end.
