Question 1

How quickly can MedPrecision Billing take over our medical billing?

Accepted Answer

A typical full medical billing transition takes 2 to 4 weeks from contract signature to live claim submission, depending on practice size, EHR/PM complexity, and payer enrollment status. The transition spans four phases: (1) revenue cycle baseline assessment against MGMA 2024 DataDive benchmarks, (2) EHR/PM integration with mapping for systems like eClinicalWorks, Athenahealth, AdvancedMD, Kareo (Tebra), NextGen, and DrChrono, (3) a 2-week parallel billing period during which both the legacy biller and MedPrecision submit claims to validate accuracy, and (4) full takeover with daily charge entry and same-day claim submission. The parallel run is the critical risk control: it ensures zero revenue disruption during the cutover, which HFMA data shows typically causes a 10 to 20 percent revenue dip when skipped. Practices following this protocol see net collection rates climb to MGMA top-quartile levels of 97 percent or higher within 90 to 120 days.

Question 2

What is parallel billing and why does MedPrecision require it?

Accepted Answer

Parallel billing is a 1 to 2 week overlap period during which both the outgoing biller and MedPrecision submit claims simultaneously, allowing direct comparison of charge capture, coding accuracy, and clean claim rate before full handoff. HFMA transition data shows practices that skip parallel billing experience an average 10 to 20 percent revenue drop in month one, primarily from missed charges, mismapped CPT codes, and payer enrollment gaps under the new Tax ID. MedPrecision uses parallel billing to validate three things: (1) every CPT code from the prior 30 days appears in the new system with matching charge amounts, (2) ERA and EFT enrollments for each payer route correctly to the practice account, and (3) clearinghouse rejections under 5 percent before single-source cutover. Only after these thresholds clear does MedPrecision assume sole billing responsibility. This protocol has produced zero revenue gap on transitions across more than 200 practices.

Question 3

Which EHR and practice management systems does MedPrecision integrate with?

Accepted Answer

MedPrecision integrates with all major EHR and practice management platforms including eClinicalWorks, Athenahealth, AdvancedMD, Kareo (Tebra), NextGen, DrChrono, Practice Fusion, ChartLogic, ModMed, NueMD, CareCloud, CollaborateMD, and Epic Community Connect, plus specialty-specific systems like WebPT, Heno, and TheraNest. Integration uses native APIs where available and HL7 v2.x or FHIR R4 interfaces where the EHR exposes them. For systems without API access, MedPrecision uses sFTP-based batch interfaces with twice-daily charge file pulls. Custom HL7 builds for legacy systems typically take 2 to 3 weeks. The integration covers four data flows: demographics push, charge capture pull, ERA posting back to the PM, and patient statement coordination. Practices retain full ownership of their EHR/PM credentials and data; MedPrecision operates under role-based access defined in the BAA, which is signed before any production data exchange begins.

Question 4

What does account setup with MedPrecision actually involve for the practice?

Accepted Answer

Account setup requires the practice to provide six items: (1) a signed Business Associate Agreement under HIPAA 45 CFR 164.504(e), (2) practice demographics including NPIs, Tax ID, and rendering provider list, (3) credentialing status for each provider with each contracted payer, (4) read-write API credentials or a dedicated billing-team login for the EHR/PM, (5) ERA/EFT enrollment forms for the top 10 payers by volume, and (6) the prior 90 days of A/R aging report from the legacy biller. MedPrecision assigns a dedicated implementation manager who completes the workflow in a shared project tracker. Total practice time investment is typically 4 to 6 hours across two weeks, concentrated in the credentialing audit and ERA enrollment paperwork. The BAA is the only blocker for accessing PHI under HIPAA, so it is executed first.

Question 5

What does the first 30 days with MedPrecision look like?

Accepted Answer

The first 30 days follow a structured cadence: week 1 is integration and BAA execution, week 2 is parallel billing setup with the first comparison batch, week 3 is full parallel claim submission with daily reconciliation, and week 4 is staged cutover with the legacy biller stepping back. Practices receive three deliverables in the first 30 days: a baseline RCM assessment report benchmarking current performance against MGMA 2024 medians (net collection rate, days in A/R, denial rate, clean claim rate), a payer enrollment status grid showing every contracted payer with ERA/EFT confirmation, and a coding audit covering 50 random encounters from the prior 60 days. Practices typically see clean claim rate improvements within the first 14 days as upstream eligibility and prior authorization gates begin running pre-submission instead of being caught at denial.

Question 6

Will the practice need to change anything in their daily workflow?

Accepted Answer

Front-desk and clinical workflow changes are minimal: providers continue charting in their existing EHR exactly as before, and the front desk continues collecting copays and patient demographics in the same screens. The only workflow change is on the billing side, which the practice is outsourcing. MedPrecision adds three pre-submission gates the practice may notice: real-time eligibility verification before each visit (typically through Availity, Waystar, or Change Healthcare clearinghouse APIs), prior authorization tracking for procedures requiring it under payer policy, and provider-credentialing alerts 90 days before any payer contract expiration. Internal staff time on billing typically drops 60 to 80 percent because charge entry, claim submission, ERA posting, denial work, and patient statements move to MedPrecision. Practices with dedicated in-house billers usually redeploy them to front-desk, intake, or scheduling roles rather than terminating positions.

Question 7

What happens to our existing accounts receivable when we switch?

Accepted Answer

Accounts receivable handling depends on the contract structure: practices choose between (1) MedPrecision working the legacy A/R alongside new claims for a percentage fee on collected dollars, or (2) the outgoing biller continuing to work their existing A/R until aging hits 120 days, then transferring residual balances. MGMA 2024 data shows the median small practice carries 22 to 28 days in A/R, with 8 to 12 percent of total A/R sitting over 90 days at any given time. MedPrecision recommends taking on legacy A/R when the outgoing biller has aged A/R over 90 days exceeding 15 percent of total, since legacy billers rarely work old buckets aggressively once the contract ends. The handoff includes a full A/R audit, a payer-by-payer recovery plan, and weekly recovery reporting until the legacy bucket clears below 5 percent of monthly charges.

Question 8

When will we see measurable revenue improvement?

Accepted Answer

Measurable revenue improvement typically appears in three waves: clean claim rate improves within 14 to 30 days as front-end eligibility and authorization gates take effect, denial rate drops within 60 to 90 days as the denial-management workflow catches CO-16, CO-97, and CO-197 patterns at the source, and net collection rate climbs to MGMA top-quartile (97 percent plus) within 90 to 120 days as aged A/R clears and underpayments are recovered against contracted fee schedules. AAPC and HFMA benchmarking data shows a typical practice transitioning from a generalist biller to a specialty-aligned RCM service captures 4 to 8 percent additional revenue within the first 6 months, primarily from coding accuracy gains, charge capture improvements, and underpayment recovery. MedPrecision reports these metrics monthly with payer-level breakouts so the practice can verify the lift against their own deposits.

Question 9

How does MedPrecision Billing price its services?

Accepted Answer

MedPrecision charges a percentage of collections, typically ranging from 4 percent to 8 percent of net collections, with the exact rate set during the proposal based on monthly claim volume, payer mix, specialty complexity, and required service scope. MGMA 2024 Cost and Revenue benchmarks place the median outsourced billing fee for ambulatory practices at 5 to 7 percent of net collections, with hospital-based and specialty surgical practices typically at 4 to 5 percent and behavioral health, ABA, and DME at the high end of 7 to 9 percent due to authorization burden. Percentage of collections aligns vendor incentives with practice revenue: MedPrecision is only paid on dollars actually collected and posted, not on charges submitted. There are no setup fees, integration fees, or contract minimums for standard onboarding under 4 providers. Custom HL7 interface builds and on-site training carry separately quoted one-time fees.

Question 10

What is included in the MedPrecision Billing percentage fee?

Accepted Answer

The percentage of collections fee covers the full revenue cycle: insurance eligibility verification, prior authorization tracking, charge entry, CPT and ICD-10-CM coding review, claim scrubbing and submission via clearinghouse, ERA and EOB posting, denial management with appeals through level 2, patient statement generation and mailing, patient phone support during business hours, monthly KPI reporting against MGMA benchmarks, and a dedicated account manager. Specifically excluded items, when needed, are billed separately: paper claim postage at cost, certified mail for level 3 appeals, on-site training beyond the included two days, custom HL7 interface development, third-party clearinghouse fees if the practice requires a specific clearinghouse outside the standard stack, and patient collections beyond 120 days when transferred to a third-party agency. The practice retains full control over fee schedules, contracted rates, and any decision to send accounts to outside collections.

Question 11

How does MedPrecision invoice the practice?

Accepted Answer

MedPrecision invoices monthly in arrears on the first business day of each month, calculated as the agreed percentage applied to net collections posted during the prior calendar month. Net collections are defined per HFMA standard as gross payments received from payers and patients, minus refunds issued, minus any duplicate payments cleared. The invoice itemizes payments by payer with reconciliation against the practice bank deposits so the practice can verify every dollar. Standard payment terms are net 15 with payment by ACH; credit card payment is available with a 2.9 percent processing surcharge passed through. MedPrecision does not hold or commingle practice funds: all payer payments deposit directly to the practice bank account, and MedPrecision invoices the practice for services rendered. This separation is a HIPAA and state-banking requirement and protects the practice from any vendor cash-flow risk.

Question 12

What are the standard contract terms with MedPrecision?

Accepted Answer

Standard contracts run on a 12-month initial term with month-to-month renewal afterward, terminable by either party with 60 days written notice. The 60-day window covers the practical handoff period: payer enrollment changes (ERA/EFT redirection) take 30 to 45 days at most major commercial payers under federal HIPAA 837/835 transaction standards, and Medicare ERA enrollment reassignment under CMS-855 typically takes 30 to 60 days. Contracts include a Business Associate Agreement under HIPAA 45 CFR 164.504(e), data ownership clauses confirming all PHI and billing data belong to the practice, a return-of-data clause requiring full export within 15 days of termination, and a non-solicitation clause covering practice staff and patients. There are no penalties for early termination, no automatic price escalators, and no minimum claim volume requirements. Pricing renegotiation occurs only at the 12-month mark or upon major scope change.

Question 13

Are there additional fees beyond the percentage of collections?

Accepted Answer

Standard onboarding under 4 providers carries no additional fees. Five categories of optional or pass-through fees may apply when practice scope requires them: (1) custom HL7 v2.x or FHIR R4 interface development for legacy or non-standard EHR/PM systems, quoted at 4,000 to 12,000 dollars one-time depending on complexity, (2) on-site training beyond the included two days at 1,500 dollars per day plus travel, (3) provider credentialing services beyond initial mapping at 350 to 750 dollars per provider per payer per CAQH-aligned application, (4) third-party collections agency fees when patient balances over 120 days are transferred (typically 25 to 35 percent of recovered dollars charged by the agency, not by MedPrecision), and (5) postage at cost when the practice requires paper claim or appeal submission. All fees are disclosed in the proposal and require written practice approval before MedPrecision incurs them.

Question 14

How does pricing change if our claim volume grows or shrinks?

Accepted Answer

Pricing automatically adjusts because the fee is a percentage of collections: revenue growth or shrinkage flows through proportionally without renegotiation. MedPrecision does not impose minimum monthly fees or volume tiers that penalize seasonal practices, new practices ramping up, or practices reducing scope. For practices growing rapidly (typically over 30 percent year-over-year for two consecutive quarters), MedPrecision proactively offers a percentage reduction at the 12-month renewal, recognizing that fixed costs of running the account stay flat while collections grow. For practices contracting due to provider departure or specialty pivot, the percentage stays the same and the dollar fee shrinks with collections; no clawback or volume penalty applies. New practices in their first 6 months pre-credentialing often pay a discounted introductory rate (typically 1 to 2 percentage points lower) until first full revenue month, recognizing minimal collections during ramp.

Question 15

What are the biggest risks when switching medical billing companies?

Accepted Answer

HFMA transition data identifies four primary risks during a billing company switch: (1) revenue gap during cutover, with practices losing 10 to 20 percent of monthly revenue when no parallel billing period is run, (2) ERA and EFT enrollment lag at major payers (typically 30 to 45 days for commercial, up to 60 days for Medicare under CMS-855R), (3) loss of working knowledge on aged A/R when the outgoing biller stops working accounts, and (4) patient billing confusion when statement formatting and remit-to addresses change. The CMS Medicare Claims Processing Manual chapter 1 specifically addresses provider enrollment timing for ERA reassignment, requiring 30 days minimum. MedPrecision controls these risks through a 2-week parallel billing period, advance ERA/EFT enrollment 30 days before cutover, an A/R audit and recovery plan covering all aging buckets, and patient statement coordination scheduled to issue from one source per billing cycle.

Question 16

How is patient and billing data migrated from the prior biller?

Accepted Answer

Data migration follows HIPAA-compliant transfer protocols defined under 45 CFR 164.502 covering minimum-necessary PHI exchange. The outgoing biller exports five datasets: (1) full patient demographics with insurance plan history per HL7 ADT segment standards, (2) the prior 24 months of charges with CPT, ICD-10-CM, modifiers, and diagnosis pointers, (3) the prior 24 months of payment posting with ERA and check-level detail, (4) open A/R aging with payer, patient responsibility split, and last-touched dates, and (5) any active prior authorizations and credentialing files. Transfer occurs over encrypted sFTP or via direct EHR/PM database export when both sides use the same system. MedPrecision validates every record on import: total charges, total payments, and total open A/R must reconcile to the dollar against the outgoing biller's final report. Discrepancies over 0.5 percent trigger a hold on cutover until resolved.

Question 17

Who handles aged accounts receivable when we switch billers?

Accepted Answer

Two contract structures are available for aged A/R: (1) the outgoing biller continues working their existing A/R until aging reaches 120 days, then transfers residual balances to MedPrecision for last-touch recovery, or (2) MedPrecision assumes A/R from day one for a percentage of collected dollars (typically 12 to 18 percent of recovered amounts on accounts over 90 days, lower on fresher buckets). MGMA 2024 data shows median small practices carry 8 to 12 percent of total A/R over 90 days; practices with weak biller performance often see this above 20 percent. MedPrecision recommends option 2 (full assumption) when the outgoing biller has aged A/R over 90 days exceeding 15 percent of total, since contract-end disengagement on aged buckets is a documented industry pattern. The recovery plan includes payer-specific re-billing, secondary claim filing, underpayment recovery, and patient balance follow-up.

Question 18

How are payers notified of the billing company change?

Accepted Answer

Payer notification involves five concrete actions completed during the parallel billing window before cutover: (1) ERA enrollment forms (ANSI 835 transaction routing) submitted to each payer redirecting electronic remits, (2) EFT enrollment updated under each payer's NACHA-aligned form so direct deposits continue routing to the practice bank account (the bank does not change), (3) Medicare CMS-855R reassignment of benefits filed if the prior biller had a Medicare Provider Transaction Access Number tied to their Tax ID, (4) Medicaid state-by-state ERA re-enrollment per state Medicaid bulletins, and (5) commercial payer portal access transferred via formal practice-administrator approval. The provider's NPI, Tax ID, and contracted fee schedules do not change; only the billing-side ERA endpoint and remit-to address change. Patients see no change to their insurance card, copay, or claims processing on the payer side.

Question 19

How does parallel billing actually work day-to-day?

Accepted Answer

Parallel billing runs for 10 to 14 business days during which both the outgoing biller and MedPrecision capture charges, scrub claims, and submit to payers, but only one source actually transmits each claim. Day-to-day execution: each morning the outgoing biller pulls the prior day's charges and submits as normal, and each afternoon MedPrecision pulls the same charges from the EHR/PM, scrubs them through the new clearinghouse, and produces a comparison report. The comparison covers four metrics per claim: CPT match, charge amount match, modifier accuracy, and payer routing. Discrepancies are reconciled within 24 hours. After 5 consecutive days of greater than 99 percent match rate, MedPrecision begins live submission for newly contracted payers; after 10 days the legacy biller stops submission and MedPrecision becomes the sole source. This protocol has produced zero revenue gap on transitions across more than 200 practices.

Question 20

Will patients notice when we switch billing companies?

Accepted Answer

Patients should notice three concrete changes only: a new remit-to address on statements (the practice bank does not change, but statement processing comes from MedPrecision), a new patient-services phone number for billing questions, and possibly a brief gap in statement issuance (typically one billing cycle) during cutover to avoid duplicate statements from both billers. Insurance cards, copays, claim processing on the payer side, and the practice's clinical operation are unchanged. MedPrecision sends a coordinated patient notification on practice letterhead 14 days before cutover, mailed with the final statement from the outgoing biller. The notification follows TCPA and state debt-collection notification standards, includes the new patient-services contact information, and clarifies that no insurance change has occurred. Patient billing call volume typically drops 30 to 50 percent in the first 60 days after cutover as MedPrecision's pre-billing eligibility checks reduce surprise balance situations.

Question 21

Does MedPrecision Billing sign a HIPAA Business Associate Agreement?

Accepted Answer

Yes. A Business Associate Agreement under HIPAA 45 CFR 164.504(e) is signed before any Protected Health Information (PHI) exchange occurs, including before access credentials are issued for the practice EHR or PM system. The MedPrecision BAA addresses the seven required elements under HHS guidance: permitted uses and disclosures, safeguard requirements, subcontractor flow-down, breach reporting timelines, return or destruction of PHI at termination, audit access for the covered entity, and material breach termination rights. The BAA explicitly limits PHI use to the minimum necessary for billing operations under 45 CFR 164.502(b). MedPrecision does not subcontract PHI access offshore; all billing staff with PHI access are US-based employees under signed individual confidentiality agreements. The BAA template is available for legal review during the proposal stage and accommodates practice-specific addenda for state-level laws stricter than HIPAA (Texas HB 300, California CMIA, New York SHIELD).

Question 22

How does MedPrecision protect Protected Health Information (PHI)?

Accepted Answer

PHI safeguards follow the HIPAA Security Rule under 45 CFR Part 164 Subpart C across three control families. Administrative safeguards include role-based access control with least-privilege provisioning, mandatory annual HIPAA training for all staff with billing access, documented sanction policies for violations, and a designated Privacy Officer per 45 CFR 164.530. Physical safeguards include facility access controls, workstation lock screens after 10 minutes of inactivity, and a clean-desk policy preventing PHI exposure. Technical safeguards include AES-256 encryption for PHI at rest, TLS 1.2 or higher for PHI in transit, multi-factor authentication on all systems handling PHI, audit logging on every PHI access event with 6-year retention per 45 CFR 164.316, and quarterly access reviews. All PHI is processed inside a HIPAA-aligned production environment; no PHI flows through email, consumer messaging, or unencrypted file shares.

Question 23

What is MedPrecision's breach notification process?

Accepted Answer

Breach response follows HIPAA Breach Notification Rule timing under 45 CFR 164.410: any suspected breach involving practice PHI triggers a written notice to the covered entity within 60 calendar days of discovery, with practical communication to the practice Privacy Officer initiated within 24 hours of detection. The breach process has four stages: (1) immediate containment within 24 hours including credential rotation and isolation of affected systems, (2) forensic assessment within 72 hours to determine scope, root cause, and PHI exposure (using the four-factor risk analysis from 45 CFR 164.402), (3) practice notification with full incident report and remediation plan, and (4) regulatory and individual notification support per HHS Breach Reporting requirements when the breach exceeds the low-probability-of-compromise threshold. MedPrecision carries cyber liability insurance with coverage for forensic, notification, and credit monitoring costs in the event of a breach involving practice PHI.

Question 24

Is MedPrecision SOC 2 Type II certified?

Accepted Answer

MedPrecision operates under the AICPA SOC 2 Trust Services Criteria covering security, availability, confidentiality, and privacy, with a SOC 2 Type II audit report available under NDA to qualifying enterprise clients (practices over 10 providers and hospital-employed physician groups). The audit covers a 12-month observation window with continuous monitoring across access management, change management, incident response, vendor management, and data-handling controls. For smaller practices not requesting the full SOC 2 report, MedPrecision provides a HIPAA Risk Analysis summary mapped to the same controls under 45 CFR 164.308(a)(1)(ii)(A). Beyond SOC 2 and HIPAA, MedPrecision maintains compliance with PCI DSS for any patient card-on-file processing (typically Level 4 merchant scope), and follows NIST Cybersecurity Framework controls for security operations. SOC 2 reports are reissued annually; the most recent report covers the calendar year ending December 2025.

Question 25

How is PHI encrypted in transit and at rest?

Accepted Answer

Encryption follows NIST SP 800-111 (storage) and NIST SP 800-52 Rev 2 (transport) standards, exceeding HIPAA Security Rule encryption guidance under 45 CFR 164.312(a)(2)(iv) and 164.312(e)(2)(ii). Data at rest uses AES-256 encryption on all production databases, application servers, and backup volumes; encryption keys are managed in a FIPS 140-2 validated key management service with key rotation every 90 days. Data in transit uses TLS 1.2 or higher for all external connections and mutual TLS for clearinghouse and EHR API connections; SSH connections use Ed25519 or RSA-4096 keys. Endpoints (laptops, workstations) use full-disk encryption (FileVault on macOS, BitLocker on Windows) and are managed through MDM with remote wipe capability. ANSI X12 837 claim files and 835 ERA files transmitted over EDI are encrypted via AS2 with X.509 certificates per the trading-partner agreement with each clearinghouse and direct-submission payer.

Question 26

What HIPAA training do MedPrecision employees receive?

Accepted Answer

All employees with PHI access complete documented HIPAA training within 30 days of hire and annually thereafter, satisfying 45 CFR 164.530(b)(1) workforce training requirements. The curriculum covers six modules: Privacy Rule fundamentals (45 CFR Part 164 Subpart E), Security Rule controls (Subpart C), Breach Notification Rule (Subpart D), the minimum-necessary standard, role-based PHI access policies, and incident reporting procedures. Specialty roles receive additional training: billing staff complete a 4-hour module on payer-specific PHI handling, IT staff complete the HHS HIPAA Security Series modules covering technical safeguards, and the Privacy Officer maintains AAPC, AHIMA, or HCCA HIPAA-specialized certification. Training completion is documented per employee with quiz score (80 percent passing required), retained for 6 years per HIPAA documentation requirements. Sanction policy includes documented warnings, suspension, and termination paths for violations, applied uniformly under 45 CFR 164.530(e).

Question 27

Does MedPrecision use offshore staff for billing work?

Accepted Answer

MedPrecision's billing operations team handling US claims is US-based; PHI access for charge entry, coding review, denial management, payer phone work, and patient phone support is restricted to US employees under direct W-2 employment with signed individual confidentiality agreements layered on top of the HIPAA BAA. This is a deliberate operational decision driven by three factors: (1) HIPAA does not prohibit offshore PHI access if a BAA flows down properly, but state laws in Texas (HB 300), California (CMIA), and several others impose stricter offshore disclosure rules that complicate compliance for multi-state practices, (2) payer phone navigation and appeals work requires fluent US-payer-system literacy that produces measurably better recovery rates, and (3) practice clients consistently request US-based staff during proposal stage. Non-PHI engineering, infrastructure, and product work may involve offshore contributors, but production PHI never crosses the US border.

Question 28

Which EHR and practice management systems does MedPrecision support?

Accepted Answer

MedPrecision supports the EHR and PM systems covering the majority of US ambulatory volume per the ONC 2024 Health IT Certification report: eClinicalWorks, Athenahealth (athenaPractice and athenaOne), AdvancedMD, Kareo (Tebra), NextGen Healthcare, DrChrono, Practice Fusion, ChartLogic, ModMed (Modernizing Medicine), NueMD, CareCloud, CollaborateMD, Greenway Intergy, Allscripts Professional, and Epic Community Connect. Specialty platforms include WebPT and Heno (physical therapy), TheraNest and SimplePractice (mental health), CentralReach (ABA), Brightree (DME), and PCC (pediatrics). Hospital-side integration covers Epic, Cerner Oracle Health, MEDITECH, and CPSI through HL7 v2.x interfaces. Each integration is mapped to four core data flows: ADT demographics push, charges and coding pull, ERA and payment posting back to the PM, and patient statement coordination. Practices on systems not on this list receive a 2 to 3 week custom HL7 or sFTP build at separately quoted scope.

Question 29

How long does an EHR integration take to set up?

Accepted Answer

Integration timelines vary by system architecture: standard API integrations with Athenahealth, Kareo (Tebra), AdvancedMD, eClinicalWorks v11+, DrChrono, and CareCloud complete in 5 to 7 business days using documented partner APIs. HL7 v2.x interfaces with hospital systems and older EHR builds (NextGen, Allscripts, Greenway) take 10 to 14 business days due to interface engine configuration and bidirectional message testing. Custom sFTP-based batch integrations for legacy or non-standard systems take 2 to 3 weeks including secure file transfer setup, mapping document approval, and three rounds of test-file reconciliation. FHIR R4 integrations with Epic Community Connect and Cerner Oracle Health take 3 to 4 weeks due to OAuth 2.0 SMART-on-FHIR client registration with the host hospital IT department. All timelines run in parallel with payer enrollment and BAA execution, so the integration is rarely the critical path on the overall 2 to 4 week onboarding window.

Question 30

Can MedPrecision build a custom HL7 or FHIR interface for our system?

Accepted Answer

Yes. Custom interfaces are built when the practice uses a system without an existing MedPrecision integration or requires non-standard data flows. HL7 v2.x interfaces use the X12N-aligned message types most relevant to billing: ADT-A04 (patient registration), ADT-A08 (patient update), DFT-P03 (charge transmission), and ACK acknowledgments per the HL7 2.5.1 standard. FHIR R4 interfaces use the resources defined in the US Core Implementation Guide v6.1.0: Patient, Encounter, Procedure, Condition, Coverage, and Claim. Build process includes a mapping document deliverable signed by both sides, a sandbox phase running test files against the practice's QA environment, and a production cutover with reconciliation against the first week of live data. Quoted cost ranges from 4,000 dollars (simple HL7 file pull) to 12,000 dollars (full bidirectional FHIR with custom extensions). Interface ownership and source code remain with MedPrecision; the practice receives full mapping documentation.

Question 31

Does MedPrecision support legacy or older EHR systems?

Accepted Answer

Yes. MedPrecision regularly integrates with legacy systems still in production at established practices, including older versions of NextGen, Allscripts Professional, Greenway PrimeSUITE, Misys (now Allscripts), and proprietary in-house systems built on FoxPro, Access, or older SQL Server schemas. Legacy integration uses one of three patterns based on what the system exposes: (1) HL7 v2.3 or v2.4 over MLLP (Minimal Lower Layer Protocol) when an interface engine is present, (2) sFTP-based batch file exchange with twice-daily charge file pulls when no real-time interface exists, or (3) read-only database access with a dedicated MedPrecision service account when the system supports ODBC connections. Legacy integrations carry no premium pricing and follow the same security controls as modern API integrations including TLS in transit, AES-256 at rest, and audit logging per HIPAA Security Rule 45 CFR 164.312(b).

Question 32

Who owns the integration credentials and data after onboarding?

Accepted Answer

The practice owns all credentials and data at all times. MedPrecision operates under role-based service accounts created within the practice's EHR/PM system using the practice's administrator privileges; the practice retains the master account, can disable MedPrecision access at any time, and can rotate credentials without notice. All clinical data, billing data, demographics, charges, and payment posting history remain in systems controlled by the practice. The BAA includes a return-of-data clause requiring MedPrecision to deliver a complete data export within 15 calendar days of contract termination, in CSV or JSON format aligned to the PM system schema. Custom interfaces built by MedPrecision are documented in mapping documents the practice receives at go-live; if the practice transitions to another biller, those mapping documents transfer with the practice and reduce the new vendor's integration time substantially.

Question 33

What data flows between MedPrecision and our EHR each day?

Accepted Answer

Four core data flows run daily: (1) demographics push at the start of each business day pulls newly registered or updated patients from the EHR ADT feed, validating insurance eligibility through the clearinghouse before the visit, (2) charge capture pull at end-of-day collects all encounters with CPT, ICD-10-CM, modifiers, and rendering provider data, (3) ERA and payment posting back to the PM occurs continuously throughout the day as 835 transaction files arrive from clearinghouses (typically every 30 to 60 minutes during business hours), and (4) patient statement coordination runs nightly to flag balances ready for statement issuance based on statement-cycle rules per payer mix. Additional periodic flows include monthly fee schedule sync, quarterly provider credentialing status updates, and annual code-set updates aligned to CMS HCPCS Level II and AMA CPT changes. All transfers are encrypted, logged, and reconcilable to the dollar.

Question 34

What net collection rate should a practice expect with MedPrecision?

Accepted Answer

MedPrecision targets a net collection rate of 97 percent or higher within 90 to 120 days of full takeover, aligning with the MGMA 2024 DataDive top-quartile benchmark for ambulatory practices. Net collection rate is calculated per HFMA standard formula: (payments received minus refunds) divided by (charges minus contractual adjustments and approved write-offs). The 97 percent threshold separates well-run revenue cycles from those leaving money on the table; the MGMA 2024 median for all reporting practices is 94.6 percent, and bottom-quartile performance is 89 percent or lower. The 3 to 5 percentage point gap between median and top-quartile typically equals 30,000 to 60,000 dollars per provider per year for primary care and 50,000 to 120,000 dollars per provider per year for specialty care. Practices entering MedPrecision below the 90 percent threshold typically see 5 to 8 point improvement in the first 6 months.

Question 35

What denial rate should a healthy practice see?

Accepted Answer

MedPrecision targets a first-pass denial rate below 5 percent, against the AAPC 2024 industry median of 9 to 11 percent and MGMA top-quartile of 4 percent or lower. Denial rate is calculated as denied claims divided by total claims submitted, measured on a 30-day rolling window. The most common denial reason codes (CARC) tracked include CO-16 (missing information), CO-97 (procedure not paid separately), CO-197 (precertification absent), CO-29 (timely filing), and CO-50 (non-covered service); these five codes account for over 60 percent of denials in MGMA 2024 specialty data. MedPrecision's denial-prevention workflow runs four upstream gates before submission: real-time eligibility verification via clearinghouse 270/271 transactions, prior authorization tracking against payer policy databases, NCCI edit checks against quarterly CMS NCCI Procedure-to-Procedure tables, and modifier validation against AMA CPT 2026 guidance. Denials that do occur trigger a 14-day appeal window with documented appeal letter templates per payer.

Question 36

What is days in A/R and what should the number be?

Accepted Answer

Days in A/R measures how long a dollar of charges sits in accounts receivable before collection, calculated per HFMA formula: (total accounts receivable / average daily charge volume over the trailing 90 days). MGMA 2024 DataDive places the median for primary care at 28 days, specialty care at 32 days, and surgical specialties at 38 to 45 days. MedPrecision targets the MGMA top-quartile thresholds: 22 days for primary care, 26 days for medical specialties, and 32 days for surgical specialties. Days in A/R is the single most actionable KPI for cash flow because each day reduced equals one day of additional working capital. The percentage of A/R over 90 days is the partner metric: top-quartile is 8 percent or lower, median is 12 percent, and bottom-quartile is 22 percent or higher. MedPrecision reports both metrics monthly with trend lines and payer-level breakouts so the practice sees exactly where aging accumulates.

Question 37

What clean claim rate is achievable with proper billing?

Accepted Answer

Clean claim rate measures the percentage of claims accepted by the payer on first submission without rejection, edit, or denial. MedPrecision targets 95 percent or higher, against the HFMA 2024 industry median of 88 percent and the MGMA top-quartile threshold of 95 percent. Clean claim rate is calculated as (accepted on first submission) divided by (total claims submitted), measured at the clearinghouse acceptance event before payer adjudication. The 7 percentage point gap between median and top-quartile compounds: every 1 percent improvement reduces rework labor by approximately 4 to 6 hours per 100 claims and accelerates payment by 5 to 9 days on average per HFMA timing studies. MedPrecision drives clean claim rate through pre-submission scrubbing against four edit sets: clearinghouse syntactic edits (837 X12 standard), payer-specific edits (LCD and NCD coverage), CMS NCCI edits, and AMA CPT modifier rules. Most rejections caught pre-submission resolve within 2 hours.

Question 38

How does MedPrecision benchmark our performance against industry data?

Accepted Answer

MedPrecision benchmarks against three primary industry datasets in monthly reporting: MGMA 2024 DataDive Cost and Revenue (separating ambulatory primary care, medical specialty, and surgical specialty), HFMA MAP Keys (the 25-metric revenue cycle benchmark set), and AAPC's annual coding and denial benchmarks for specialty-specific accuracy. Each monthly KPI report shows the practice's current value, the MGMA median for the practice's specialty, the MGMA top-quartile threshold, and a trend line for the prior 12 months. Benchmarks are filtered by specialty and geography where data permits (MGMA reports separate Northeast, Midwest, South, and West medians for some metrics). Practices receive an annual deep-dive review against AMA CPT specialty benchmark data and CMS Physician Fee Schedule comparison showing reimbursement-per-RVU performance. This benchmark transparency lets the practice see exactly where they stand and where the next dollar of improvement lives.

Question 39

How much additional revenue does a typical practice capture by switching to MedPrecision?

Accepted Answer

AAPC and HFMA benchmarking data shows a typical practice transitioning from a generalist biller to a specialty-aligned RCM service captures 4 to 8 percent additional revenue within the first 6 months, with the median lift around 6 percent. The lift breaks down across four sources per the HFMA 2024 RCM Performance Study: coding accuracy gains (1 to 3 percent, often from underutilized E/M levels and missed modifiers), charge capture improvements (1 to 2 percent, from procedures completed but not billed), denial recovery (1 to 2 percent, from systematic appeal of recoverable denials), and underpayment recovery (0.5 to 1 percent, from contracted-rate enforcement against payer payments). For a 5-provider primary care practice billing 4 million dollars annually, a 6 percent lift equals 240,000 dollars per year in additional collections. The lift typically more than offsets the percentage-of-collections fee, producing net positive ROI within the first 90 days post-cutover.

Question 40

Which medical specialties does MedPrecision handle?

Accepted Answer

MedPrecision handles billing for over 30 specialties, structured into seven specialty teams: primary care (family medicine, internal medicine, pediatrics), behavioral health (mental health, ABA, addiction medicine), surgical (orthopedic, general surgery, plastic surgery, ophthalmology, ENT), procedural (cardiology, gastroenterology, dermatology, urology, pain management), physical and occupational therapy, women's health (OB-GYN, fertility), and specialty practice (urgent care, hospitalist, anesthesia, radiology, pathology, DME, home health). Each specialty team is staffed with coders holding AAPC CPC or AHIMA CCS-P certifications plus specialty-specific credentials where applicable: CPC-A with specialty experience, CIRCC for cardiology, CASCC for ambulatory surgery, COBGC for OB-GYN, and CHONC for hematology-oncology. Specialty depth matters because CPT 2026 contains over 11,000 codes and CMS 2025 NCCI edits reach 750,000+ procedure pairs; generalist billers cannot maintain accuracy across all specialty code families simultaneously.

Question 41

What makes specialty billing different from general medical billing?

Accepted Answer

Specialty billing differs from general billing across five technical dimensions: (1) specialty CPT code families with narrow application (CPT 90832-90838 for psychotherapy, 97161-97164 for PT evaluation, 99202-99215 for E/M with specialty-specific level documentation), (2) specialty modifiers (modifier 25 for separately identifiable E/M, GP/GO/GN for therapy disciplines, modifier 59 for distinct procedural service, X-modifiers replacing 59 for Medicare), (3) specialty-specific NCCI edits and Medically Unlikely Edits (MUE) capping units per code per day, (4) specialty payer policies (mental health parity under MHPAEA, ABA medical-necessity LCDs, PT plan-of-care recertification per CMS Pub 100-02 chapter 15), and (5) specialty fee schedule differences (CMS conversion factor applies but specialty RVUs vary by specialty per the AMA RUC). A generalist coder making a 2 percent error rate across these five dimensions produces measurably worse net collections than a specialty-trained coder.

Question 42

How is a MedPrecision specialty team structured?

Accepted Answer

Specialty teams operate under a pod structure: each pod is led by a specialty Senior Coder (AAPC CPC plus specialty credential, 5+ years specialty experience), staffed with 2 to 4 specialty Coders, supported by a dedicated denial-management specialist and an A/R follow-up specialist trained in specialty payer policy. Pod size scales with assigned practice volume: a single pod handles 8 to 12 small specialty practices or 2 to 4 large multi-provider specialty groups. Pod composition is held constant for each practice client (practices do not rotate through random staff), which produces measurable benefits: clean claim rate improves an additional 2 to 3 points after the first 90 days as the pod learns the practice's documentation patterns. Pods report through a Director of Specialty Operations who maintains weekly variance reviews against MGMA specialty-specific benchmarks and the HFMA MAP Keys metric set.

Question 43

Does MedPrecision handle highly specialized billing like ABA, DME, or anesthesia?

Accepted Answer

Yes. ABA (Applied Behavior Analysis) billing is handled by a dedicated team trained in CPT codes 97151-97158 and 0362T/0373T, with concurrent-session billing rules per the BACB 2024 guidance and state-Medicaid LCD variations across all 50 states. DME (Durable Medical Equipment) billing is handled by a team trained in HCPCS Level II codes, CMS Pricing, Data Analysis, and Coding (PDAC) certification verification, KX modifier documentation, and the CMS DME MAC jurisdiction structure (Noridian for A and D, CGS for B and C). Anesthesia billing is handled by a team trained in time-based units, ASA Relative Value Guide, modifier QK/QY/QX/QZ for medical direction, and the AMA CPT 00100-01999 series. Each specialty has its own documented payer-policy library, modifier reference, and denial-prevention checklist updated quarterly against AMA CPT changes, CMS NCCI updates, and major commercial payer policy bulletins.

Question 44

Can MedPrecision handle multiple specialties under one practice?

Accepted Answer

Yes. Multispecialty group practices are handled by assigning the practice to multiple specialty pods coordinated by a single dedicated Account Manager, so the practice has one point of contact while each specialty's claims route to the appropriate pod. This structure matters because multispecialty groups face two specialty risks generalist billers fail at: (1) cross-specialty E/M level inconsistency (a general internist and a cardiology consult on the same patient must document and bill at different levels under AMA CPT 2026 E/M guidelines), and (2) NCCI bundle conflicts when two specialties bill on the same day for the same patient (modifier 25 and 59 application varies by specialty pair per CMS NCCI Policy Manual chapter 1). The Account Manager runs weekly variance reviews across pods to catch cross-specialty patterns. Pricing for multispecialty groups uses a blended percentage reflecting the weighted complexity of each specialty's volume.

Question 45

How does MedPrecision keep up with specialty coding changes each year?

Accepted Answer

Specialty coding stays current through five quarterly update cycles aligned to authoritative source releases: (1) AMA CPT annual update each January with new, revised, and deleted codes, (2) CMS NCCI Procedure-to-Procedure and Medically Unlikely Edits quarterly updates (January, April, July, October), (3) CMS HCPCS Level II quarterly updates, (4) CMS Physician Fee Schedule annual update each January with conversion factor and RVU changes, and (5) ICD-10-CM annual update each October from CDC NCHS. Each specialty pod completes mandatory continuing education aligned to AAPC CEU requirements (36 CEUs every 2 years) plus internal specialty-specific quarterly training. Major specialty changes (E/M overhaul in 2021, telehealth permanent rules in CY2024 PFS, behavioral health expansion in 2024 to 2026) trigger documented training programs with assessment before applying to client claims. Practices receive a specialty-coding-update bulletin each January summarizing what changed and what it means.

Question 46

How does MedPrecision serve solo and small practices (1 to 3 providers)?

Accepted Answer

Solo and small practices (1 to 3 providers) are served by a 2-person service team: one dedicated specialty-trained Coder/Biller handling daily charge entry, claim submission, and ERA posting, plus a shared Account Manager covering 8 to 12 similar-sized practices for monthly KPI review and escalations. Pricing typically falls in the 6 to 8 percent of net collections range reflecting the proportionally higher per-claim service cost at lower volume. Reporting includes monthly KPI dashboards benchmarked against MGMA 2024 small-practice medians (28 days in A/R, 94 percent net collection rate, 12 percent A/R over 90 days) plus weekly written status notes during the first 90 days of onboarding. Solo practices benefit disproportionately from outsourcing because billing labor at 1 to 3 providers rarely justifies a dedicated W-2 biller; MGMA data shows solo practices with in-house billing run net collection rates 3 to 5 points below outsourced peers.

Question 47

How does MedPrecision serve group practices (4 to 20 providers)?

Accepted Answer

Group practices (4 to 20 providers) are served by a 3 to 5-person dedicated pod: a specialty Senior Coder, 2 to 3 Coder/Billers, a dedicated denial-management specialist, and a dedicated Account Manager (not shared). Pricing typically falls in the 5 to 7 percent of net collections range, reflecting volume economies on per-claim labor. Reporting depth expands to weekly KPI dashboards, provider-level performance breakouts (RVU production, charge lag, denial rate per provider), and monthly executive reviews with the practice administrator. Group practices receive specialty-specific reporting when the group spans multiple specialties (multispecialty group practices route claims to multiple specialty pods coordinated by the Account Manager). MGMA 2024 data places median group practices at 26 days in A/R and 95 percent net collection rate; MedPrecision targets 22 days and 97 percent for clients in this segment within 120 days of cutover.

Question 48

How does MedPrecision serve large multi-site groups (21+ providers)?

Accepted Answer

Large multi-site groups are served by an enterprise pod model: 6 to 12 dedicated billing staff structured by site, specialty, or function (charge entry, denial management, A/R follow-up, payer-specific specialists for major contracts) plus a Director of Account Operations (not shared) and an executive sponsor for quarterly business reviews. Pricing typically falls in the 4 to 5.5 percent of net collections range. Enterprise reporting includes daily operational dashboards, weekly variance reports against budget, monthly multi-site rollups with site-level and specialty-level drill-downs, and quarterly executive reviews benchmarking against MGMA specialty-and-size-matched peers and the HFMA MAP Keys metric set. Enterprise clients also receive a dedicated implementation manager for site rollouts, custom HL7 or FHIR interface support for the typical multi-site EHR architecture, and a SOC 2 Type II report on demand. Onboarding for enterprise groups typically runs 6 to 8 weeks rather than the standard 2 to 4.

Question 49

Are dedicated teams really dedicated, or shared across many practices?

Accepted Answer

Team dedication scales with practice size: solo and small practices (1 to 3 providers) share an Account Manager across 8 to 12 similar-sized clients but receive a dedicated Coder/Biller for daily work; group practices (4 to 20 providers) receive a fully dedicated 3 to 5-person pod with no shared resources at the operational level; and enterprise groups (21+ providers) receive a fully dedicated pod plus a dedicated Director of Account Operations. Dedication matters because billing accuracy improves measurably as the team learns the practice's documentation patterns, payer mix, and provider-specific habits: clean claim rate typically improves an additional 2 to 3 points in the second 90 days for clients with stable dedicated teams. MedPrecision's contract specifies team continuity: any planned staff change (vacation coverage, role transition) is communicated to the practice in advance, and replacement staff complete a documented 30-day shadow before primary responsibility transfers.

Question 50

Does pricing differ for hospital-employed physician groups?

Accepted Answer

Yes. Hospital-employed physician groups and faculty-practice plans typically receive enterprise-tier pricing in the 3.5 to 5 percent of net collections range, reflecting both higher claim volume and higher complexity from professional-component billing alongside hospital facility charges. Hospital-employed groups have specific billing requirements MedPrecision handles: (1) split/shared visit rules under CMS PFS 2024 final rule for inpatient and outpatient encounters, (2) place-of-service code accuracy across POS 22 (outpatient hospital), POS 23 (emergency department), and POS 31 (skilled nursing), (3) modifier 26 (professional component) and TC (technical component) correct application, and (4) CMS Stark and Anti-Kickback compliance reporting for the practice's compliance officer. Reporting includes physician-level wRVU production for compensation calculation, payer-mix analysis for contract negotiation, and quality measure performance feeding into MIPS and ACO reporting under CMS QPP.

Question 51

How does reporting depth differ across practice sizes?

Accepted Answer

Reporting scales with practice size across four dimensions. Solo and small practices receive monthly KPI dashboards benchmarked against MGMA 2024 small-practice medians, plus quarterly business reviews. Group practices receive weekly KPI dashboards, monthly executive reviews with provider-level breakouts, and quarterly business reviews including MGMA specialty-and-size-matched comparisons. Enterprise groups receive daily operational dashboards, weekly variance reports against budget, monthly multi-site rollups, and quarterly executive reviews aligned to HFMA MAP Keys. All practice tiers have access to an on-demand reporting portal showing real-time A/R aging, denial trends by CARC code, payer payment lag, and clean claim rate. Custom reporting for specialty-specific needs (RVU production for compensation calculations, payer-mix analysis for contract negotiations, CMS quality-measure rollups for MIPS reporting) is available across all tiers; complexity of custom reporting drives whether it is included in the base fee or quoted separately.

MedPrecision Billing Help Center

What is the MedPrecision Help Center?

All 8 topics

Getting Started with MedPrecision Billing

Pricing, Contracts, and Invoicing

Switching from a Current Biller

HIPAA, Compliance, and Data Security

EHR and Software Integrations

Performance, KPIs, and Benchmarks

Specialty-Specific Billing

For Different Practice Sizes

The questions practice owners ask first.