Texas practices have hundreds of billing companies to choose from. The right one is a force multiplier; the wrong one is a slow bleed. Use the framework below to separate the two.
Specialty match is non-negotiable
A firm that bills for primary care but none of their coders are CPC-certified for mental health will cost you 10% of your mental-health revenue in denials. Ask for specialty-specific case studies.
Transparency on reporting
You should see every KPI — first-pass acceptance, denial rate, A-R aging buckets, days in A-R, collection rate — in a dashboard that updates daily. If the firm sends monthly PDFs, keep looking.
Pricing models, explained honestly
Percentage-of-collections is most common (typically 4–8%). Flat per-claim pricing works for high-volume, low-balance practices. Hybrid models are a red flag unless carefully explained.
People, not just software
A named account team that knows your practice beats any “AI-first” pitch. Ask who will work your claims, how often you will meet, and what happens when your rep goes on vacation.
Questions to ask on the sales call
What is your first-pass acceptance rate across the book? How quickly do you work denials? Will you share payer-by-payer contract analysis? Who owns my data if I leave?