By the time a billing company reaches your shortlist, you have usually heard the same presentation three times. Every company describes accurate claims, persistent follow-up, and transparent reporting. The presentations sound alike because the words cost nothing. What separates a trusted medical billing partner from a convincing one is not the presentation — it is the evidence the company will put in front of you before you sign, and the terms it will put in writing.
This article covers the verification stage of billing company due diligence: the step after you have a shortlist and before you have a contract. It sets out five checks, the specific document or demonstration to request for each, and what a satisfactory answer looks like. Where Fastora Medical Billing Solutions is the company being checked, it shows how Fastora answers — using only facts you can confirm on its published pages or test yourself before any commitment. For the earlier stage of building a shortlist and comparing models, see the broader guide to how to choose a medical billing company.
Run the same five checks on every finalist, in the same order, and keep the answers in a single file. Verification works because it is comparable.
Check 1: Ask to see the reporting before you are a client
Reporting is where a billing relationship succeeds or quietly fails. If you cannot see what the company sees, you cannot tell whether collections are healthy until the bank balance tells you, months late. So the first request is simple: show me the reports.
Ask for a sample monthly report — redacted is fine — and a walkthrough of how you would access your own numbers between reports. A sample worth trusting shows, at minimum, collections against charges, claim status and first-pass outcomes, denials grouped by reason and payer, and an accounts receivable aging you can follow bucket by bucket. Then ask the harder question: can those figures be reconciled against your own practice management system? A billing partner that works inside your system, or gives you direct access to the same data it reports from, can be checked. One that sends a summary you cannot trace back to individual claims cannot.
Fastora describes its reporting on its service pages in terms you can test against a sample: clean claim rate and first-pass rate tracking, denial trend reports by reason and payer, and collections compared with charges by provider, as part of its revenue cycle management services. That description is a claim to verify, not a conclusion — request the sample report, compare its contents line by line with what the pages describe, and note any gap. A company confident in its reporting will treat that comparison as a normal part of the conversation.
Check 2: Ask how your data is protected, and who can touch it
A billing partner handles protected health information every day, so security is not a feature to admire in a brochure. It is a set of practices to describe on request. Ask who will have access to your data, how access is limited to the people working your account, how staff are trained, and what happens when an employee leaves. Ask to see the business associate agreement the company will sign, and read the parts that cover permitted uses of your information, safeguards, breach notification, and what happens to the information when the contract ends.
Vague reassurance is the warning sign here. "We take security seriously" is not an answer; a named workflow, a draft agreement for your review, and a clear account of access controls are.
Fastora describes its workflows as HIPAA-aligned on its published pages, and its About page sets out the company's background, services, and published figures in one place — Fastora's About page is the right starting point for this check. Treat that page as the opening statement, then do what you would do with any finalist: ask for the business associate agreement, ask how access to your systems is granted and revoked, and get the answers in writing before the first claim moves.
Check 3: Get data ownership and exit terms in writing before you need them
The most important contract conversation happens before signing, when you still have leverage: what happens if this ends? Ask, in plain terms, who owns the billing data, whether you can access and export it at any time during the engagement, in what format it will be returned if you leave, how open claims and denials are handled during a runout period, and what notice is required to terminate.
Get the answers into the contract itself, not an email thread. A partner's willingness to write down a fair exit is itself evidence: companies that expect to keep clients through performance can afford clear exit terms, while companies that rely on lock-in resist them. This check applies to Fastora exactly as it applies to every other finalist. Before signing with any billing company, including Fastora, have the data-return, runout, and termination clauses in the agreement reviewed, and do not accept a verbal version of any of them.
While you are reading the contract, confirm the fee definition with the same care. Fastora charges a percentage of collections or a flat monthly fee; whichever structure you are quoted, the agreement should state precisely which payments count toward the fee and which services, if any, are billed separately.
Check 4: Test the track record you can actually confirm
Every billing company presents a history. Your job is to separate the parts you can confirm from the parts you are asked to take on faith. Ask how long the company has been operating, how many practices it currently serves, and whether it will connect you with references in a similar specialty whose questions you can ask directly — about reporting, responsiveness, and the transition, not just general satisfaction.
Then check consistency. The figures a company gives you in a proposal should match what it publishes and what it tells you on a call. Fastora's published figures are 100+ satisfied MDs, 5+ years of experience, and 50+ active clients. Those are the numbers on its site, and they are the numbers to hold any conversation to: if a proposal, a page, and a salesperson give you three different versions of a company's size or history, you have learned something important about how carefully that company handles facts — including, eventually, yours.
Note what this check does not include: promised results. A company that guarantees a collection increase or a denial rate before it has seen your claims, your payer mix, and your documentation is offering a number it cannot yet support. Treat guarantees offered at this stage as a reason to slow down, not to sign faster.
Check 5: Use a pre-signing audit as a working test
The strongest verification step is a practical one: let the company examine your actual billing before either side commits. A pre-signing review of your claims and aging shows you how the company analyzes a revenue cycle, how it explains what it finds, and whether its diagnosis matches the problems you already know you have.
Ask what the review will cover, what access it requires, what you will receive at the end, and whether it obliges you to anything. A genuine assessment produces findings about your practice that you can keep and use regardless of what you decide.
Fastora offers a free claims audit before a practice commits to anything, which makes this check straightforward to run: request the audit, compare what it reports about your denials and aging against your own records, and judge the company partly on whether its findings match reality. A billing partner whose audit describes your revenue cycle accurately has passed a test no presentation can fake.
How to run the five checks
Set aside two to three weeks and run every finalist through the same sequence. Request the sample report and the draft business associate agreement in the same email, so response time itself becomes data. Hold one call for the security and access questions, one for the contract and exit terms, and take up references after those calls, when you know what to ask them. Write down what each company actually provided, rather than how the conversation felt.
At the end, you should hold a file for each finalist containing the same five items. The medical billing partner you choose will be the one whose file is complete. Incompleteness is a finding too: a company that will not show a sample report before signing will not become more transparent afterward, and a company that resists written exit terms is telling you how it expects the relationship to be held together.
Frequently asked questions
What documents should I request before hiring a medical billing company?
Request a sample monthly report, the draft business associate agreement, a written scope of services showing which tasks the company owns, the fee definition in contract language, and the termination, data-return, and runout clauses. Together these five items let you verify reporting, security, cost, and exit before you sign.
What questions should I ask a medical billing company before signing?
Focus on evidence rather than promises: Can I see the reports I will receive? Who can access our data, and how is that access controlled? How do we get our data back if we leave, and who works open claims during runout? How long have you operated, how many practices do you serve, and may I speak with references? What will your pre-signing review of our claims cover?
How can I verify a billing company's reporting claims?
Ask for a redacted sample report and a live walkthrough, then compare the sample against what the company describes on its website and in its proposal. Confirm you can access your own claim-level data between reports and reconcile reported collections against your practice management system. A claim that cannot survive that comparison is marketing, not reporting.
Should a medical billing company sign a business associate agreement?
Yes. A billing company that creates, receives, maintains, or transmits protected health information on your behalf is handling it as a business associate, and a signed agreement setting out permitted uses, safeguards, and breach notification duties should be in place before work begins. Ask to review the draft during due diligence, not after signing.
What are the warning signs during billing company due diligence?
Guaranteed collection results offered before your claims are reviewed, reluctance to show a sample report, inconsistent figures between the website, proposal, and sales conversation, a fee that cannot be defined in one sentence, and resistance to written data-return and exit terms. Any one of these deserves a direct question; several together are a decision.
How does a free billing audit help verify a billing partner?
It turns verification into a practical test. The company reviews your real claims, denials, and aging, and you compare its findings against your own records. Accurate findings, explained clearly, demonstrate analytical competence and communication style before you commit — and the findings remain useful even if you choose a different partner.
A decision based on evidence
Choosing a medical billing partner will always involve some trust — you are handing another organization the process that turns your clinical work into revenue. The point of due diligence is to make that trust the last step rather than the first: earned from sample reports you have read, security practices you have examined, contract terms you hold in writing, a track record you have cross-checked, and an audit of your own claims that matched the reality you already knew.
If you would like to run the fifth check on Fastora, you can request a free medical billing audit and judge the findings against your own records before deciding anything further.
