What to Look for in a Medical Billing Company in 2025

With all these demands, many healthcare practices are turning to medical billing companies to streamline operations and maximize reimbursement.

But not all billing companies are the same. Choosing the right partner can make a significant difference in your practice’s efficiency and bottom line. Here's a comprehensive guide to what providers should look for when selecting a medical billing company in 2025.

1. Proven Experience in Your Specialty

Different medical specialties face unique billing challenges. Whether it’s navigating bundled payments in orthopedics or coding complexities in behavioral health, your billing company should have hands-on experience with your specific field.

Questions to ask:

Do you currently work with other [specialty] practices?

What are common billing pitfalls in this specialty, and how do you avoid them?

Example: A company like UMBSBillingServices.com advertises its multi-specialty expertise, including internal medicine, pediatrics, and urgent care.

2. Up-to-Date Compliance and Coding Knowledge

Medical billing is closely tied to regulatory compliance. As of 2025, HIPAA rules, ICD-11 updates, and payer-specific policies are more complex than ever. Your billing partner must:

Employ certified coders (CPC, CCS)

Conduct routine compliance training

Stay informed on updates from CMS and commercial payers

Failing to comply with the latest standards can lead to claim denials, audits, or even penalties.

3. Advanced Technology and Software Integration

Modern billing companies should use automation and analytics to streamline claims, prevent denials, and track revenue trends.

Look for:

EHR integration (Epic, Kareo, Athena, etc.)

Real-time eligibility checks

Claim scrubbing and automation

Dashboard reporting tools

Tip: Leading firms like MyMedicalBillingService.com offer full integrations with most EHRs and real-time KPI dashboards for transparency.

4. Strong Track Record of Performance

Data speaks louder than promises. Review the company’s actual performance metrics.

Key KPIs:

First-pass claim acceptance rate (should be >95%)

Average days in A/R

Denial rate and resolution time

Client retention rate

Ask for client testimonials or case studies that highlight improved cash flow or reduced denials.

5. Transparent Communication and Reporting

Effective billing partners are not just vendors — they’re extensions of your practice. You need:

Clear monthly reports

Dedicated account manager

Fast response times for questions or issues

Providers like DocVaz.com include 24/7 dashboard access, customized reporting, and dedicated U.S.-based support teams.

6. Customizable and Scalable Solutions

Your billing needs may change — especially if you're adding providers, opening new locations, or launching new services.

The company should offer:

Custom plans tailored to practice size

Add-on services like patient billing, credentialing, or coding audits

Scalability to handle increased patient volume without loss of quality

Avoid cookie-cutter solutions. One-size-fits-all doesn’t work in today’s complex billing environment.

7. Transparent, Fair Pricing Models

Billing companies usually charge:

A percentage of collections (commonly 4%–7%)

Or a flat rate per claim/encounter

Ask:

Are there setup fees, hidden charges, or lock-in contracts?

What services are included — and which cost extra?

Is patient support (billing questions, statements) included?

The right partner offers value, not just low fees.

8. Robust Security and HIPAA Compliance

With cyberattacks on the rise in 2025, your billing partner must prioritize data security.

Confirm:

HIPAA-compliant infrastructure

Encryption of PHI (in transit and at rest)

Regular data backups

Business Associate Agreement (BAA) availability

Don’t compromise your patients' privacy by working with a company lacking proper safeguards.

9. Support for Appeals and Denied Claims

A reliable company doesn’t just submit claims — it actively works to resolve denials and get you paid.

Make sure they:

Track and categorize denials

File appeals promptly

Analyze trends to prevent repeat issues

Ask for denial recovery stats or examples of complex claims they successfully appealed.

10. Positive Industry Reputation and Client Feedback

Lastly, reputation matters. Search for third-party reviews, Google ratings, and client testimonials. Don’t hesitate to ask for references.

📣 Pro tip: Look for companies that are:

Featured in industry publications

Rated highly on G2, Capterra, or Trustpilot

Actively publishing billing tips, trends, or compliance guides

Final Thoughts

Choosing the right medical billing company in 2025 is a strategic decision — one that affects your revenue, compliance, and overall peace of mind.

By evaluating:

Industry expertise

Technology and support

Performance metrics

Security standards

And customer satisfaction

…you can confidently choose a partner who will help your practice thrive.