Unhappy with your billing but afraid to switch? You are not the only practice in that middle. The numbers feel off, but a past transition (yours or a colleague's) meant months of slow cash, an overwhelmed front desk and frustrated providers. So you stay, and the cost shows up as a slow drift instead of one bad quarter. In this solo episode, Dr. Heather Signorelli shows practice owners and managers how to tell whether billing is really the problem, how to improve it with the team you already have, and how to switch without losing money if the numbers say it is time. Decide from your numbers, not your nerves. IN THIS EPISODE • Why billing transitions go wrong: the five places cash gets stuck (credentialing, ERA/EFT, charge lag, old A/R and people) • Why one strong month of collections is not proof of a healthy revenue cycle • The six numbers that tell you if your billing is working • How to improve billing without switching companies • What a safer transition looks like if you do switch • -The two objections practices raise before a change THE SIX NUMBERS (use a three-month average) 1. Net collection rate: Green 95%+ | Yellow 90 to 94% | Red under 90% 2. Denial rate (first submission): Green under 5% | Yellow 5 to 10% | Red over 10% 3. Insurance A/R over 90 (share of insurance A/R): Green under 10% | Yellow 10 to 15% | Red over 15% 4. Patient A/R over 90 (vs. 3 months ago): Green down | Yellow flat | Red up 5. Days in A/R: Green under 35 | Yellow 35 to 50 | Red over 50 6. Charge lag (date of service to claim sent): Green 3 days or less | Yellow 4 to 7 | Red over 7 Score: 2 points per green, 1 per yellow, 0 for red or unknown. Max 12. Two or more reds: get a second set of eyes before deciding anything. Ranges are working comparison points, not universal benchmarks. IF YOU DO SWITCH: TRANSITION CHECKLIST • Credentialing and payer enrollment confirmed for every provider, started first • Software contract reviewed: who works old dates of service, and for how long • Admin access to every payer portal held by the practice, with the list saved • ERA and EFT routing mapped, first remittances verified • Clean cutover by date of service • Old A/R run as its own project, with an owner and a weekly report • Front desk trained before go-live; short change list for providers • A patient statement plan for old dates of service • Charge lag and denial rate reviewed weekly for the first 90 days THREE ACTIONS THIS WEEK • Score your six numbers. Write "unknown" where you cannot get one. • Send your billing company one email asking for the six numbers every month, with a three-month trend and the detail behind every red. The scorecard writes it for you. • Pick your one or two biggest reds and put a 90-day review on the calendar.