Straight answers, before you ever speak to us.
FAQs
The questions practices actually ask when reviewing a billing partner — onboarding, day-to-day production, credentialing, reporting, pricing and how patient information is protected.
FAQ
Getting started
What the first 30 days with Pure Billing look like.
Do we have to change our EHR or practice management system?
No. We work inside the systems your practice already uses. Onboarding sets up named user access at the least privilege needed for the agreed scope, and your clinical workflow stays exactly as it is.
How long does onboarding take?
Most outpatient practices go live within two to three weeks. That covers the signed services agreement and BAA, system and clearinghouse access, EDI/EFT/ERA enrollment checks, a baseline of AR ageing and denial categories, and an agreed reporting pack and cadence.
Can you take only part of the revenue cycle?
Yes. Practices commonly start with denial management or AR recovery while keeping charge entry in-house. The scope split is written into the agreement so there is no ambiguity about who owns which claim at which stage.
What do you need from us to get started?
System access, your payer mix and fee schedule, current credentialing and enrollment status, a recent AR ageing report and a denial report for the last quarter. No patient-identifiable information is needed before the BAA is executed.
What happens to our existing aged AR?
Old AR is worked as its own track so it does not compete with current claim production. Balances are prioritised by recoverability, dollar value and filing deadline, and write-offs are recommended with rationale rather than applied silently.
How do you handle the transition from our current biller?
We agree a cut-over date that separates new charge entry from legacy claim follow-up, confirm who retains historical AR, verify clearinghouse credentials and EFT/ERA routing, and baseline your metrics before go-live so the change is measurable.
FAQ
How the billing works
Day-to-day production, quality control and follow-up.
How quickly are charges submitted?
Charges are entered and submitted within 48 to 72 hours of receiving complete documentation. Where documentation is incomplete, the claim is queued and the gap is reported back to the practice the same day rather than held silently.
What quality control happens before a claim goes out?
Every charge is reviewed by a quality analyst against the payer’s rules, the documentation and the fee schedule before submission. Scrubbing catches coding, modifier, demographic and eligibility issues that otherwise return as rejections.
How are rejections and denials handled?
Clearinghouse and payer rejection reports are pulled within 24 to 48 hours of submission, corrected and resubmitted immediately. Denials are worked by AR representatives who log the root cause, so recurring categories get a front-end fix rather than repeat rework.
How often is unpaid AR followed up?
Open claims are followed up on a biweekly cadence until they are paid, appealed or written off with your approval, with the goal of keeping AR outside the 90 to 120 day band under control.
Do you handle patient statements and patient balances?
Yes, where it is in scope. Patient responsibility is separated from payer AR, statements follow an agreed cycle, and patient calls are handled with a scripted, documented process. Collections escalation is only done on your written instruction.
Do you do coding as well as billing?
We handle coding and charge posting as part of the scope, and flag documentation that will not support the level billed. Where a specialty needs certified coder review beyond our scope, we say so rather than guessing.
Do you provide scribe services?
Yes. Scribe support runs alongside billing so documentation is captured accurately at the point of care, which reduces the downstream coding queries and documentation-related denials.
FAQ
Credentialing and enrollment
Getting and keeping providers billable.
How long does credentialing take?
It varies materially by payer, state and provider type, and it is outside any billing partner’s direct control. We set expectations per payer, track status weekly, and advise on whether to hold or park billing while enrollment is pending.
Do you handle EDI, EFT and ERA enrollment?
Yes. Electronic claim submission, electronic funds transfer and electronic remittance enrollment are completed as part of onboarding, because manual paper remittance is the single most common cause of slow, incomplete payment posting.
Can you add a new provider or a new location mid-contract?
Yes. New providers and locations are handled as a defined workstream: enrollment applications, CAQH maintenance, revalidations and payer effective dates, with billing guidance for the gap period.
FAQ
Reporting and performance
What you see, and how often.
How is performance reported?
A weekly production and rejection summary, plus a monthly performance review covering AR ageing, denial categories, collections and trend commentary with named owners and next actions. Every figure traces back to claim-level detail.
Which metrics do you hold yourselves to?
Clean claim rate on first submission, first-pass denial rate by category, days in AR, percentage of AR over 90 days, net collection rate and turnaround time from encounter to submission. We agree targets against your own baseline, not an industry average.
Can we see the work in our own system?
Yes. Because our team works under named users inside your EHR and PMS, you can audit charge entry, claim notes and follow-up activity yourself at any time without requesting anything from us.
FAQ
Commercials
Pricing, contracts and exit.
How is pricing structured?
Typically a percentage of collections for full revenue cycle management, or a defined monthly fee for a narrower scope such as AR recovery or credentialing. Pricing depends on specialty, claim volume, payer mix and scope, and is quoted after the Revenue Health Check rather than from a rate card.
Is there a long-term lock-in?
No. Engagements run on a notice period rather than a multi-year lock-in. At exit we cooperate on transition, return or destroy working files under the BAA, and hand over the status of every open claim.
What size of practice do you work with?
Independent providers through to multi-provider outpatient groups across 36 practices today. Very large health systems with enterprise procurement requirements should speak to us first about fit before starting a review.
FAQ
HIPAA, PHI and security
How patient information is protected.
Do you sign a Business Associate Agreement?
No. We work inside the systems your practice already uses. Onboarding sets up named user access at the least privilege needed for the agreed scope, and your clinical workflow stays exactly as it is.
Where does our patient data actually sit?
Most outpatient practices go live within two to three weeks. That covers the signed services agreement and BAA, system and clearinghouse access, EDI/EFT/ERA enrollment checks, a baseline of AR ageing and denial categories, and an agreed reporting pack and cadence.
Should we send patient information to start a conversation?
Yes. Practices commonly start with denial management or AR recovery while keeping charge entry in-house. The scope split is written into the agreement so there is no ambiguity about who owns which claim at which stage.
Are you SOC 2 or HITRUST certified?
System access, your payer mix and fee schedule, current credentialing and enrollment status, a recent AR ageing report and a denial report for the last quarter. No patient-identifiable information is needed before the BAA is executed.
Question not answered here?
Ask us directly. Discovery conversations are run by the team that would operate your account, not by a separate sales function.
Question not answered here?
Problem landscapes and billing workflows by discipline — primary care, cardiology, dermatology, orthopedics, behavioral health, OB/GYN, gastroenterology and ophthalmology.
