Management of Pathology Practices

August 2010

Management Home Page 


Changing Billing Services

By Mick Raich, Vachette Pathology


A recent news story about pathology reports being found in a dump made me smile (see The Boston Globe, August 13, 2010).  My first thought was that some pathology group cancelled their contract with a biller, and now the biller was cleaning out the cabinets. 


Obviously this was a distinct violation of HIPAA and not very professional.  This story made me think about what happens when you terminate your billing service.  How are they supposed to treat you?  How do you move through this process in a professional way?


In my position, we are often brought in to work with groups that are moving through this process.  They are unhappy with their current billing service, and the reasons for this dissatisfaction are often similar.  This includes that the billing service keeps changing service representatives and there is no longer a personal relationship, the billing service was sold to another company and all the players have changed, or the biller is not providing quality service, i.e. the cash flow is declining.  The reason doesn’t matter - the bottom line is that this is a business divorce, and like many divorces, it can get messy. 


If you are considering a billing change, there are several things to think about.  First and foremost is your current billing contract.  You have to find your contract.  Yes, there are many practices that cannot even locate their billing contract.  Then you have to read over the contract carefully and understand that this contract will likely be pushed to the letter of the law, so know every detail.  Using a lawyer here is not a bad idea.


The next step is to prepare for the worst possible scenario.  Know what may happen and know all the negative options available.  Start working with your new billing entity six months before the transition date; get the interfaces written and the new relationships developed.  Understand what will take place with your revenue stream during this transition and know what is going to take place with your old accounts receivables. 


The final step is to audit the ending of your current relationship.  When billers know you are leaving their services, they have a tendency to limit their involvement.  I have seen numerous nightmare scenarios where billers failed to file claims or left accounts unresolved.  It is best to be very attentive to your accounts during this exit period and pay close attention to the revenue.  Remember, your revenue does not have to decrease when you change billers.  There is no reason a practice should lose money going through this process. 


In summary, there are numerous quality pathology billing firms in the nation.  These privately held companies have a strong history of taking care of their clients and the smart ones treat their clients that are leaving with the ultimate respect.  They know that in the end, the new billing entity may fail, and they may gain this business back and have another chance to prove their worth. 


Mick Raich is the President and CEO of Vachette Pathology.  He has over 15 years experience in the pathology and laboratory billing environment.  To date he has worked with over 250 various pathology and laboratories nationwide.  Contact: or call 866-407-0763.