Independent benchmarks to manage your billing provider

Get the best from
your billing
provider.

Your billing company is doing important work in a field that's changing fast. But without independent benchmarks, you really don't know how they're performing. And that could be costing you tens of thousands every year. We give you the answer. Monthly. So you can start managing them.

See how it works

$297 first month · then $497/mo · cancel anytime · 10× ROI guaranteed

The scale of what's at stake

There are real problems
across the medical billing industry.

The challenges for medical billing companies have been highlighted in multiple reports across the years, and the cost is clear to see.

$125B

Lost annually across U.S. physician practices to billing inefficiencies — the prize for getting this right is enormous.

American Medical Association · 2023

$68K

Average annual revenue per physician sitting on the table at typical performance levels.

MGMA DataDive · 2023

42%

Of denied claims never resubmitted industry-wide — every appeal recovered is pure margin.

AMA Physician Practice Benchmark · 2022–2023

34%

Average revenue lift when practices actively benchmark vendor performance.

MGMA · 2023

11%

Average claim denial rate; top performers run below 4% — the gap is closeable.

HFMA Revenue Cycle Benchmark · 2022–2023

73%

Of practices have no independent way to benchmark their billing partner — not because they don't trust them, but because the tools didn't exist.

Advisory Board · 2022

The honest problem

You don't know
what you don't know.

Medical billing isn't a static service you can set and forget. CMS rules shift. Payer contracts evolve. AI-powered claim optimization went from premium feature to industry standard in about eighteen months. Your billing partner is navigating all of this on your behalf — and probably doing a good job.

But "probably" is doing a lot of work in that sentence.

The hard part isn't that billing companies underperform. The hard part is that nobody — not you, and often not them — has the independent, specialty-specific benchmarks needed to know where they're genuinely excelling and where there's room to push harder. They're inside the work. You're running a practice. Neither of you is sitting in the bleachers with the scorecard. That's where we come in.

"The best vendor relationships in healthcare are the ones where the client brings independent data to the table. It changes the conversation from 'trust us' to 'here's what we're achieving together.'"
— Industry advisor, healthcare RCM

Why now

Three things just changed.
Is your medical billing partner keeping pace?

Medical billing companies are not well known for being fast to evolve. And there are more opportunities than ever before for them to improve their operations, and get your practice better results. The question is whether they are implementing change at the right pace — and whether you have the information to push them along.

01

CMS is rewriting the rules

The Prior Authorization Final Rule, interoperability mandates, and value-based care incentives are reshaping payer relationships in real time. Your partner is adapting. Are they adapting fast enough? You should both know.

02

AI just became standard equipment

Predictive denial management, automated appeals, real-time payer intelligence — what was cutting-edge in 2023 is baseline in 2026. The best billing companies are racing to deploy it. Helping yours know how they compare is one of the most valuable things you can do as a client.

03

Payer contracts need active management

Medicare Advantage now exceeds traditional Medicare. Managed care contracts demand renegotiation, not renewal. This is hard, specialized work — exactly where independent benchmarking helps your partner make the case internally for the resources they need.

51%

Medicare beneficiaries on Medicare Advantage

CMS · 2024

86%

Physicians say prior-auth burden has increased

AMA · 2023

34%

Avg revenue lift from active vendor benchmarking

MGMA · 2023

The reframe

This isn't about catching
your billing company out.
It's about giving you data to manage them and get world class results.

Imagine your partner walks into your quarterly review with confidence: "Here's where we're top-quartile. Here's where we're closing a gap." That's the relationship most practices think they have but can't actually verify. Take 60 seconds to see where you stand today.

No email required

How it works

Sign up today.
First report within 3 days.

Easy uploading of your data, no new software required, powerful results.

  1. 01

    Tell us about your practice

    We start with the basics — your specialty, practice size, payer mix, and current billing vendor. A short structured intake under 15 minutes. Enough context to benchmark you against practices like yours, not against a generic average.

  2. 02

    Connect your data — your way

    You choose how we get your billing data. Direct integration with your existing systems, or a simple monthly export from your billing portal — whichever your practice is comfortable with.

    • Practice management (Athenahealth, eClinicalWorks, Kareo, ModMed, DrChrono)
    • Revenue cycle management platforms
    • Clearinghouse reports (Availity, Change Healthcare, Waystar)
    • ERA files, denial reports, A/R aging, claim status reports

    No system access required if you prefer the export route. Either way, your data stays yours.

  3. 03

    We run the analysis

    Within 72 hours of receiving your data, we run a full benchmarking analysis against top-quartile standards for your specialty and practice size. Denial rates, clean claim rates, Days in A/R, prior auth approval rates, contract compliance. We do the work. You don't lift a finger.

  4. 04

    You get a conversation, not just a report

    The most valuable thing in your monthly report isn't the numbers. It's a set of specific, plain-English talking points to bring into your next vendor check-in. Not gotchas — the questions a great client asks a great partner.

    Talking points you'll bring to your next review

    • "Our clean claim rate is 88% — top quartile is 96%. What would it take to close that gap together?"
    • "We saw 42% of denials weren't appealed last quarter. What's driving that, and how can we support a different approach?"
    • "When did we last review our top five payer contracts? Want to do it together this quarter?"
    • "What new tools have come out this quarter that would move the needle for a practice like ours?"
  5. 05

    Stay ahead, together

    Every report includes a forward-looking briefing on what's shifting in the industry — new tools, rule changes, automation capabilities. Things your billing partner is probably already tracking, but that you should be conversational in too.

"Billing companies will tell you privately: their best clients aren't the easiest ones. They're the ones who pay attention. The ones who know what good looks like."

$297 first month · $497/month thereafter · 10× return guarantee

Your monthly report

Not just numbers.
A conversation starter.

Every month you receive three things — flowing one into the next. Here's exactly what they look like.

01

What it actually means.

We translate your billing data into plain English — and into dollars. Every month we look at the metrics that matter for your specialty and tell you, in clear language, what they mean and what they're costing you in real revenue terms.

The kinds of metrics we cover

  • First-pass clean claim rate
  • Claim denial rate
  • Denial appeal rate
  • Days in Accounts Receivable
  • Net collection rate
  • Prior auth approval rate
  • Claims written off without appeal

Each metric is contextualised against the top-quartile benchmark for your specialty and translated into a dollar opportunity for your practice.

02

Questions to ask your billing company.

Walk into your next vendor review armed — not guessing. We turn the analysis into a short set of precise, plain-English questions to put directly to your billing company. Questions they should be able to answer immediately if they're doing their job.

The kinds of questions we'll hand you

  1. 01"Why is our denial appeal rate so far below the top-quartile benchmark — and what is your plan to change that?"
  2. 02"What specific actions are you taking this month to bring our Days in A/R down, and what is your target for next quarter?"
  3. 03"How many claims in the last 90 days were written off without a single appeal attempt — in both count and dollar value?"
  4. 04"What are the top three rejection reason codes driving our clean claim rate, and what process changes are you making?"
  5. 05"When did you last review our fee schedules against current payer contracts for our top five payers — and what did you find?"

Questions are generated specifically from your data each month. They change as your performance changes.

03

What's changed this month.

Medical billing isn't static. AI, automation, and CMS rule changes are continuously shifting what best practice looks like — and what your billing company should already be doing. Every report closes with a forward-looking briefing on what's changed, and the questions it raises about your vendor's capabilities.

The kinds of updates we'll send

CMS Prior Authorization Final Rule — Implementation Deadline Approaching

As of January 2026, CMS requires impacted payers to implement electronic prior authorization via FHIR APIs. Your billing company should already be testing integrations.

Ask them: "Are you API-connected to our top five payers for prior auth, and if not, what is your timeline?"

Medicare Advantage Denial Rates Rising — Industry-Wide Signal

Denial rates across Medicare Advantage plans rose sharply in Q1. If your MA volume is significant, your billing company should have a specific response strategy.

Ask them: "Have you adjusted our MA appeal workflows in response to the latest denial trend?"

AI-Powered Claim Scrubbing — Now Table Stakes, Not Premium

The largest RCM platforms now ship AI-driven pre-submission claim scrubbing. If your billing company isn't using predictive claim validation, your clean claim rate is suffering unnecessarily.

Ask them: "What AI or predictive tools are you currently using at the pre-submission stage?"

Monthly updates reflect actual regulatory and industry developments at the time of your report.

"Every month. For every client. Delivered within 72 hours of receiving your data."

First month $297 · $497/month thereafter · 10× return guarantee or full refund

What you get

Become the kind of client
billing companies love working with.

Informed. Specific. Constructive. Bringing data instead of complaints. Asking the right questions instead of guessing. Pushing for excellence in the places where excellence is achievable, and acknowledging the wins where they're happening.

Reporting

Independent benchmarking reports

Your billing partner's performance measured against top-quartile standards for your specialty — external validation when they're crushing it, early warning when something drifts.

Audits

Contract & fee schedule audits

Surface systematic underpayments, expired rates, and payer compliance gaps — so you and your partner can chase them together.

Monitoring

CMS & regulatory monitoring

Stay ahead of the rule changes reshaping your revenue. Be conversational in the same things your billing partner is tracking.

Conversation

Monthly review talking points

Specific, plain-English questions and benchmarks to bring into your next check-in. Constructive, not combative.

Technology

Technology gap analysis

See where your partner's toolkit stands against today's AI-driven billing capabilities — and help them justify the upgrades that move the needle.

Our promise

The 10× Guarantee.

In your first month, we guarantee your report will identify revenue opportunities worth at least 10x what you paid us — or we refund every cent. No clauses. No fine print. No awkward conversation.

If your billing partner is already top-quartile across the board, we'll be the first to tell you — and you'll have the documented proof to celebrate them with.

Take control

Your billing partner is
doing important work.
Help them do it at the highest level.

Get the independent benchmarks, industry intelligence, and conversational tools to be the best client they have. Risk-free, first month at half price.

$297 first month · $497/month thereafter · 10× guarantee

PracticeSide

Get the best from your billing provider.

433 Broadway, New York 10013

Independent

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