Switching Dermatology Billing Companies Without Losing Cash Flow

Sequence the transition before you give notice

• Confirm the notice period and what the outgoing contract says about open A/R after termination.
• Agree who works claims already submitted, and for how long, in writing.
• Get system access provisioned for the new team before the notice window starts, not after.
• Set the cutover on a charge date, not a calendar date, so no encounter falls between the two teams.

Protect the legacy A/R

Aged claims are the first thing an outgoing team stops working and the last thing an incoming team is paid to touch. Decide explicitly which party works pre-cutover claims, and if it is the new team, agree the terms up front rather than discovering the gap at day 30.

Take a full A/R snapshot on the cutover date — by payer, by aging bucket, by provider. Without it there is no way to tell later whether the new team recovered the backlog or quietly wrote it off.

Run parallel for the first two weeks

Submitting through the new process while the old process stays reachable catches enrollment gaps, clearinghouse routing errors and payer ID mismatches at a scale of days rather than months.

Watch first-pass acceptance daily during this period. A rejection spike in week one is almost always an enrollment or setup issue, and it is cheap to fix immediately and expensive to fix at 45 days.

Do not forget credentialing and EFT

• Confirm ERA and EFT enrollment routes to the correct account under the new arrangement.
• Verify each rendering provider's payer enrollment is active and correctly linked to the billing entity.
• Check that any group NPI or taxonomy change is reflected with every payer before the first submission.