We are thinking about changing billing companies. The switch would require us to use different technology, too. How can I compare the two, other than talking to actual customers of each company? We are also having problems getting out of a contract with our current company. Their contract automatically renewed; we didn’t realize that would happen.

Well, it’s sure worthwhile to talk to their customers. I’d ask for data on average days-in-A/R, percent denials, and percent net collections for all their practices. Also, pry into how well their billing company will communicate back to your practice. Specifically, you need to know reasons for denials, so that if there are problems on your end (e.g., poor registration, poor copay collection) you can fix those problems. You need to know what the billing companies are finding out. They can’t fix the entire billing process from their end. 

Look into the prices, including your costs to switch technologies and their regular cut. 

On the automatic renewal: You might be stuck, but look for an out in the contract language, either regarding the automatic renewal or a decision to change vendors. You can also just have a frank conversation with them that you found it unfair, that you don’t want to work with them, and that it's in their best interest not to hold onto an unhappy client, so what can they suggest to make everyone happy? You may end up paying them something. 
