The Five Questions That Tell You Everything

When a healthcare CFO sits down to evaluate a new banking partner, the pitch deck is usually full of soft answers: "trusted relationship," "industry expertise," "concierge service." Those phrases mean nothing.

The actual evaluation is five questions, asked in this order. The answers reveal whether the bank is built for multi-entity healthcare or for generic small business.

Question 1: How Fast Can You Open a PC Account?

The answer should be in days, not weeks. Five to ten days for a healthcare-native bank with MSO-PC native onboarding. Thirty-five to forty-five days at most money-center banks.

This question separates banks that have built workflow for healthcare from banks that treat MSO-PC structures as a one-off exception.

Question 2: What Does Your Lockbox Cost All-In, Per Check?

Not just the per-item fee. The all-in cost, including image capture, EOB digitization, monthly platform retainer, exception handling, and online portal seats.

Healthy bundled pricing is $2.50 to $3.00 per check, all-in. Anything significantly higher means the bank is monetizing through hidden lines. Anything significantly lower with a small print exception fee structure usually adds up to the same amount.

Question 3: Can You Support Virtual Accounts With Per-Entity Routing?

Critical for any MSO-PC platform with more than five entities. The answer should be a confident yes, with specifics: how many virtual accounts under one master, how routing identifiers are issued, how reconciliation flows per entity, whether sweep rules can be configured per virtual account.

If the answer is "we can talk about that," the bank does not natively support it.

Question 4: What's Your FDIC Coverage Strategy Per Entity?

The base FDIC limit is $250K per entity. For healthcare platforms with multiple entities each holding $1M+, that is insufficient.

The answer should reference IntraFi sweep networks or equivalent, with extended coverage to $10M per entity. The bank should be able to enroll each PC separately and roll up the coverage status into one dashboard.

Question 5: What Does Wire Transfer Cost, and What Are Your Cutoff Times?

For acquisitive platforms, wire mechanics matter on closing day. The answer should be a flat per-wire fee (Lemma is $15 flat), Same-Day ACH where applicable, and Fedwire cutoff times that work for east coast and west coast closes (4 PM Eastern is the minimum acceptable).

If the wire desk is "available during business hours" with no documented cutoff, you will eventually close a deal on a Monday instead of a Friday because of it.

The Sixth Question, Optional

If you have time for one more: "what does the implementation look like, and who is my point of contact during onboarding?" If the answer is a named human with a defined SLA, you have a partner. If the answer is "we'll route you through our team," you have a vendor.