Five questions before signing your next bank

When healthcare finance leaders evaluate new banking partners, vendor pitches emphasize soft benefits like "trusted relationships" and "industry expertise." These talking points lack substance.

The actual assessment hinges on five concrete questions, presented sequentially, that determine whether a bank serves multi-entity healthcare or treats such structures as exceptions.

Question 1: How fast can you open a PC account?

Healthcare-native banks should deliver accounts within five to ten days through MSO-PC native processes. Generic small business banks typically require thirty-five to forty-five days.

This question distinguishes banks with healthcare workflow infrastructure from those treating MSO-PC setups as anomalies.

Question 2: What does your lockbox cost all-in, per check?

The inquiry addresses total bundled pricing, not just per-item fees, but image capture, EOB digitization, platform retainers, exception handling, and portal access combined, the way Lemma's medical lockbox pricing (opens in a new tab) is bundled.

Competitive bundled pricing ranges from $2.50 to $3.00 per check, all-in. Higher costs suggest hidden monetization; suspiciously lower rates with exception clauses typically yield equivalent expenses.

Question 3: Can you support virtual accounts with per-entity routing?

This proves essential for MSO-PC platforms exceeding five entities (opens in a new tab). Banks should confidently explain virtual account limits, routing identifier issuance, per-entity reconciliation flows, and per-account sweep configuration.

Vague responses indicate insufficient native support.

Question 4: What's your FDIC coverage strategy per entity?

Standard FDIC protection covers $250K per entity, the floor explained in FDIC coverage versus sweep network coverage (opens in a new tab). Multi-entity healthcare platforms holding $1M+ per entity require enhanced coverage.

Banks should reference IntraFi sweep networks or equivalents extending protection to $10M per entity, with separate PC enrollment and consolidated dashboard reporting.

Question 5: What does wire transfer cost, and what are your cutoff times?

For acquisition-focused platforms, wire mechanics significantly impact closing timelines, down to the wire choreography of closing in one banking day (opens in a new tab). Acceptable responses include flat per-wire fees, Same-Day ACH options, and Fedwire cutoffs accommodating both coasts (4 PM Eastern minimum).

Vague "business hours availability" without documented cutoffs risks delaying closings.

The optional sixth question

Time permitting, ask: "What does implementation resemble, and who leads onboarding?" Named contacts with documented service-level agreements indicate partnership; generic team routing indicates vendor relationships.